Before the District Consumer Disputes Redressal Forum, Rohtak.

                                                          Complaint No. : 687.

                                                          Instituted on     : 22.12.2016.

                                                          Decided on       : 23.07.2018.

Birma Devi(aged 49 years) wd/o Sh. Rajender s/o Sh. Mangal Ram r/o Vill. Karamgarh P.O.Bibipur Tehsil & District Jind(Haryana), Mb. 9416518327.

                                                          ………..Complainant.

                             Vs.

1. Life Insurance Corporation of India through its Sr. Divisional Manager, Life Insurance Corporation of India, Divisional Office 3,4,5 SCO, Sector-1, Rothak-124001.
2. The Branch Manager, L.I.C. of India, 85-86, “Urban Estate No.1, Behind Telephone Exchange Hisar.

……….Opposite parties.

          COMPLAINT U/S 12 OF CONSUMER PROTECTION ACT,1986.

BEFORE:  SH.RAJBIR SINGH DAHIYA, PRESIDENT.

                   SH. VED PAL, MEMBER.

Present:       Sh.Chander Singh, Advocate for the complainant.

                   Sh.S.P.Gulati, Advocate for opposite parties.

                                      ORDER

RAJBIR SINGH DAHIYA, PRESIDENT:

1.                          Brief facts of the case are that husband of the complainant purchased three life insurance policies bearing no.179613589, 179613590 & 179613591 for sum assured Rs.62500/- each  and each policy commencing from 15.04.2013. That husband of the complainant namely Rajender has expired on 04.01.2014 and the complainant being the legal heir of deceased Rajender  is beneficiary of the policies and is entitled to sum assured of Rs.62500/- each policy alongwith other benefit arisen out of the policies. That complainant lodged the claim for the payment of sum insured and submitted all relevant documents. That OP No.2 vide its letter dated 06.04.2015 had repudiated the death claim of Rejender by alleging that said Rajender had withheld correct information from them regarding his health at the time of affecting assurance. That complainant requested the OP to reconsider the claim but to no effect. That the act of opposite parties of repudiating the genuine claim of the complainant is illegal and amounts to deficiency in service. Hence, this complaint and the complainant has prayed for directing the opposite parties to pay Rs.187500/-(Rs.62500/- each policy) alongwith interest, compensation and litigation expenses to the complainant.

2.                          After registration of complaint, notice was issued to the opposite parties. Opposite parties in its reply has submitted that it is correct that three policies bearing no.179613589, 179613590 & 179613591 for the sum assured of Rs.62500/- each was issued on the life of Rajender s/o Mangal Ram and complainant is nominee. That the deceased life assured had made deliberate misstatement and concealment of material information regarding his health. That deceased was suffering from Cancer for last 4-5 years and was taking treatment from PGI Rohtak. Hence the complainant is not entitled to any claim as alleged. That the claim was repudiated vide letter dated 06.04.2015 and complainant was informed accordingly. That there is no deficiency in service on the part of opposite party and dismissal of complaint has been sought. 

3.                          Ld. counsel for the complainant in his evidence has tendered affidavit Ex.CW1/A to Ex.CW3/A, documents Ex.C1 to Ex.C5 and has closed his evidence. On the other hand ld. counsel for the OP has tendered affidavit Ex.R1, documents Ex.R2 to Ex.R11 and closed his evidence.

4.                          We have heard learned counsel for the parties and have gone through material aspects of the case very carefully.

5.                          The main objection taken by the respondents is the claim Enquiry report Ex.R11 page No.1 to 6 prepared by some officer of respondents/opposite parties which has been made the basis to reject the claim of the complainant. The company has also taken an objection that the deceased had a pre-existing disease of cancer. Mere observation by the Enquiry officer in para no.12, 13, 15 & 16 cannot take the place of evidence which is missing. In this case the allegation of pre-existing disease is mentioned only in the reply of the complaint by the opposite parties. Nothing concrete has been brought on record to substantiate this objection also. On the contrary, the complainant find support of her averments by statements of Sh. Satbir Singh and Sh. Ram Karan which is a part of Ex.R11 at page no.7 and 8 given to the said enquiry officer of the opposite parties to prepare Ex.R11. Hence the objections raised by the OPs are negated.

6.                          As such this complaint succeeds and we award Rs.187500/-(Rupees one lac eighty seven thousand five hundred only) of all the alleged three policies alongwith interest @ 9% p.a. from the date of filing the present complaint i.e. 22.12.2016 till its realization, other benefits under the policy, if any and shall also pay Rs.5000/-(Rupees five thousand only) towards litigation expenses and compensation to the complainant within one month from the date of decision.   

7.                         Copy of this order be supplied to both the parties free of costs.      File be consigned to the record room after due compliance.

Announced in open court:

23.07.2018.

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                                                          Rajbir Singh Dahiya, President

                                                          ..........................................

                                                          Ved Pal Hooda, Member.