DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, MANSA. Complaint No.201/26.12.2007 Decided on : 23.06.2008 Parwati Devi Wd/o Sh.Ram Lal S/o Sh.Gosain Ram, Resident of P.W.D. Rest House, Court Complex, Mansa. ..... Complainant. VERSUS Life Insurance Corporation of India through its Branch Manager, Mansa. ..... Opposite Party. Complaint under Section 12 of the Consumer Protection Act, 1986. ..... Present: Sh.S.K.Singla, counsel for the complainant. Sh.Sushil Bansal, counsel for the opposite party. Before: Sh.Sarat Chander, Member. Smt.Neena Rani Gupta. ORDER: Parwati Devi (hereinafter called as the complainant) has filed the present complaint against the Branch Manager, Life Insurance Corporation of India through its Branch Manager, Mansa (hereinafter called as the opposite party) for issuance of a direction to the opposite party to pay the insurance claim of Rs.40,000/- to her along with interest @ 18% and Rs.5,000/- as compensation and Rs.1,000/- as litigation costs. Admitted facts of the case are that Ram Lal, deceased husband of the complainant had obtained a Policy bearing No.161483718 commencing from 28.1.2003 from the opposite party and during his life time he had been paying the insurance premiums regularly. Ram lal Contd........2 : 2 : unfortunately died on 16.06.2003 and the complainant, being his nominee had duly informed the OP company about the death of his husband and deposited the insurance claim with the opposite party. When the complainant did not receive any response from the OP, she had sent a letter dated 14.7.2007 to the head office at Ludhinana of the OP company for expediting the matter. But no reply was ever sent to her by the head office even. Thereafter she sent a legal notice dated 1.11.2007 upon the OP and in its reply dated 15.11.2007, the OP company had repudiated the claim of the complainant which is alleged as illegal and wrong. Due to the repudiation of the claim of the complainant, the complainant alleges to have suffered mental, as well as physical harassment. Hence this complaint. In the written version filed by the opposite party, it was denied that the claim of the complainant was wrongly repudiated. It rather reiterated its stand and contended that the complainant was not entitled to any reimbursement as per terms and conditions of the policy. The OP has further contended that the complainant had sent only a notice dated 1.11.2007 and failed to submit any claim within three years from the date of death i.e. 16.6.2003 as per terms of the policy. A prayer for dismissal of the complaint was accordingly made. Both the parties have led their respective evidence in the shape of affidavits and documents. We have considered the arguments advanced by the learned counsel for the parties and carefully scrutinized the entire evidence placed on record by them. Exhibit C-3 is the copy of the insurance policy obtained by Ram lal, husband of the complainant from the opposite party. The counsel for the OP has vehemently argued that the complainant had failed to submit Contd........3 : 3 : all the requisite documents within three years from the date of death i.e. 16.6.2003 of his husband and hence the claim was not given, being time barred. To rebutt this stand, the counsel for the complainant has placed on record Ext.C-5, a letter written by the complainant to the Divisional Manager, LIC, Ludhiana dated 14.07.2006 giving all the details and Ext.C-4 Certificate of Employer. The OP has not refuted this letter. The counsel for the OP has placed on record Ext.OP-2, Policy Servicing Manual No.11 and under head 4.2 Intimation of Death received after 3 years from the date of death of this manual, it has been held that, when an intimation of death of the life assured is received from a person lodging his claim after a lapse of three years from the date of death and , if it is found that the death of the life assured had occurred within three years from the date of risk/revival under the policy, the claimant should be informed that the claim is barred by limitation since no claim has been lodged with the corporation by submitting necessary proof of death of the life assured under the Policy. Simultaneously, arrangements should be made for immediate investigation about the bonafides of the claim without the knowledge of the claimant. If the claimant submits proper proof of death and a reasonable explanation for not lodging claim in time and if the investigation report has not brought out any adverse information, necessary claim forms may be issued. The OP Company itself has not taken any action in accordance with the above Manual, if it was of the view that the complainant had failed to lodge her claim within three years. The OP Company never informed the claimant that the claim is barred by limitation or never made any arrangement for immediate investigation about the bonafidies of the claim. As per record on the file, the OP Company came into action only on Contd........4 : 4 : 15.11.2007 after the receipt of the legal notice dated 1.11.2007 from the complainant and no investigation was ever made by the OP Company within the period dated 16.6.2003 (the date on which the husband of the complainant had died) to 15.11.2007. Since the OP Company had failed to submit any investigation report, if carried out by it, in accordance with the above Manual, so it can be deemed that no adverse information is there against the claim and there are no strong grounds to suspect the claim to justify repudiation on account of the claimant having submitted the claim after 3 years. Otherwise also, according to the complainant, she had duly submitted the claim within limitation and a letter dated 14.07.2006 had been issued to the Divisional Manager, LIC, Ludhiana for expediting the matter. The Opposite party did not abide by its own Manual and thus is held to be deficient in service by not making good the claim of the complainant. The inaction of the OP Company had thus compelled the complainant to knock at the doors of this Forum for the redressal of her grievance. As a consequence of the foregoing reasons, the complaint is allowed with a direction to the opposite party to pay the claim amount of Rs.40,000/- to the complainant after she submits the requisite documents. The OP is also burdened with Rs.2000/- as compensation. Compliance of the order be made within one month from the date of receipt of the copy of the order. Copy of the order be supplied to the parties free of charges under the rules and file be arranged, indexed and consigned to record. Pronounced: 23.06.2008 Neena Rani Gupta, Sarat Chander, Member. Member.
