Date of filing:- 03/09/2022.
Date of Order/Judgement:-24/04/2023.
DISTRICT CONSUMER DISPUTE REDRESSAL COMMISSION,
B A R G A R H.
Consumer Complaint No. 25 of 2022.
(1) Dasarath Mirdhha, aged about 71(seventy one) years, son of Charaka Mirdha
(2) Deepak Kumar Mirdhha, aged about 37(thirty seven) years, Son of Dasaratha
Mirdha, both resident of Kadalipali, Po. Lenda, under Ps/Tahasil. Barpali,
Dist. Bargarh. Complainant.
V e r s u s
Life Insurance Corporation of India, Padampur Branch represented through its, Branch Manager, At/Po. Padampur, Dist. Bargarh.
Opposite Party.
Counsel for the Parties:-
For the Complainants :- :- Sri G.Meher, Advocate with Associates.
For the Opposite Party:- :- Sri Mahendra Sahu, Advocate.
-: P R E S E N T :-
Smt. Jigeesha Mishra ..... ..... ..... ..... ..... P r e s i d e n t.
Smt. Anju Agarwal ..... ..... ..... ..... ..... M e m b e r (W).
Dt.30/01/2023. -: J U D G E M E N T:-
Presented by Smt. Anju Agrawal, Member (w):-
- The case of the Complainant is that the Complainant No.1 son namely Pradip Kumar Mirdha died on Dt. 05/09/2021 at his residential house at Kadalipali, Po. Lenda under Ps/Tahasil. Bargarh District. That, during his lifetime the said Pradip Kumar Mirdha has taken a policy vide No. 859441764. The Complainant No.2 is the nominee to the said policy. That, soon after the death of the insured, the Complainant No.2 approached the Opposite party for Rs.10,00,000/-(Rupees ten lakh)only through due procedure but on dated 22/10/2021, the Opposite Party has issued a letter for cooling off the policy. The Opposite Party has also mentioned in the letter that the Rs.28,011/-(Rupees twenty eight thousand and eleven)only has been refunded which is not true. The Opposite Party refused grant to the sum insured after the death of Pradip Kumar Mirdha.
Being aggrieved, the Complainant sought redressal before this Commission.
- The Opposite Party LIC Padampur Branch in its version stated that the Complaint does not come under the provision of Consumer act. That the insured namely pradip Kumar Mirdha, son of the Complainant No.1 died on Dt. 05/09/2021 at his residence house at Kadalipali, Po. Lenda under Ps/Tahasil Barpali, Dist. Bargrh has not been intimated by any person to the Opposite party and the Opposite Party has not received any intimation regarding the death of the insured. That, the policy was issued on 27/08/2021 from policy proposal received by the Opposite party from Agent Shantanu Kumar Mishra ZMs Club bearing code No. 00774594 vide proposal no. 1848 bearing policy No. 859441746, SA 10,000,00/-(Rupees ten lakh)only on the life of Sri Pradip Kumar Mirdha and nominee was Deepak Kumar Mirdha, Brother. That the Opposite Party has received an application from LA. On 22/10/2021 which was witnessed by the Agent and counter sign by the Development officer for taking cooling off action of the policy and as per request cooling off action was taken and amount of Rs.28011/-(Rupees twenty eight thousand eleven)only was refunded to policy holders A/c No. 1128047793 through NEFT. That, a policy of contract is based on Uherrima fides in the instant case, it is a case of early death claim and had the policy not been cancelled, the LIC would have conducted investigation to ascertain bonafideness of the claimant with the provision of section 45 of Insurance Act 1938. There is no intimation of death of the L.A. till cooling off action was taken, hence, the question of repudiation letter does not arise.
Hence, the Opposite Party is not liable for any insured amount, the Complainant may be dismissed.
- The Complainant filed.
- Copy of LIC, Padampur Branch off Ref: NB/Cooing off/PDP Dt. 22/10/2021.
- Copy of Death certificate of Registration No. 767/2021.
- Copy of Policy No. 859441764 and first premium receipt.
- Copy of Aadhar card No. 912031530642 of Deepak Ku Mirdha.
- Copy of Aadhar No. 86969531884 of Pradip Ku. Mirdha.
- The Opposite Party LIC filed the following documents.
- Copy of application of Pradip Kumar Mirdha to the LIC.
- Copy of granting of cooling off the application.
- Copy of letter regarding cooling of policy and refuned amounts of Rs.28011/-(Rupees twenty eight thousand eleven)only (through NEFT) to Pradip Ku. Mirdha.
- After perusal of the Complaint petition, version of the parties and documents filed the following issues are framed.
ISSUES
- Whether the Opposite Party is deficient in its service.
- What relief the Complainant is entitled to get.
Issue No.1
The Complainant No.1 son Pradip Kumar Mirdha on Dt. 27/08/2021 has paid his first premium of Rs. 27,842/-(Rupees twenty seven thousand eight hundred forty two)only to the Opposite Party vide policy No. 859441746 valid from period 27/08/2021 to 27/08/2042. In the said policy the nominee was Deepak Kumar Mirdha Complainant No.2 the insured Pradip Kumar Mirdha died on Dt. 05/09/2021 at his residential house at Kadalipali at Bargarh. The said policy was received by Opposite Party from agent bearing code No. 00774594. On Dt. 14/10/2021, a application was issued from Pradip Kumar Mirdha regarding cooling off policy to the Opposite Parry which was signed by the agent bearing code No. 00774594 and in the application it is specifically mentioned that the insured got the policy bond on 12/10/2021. Now, the question arises, can a person who died on 05/09/2021 apply for cooling off policy on Dt. 14/10/2021.The said agent of LIC must be knowing the insured, when a person apply for cooling off policy to the documents need to be verified it reveals that the Opposite party has done unfair trade practice by getting signature of the insured on the date when the insured had died already Section 45 of the Insurance Act expects all Insurance Companies to work as fiduciary and all genuine claims to be settled even of after the death of the injured happens even after one day of policy commencement. No doubt Insurance contract is basing on good faith and it is the duty of the insured to disclose the history but at the same time it is the duty of insurance company to enter into contract after proper physical verification and report. The said Insurance policy was issued after due verification. For the non settlement of the insurance claim the Complainant is harassed.
Issue No.2
The Complainant is entitled for the relief claimed.
O R D E R
The Complaint is allowed on contest against the Opposite party. The Opposite party is directed to pay Rs.10,00,000/-(Rupees ten lakh)only to the Complainant @ 9% intrest from Dt. 22/10/2021 till realization.
Further the Opposite Party is directed to pay Rs.20,000/-(Rupees twenty thousand)only litigation expenses to the Complainant No.2.
Failing which the entire order with claim 12% P.A till realization.
Order pronounced in open court on 24th day of April 2023.
Supply free copies to the parties.
Typed to my dictation
and corrected by me.
I agree/-
( Smt. Jigeesha Mishra) (Anju Agarwal)
Dt.24/04/2023 Dt.24/04/2023.
P r e s i d e n t. M e m b e r (w)
