DISTRICT CONSUMER DISPUTES REDRESSAL FORUM,<br /> BATHINDA (PUNJAB)<br /> <br /> CC No. 26 of 22-01-2007<br /> Decided on :16-05-2007<br /> <br /> 1.Ritu Rani @ Nitu Rani widow of Krishan Lal Chawla S/o Sh. Ganga Ram.<br /> 2. Sakshi Chawla born on 12.2.2003 minor daughter of Krishan Lal Chawla S/o Ganga Ram; through her mother Ritu Rani as appointee/natural guardian/next friend of the minor & both residents of H. No. 6129 Gali Ganga Ram Wali, Near Geeta Bhawan, Purana Thana Road, Bathinda.<br /> Complainants<br /> <br /> Versus<br /> <br /> 1.Life Insurance Corporation of India, Branch Office, Bibiwala Road, Bathinda, through its Branch Manager.<br /> 2.The Manager (Claims), Life Insurance Corporation of India, Divisional Office, Urban Estate,. Phase-I, Dugri, Ludhiana.<br /> ...Opposite parties<br /> <br /> Complaint under Section 12 of the Consumer Protection<br /> Act, 1986.<br /> <br /> QUORUM :<br /> Sh. Lakhbir Singh, President<br /> Sh. Hira Lal Kumar, Member <br /> Dr. Phulinder Preet, Member<br /> <br /> For the Complainant : Sh. K.K. Vinocha,Advocate.<br /> For the Opposite parties : Sh. Sandeep Baghla,Advocate.<br /> <br /> O R D E R <br /> <br /> LAKHBIR SINGH, PRESIDENT<br /> 1. Instant one is a complaint under Section 12 of the Consumer Protection Act, 1986 (Here-in-after referred to as `Act') which has been preferred by the complainants seeking direction from this forum to the opposite parties to pay them ordinary claim of policies 300050360 and 300222792 for insured sum of Rs. 2.00 Lacs and Rs. 1.00 Lacs respectively alongwith accrued benefit thereon excepting accidental benefits after deducting loan amount with interest from payable amount; Rs. 90,000/- as compensation and Rs. 10,000/- as cost of litigation; benefit to complainant No. 2 on attaining the age of majority/at the time of maturity of policy of Rs. 1.00 Lac in its terms; reserve the right to accidental benefit of the policies to be decided as per final police investigation if the decision does not come during the pendency of this claim.<br /> 2. Version of the complainants as emanates from the complaint itself lies in the narrow compass as under :<br /> 3. Krishan Lal Chawla was the husband of complainant No. 1 and father of complainant No. 2. He has since been died on 21.8.06. Complainant No. 2 is minor. Complaint has been filed by her through her natural guardian and next friend i.e. her mother who is complainant No. 1. Deceased Krishan Lal Chawla had purchased policy No. 300050360 in table 133-15. Sum insured was Rs. 2.00 Lacs. Date of commencement of this policy was 28.7.02. Its premium was paid upto 28.7.06. Another policy No. 300222792 in table 103-20 was purchased. Its date of commencement was 28.6.03 and sum insured was Rs. 1.00 Lac. Premium of this policy stands paid upto 12/2006. As regards policy No. 300050360, complainant No. 1 was appointed as nominee being wife whereas regarding second policy nominee is complainant No. 2 and complainant No. 1 is appointee/receiver. Complainant No. 1 claims that in the event of death of the insured before maturity, she becomes entitled to receive entire sum of both the policies. However, complainant No. 2 in respect of policy No. 300222792 is also entitled to the amount equal to sum assured on attaining the age of maturity or maturity of policy as the case may be. Krishan Lal Chawla has died due to drowning at Bathinda. Daily Diary Report No. 10 dated 22.8.06 was recorded in this respect in Police Station, Thermal Plant, Bathinda. At the first instance, police had initiated the proceedings under Section 174 of the Code of Criminal Procedure. Post Mortem was conducted at Civil Hospital, Bathinda. Doctor who conducted Post Morten recorded that cause of death would be determined after report from the Chemical Examiner, Govt. of Punjab, Patiala which has not so far been received. Intimation about his death was given by the complainants to opposite party No. 1 by way of moving application most probably on 3/4-9-06. Some forms were issued on the same day for submitting after their completion. Columns of the forms were got filled in by her. They were got attested and thereafter submitted to the Branch Office of opposite party No. 2 at Bathinda on 8.9.06 accompanied by attested copy of the Daily Diary Report, Post Mortem Report, original policy for assured sum of Rs. 1.00 Lacs and Death Certificate. Intimation was also given that other insurance policy of Rs. 2.00 Lacs was already in the LIC regarding the loan received by the assured. Request was made by complainant No. 1 to pay ordinary claim at the first instance. Further request was made that accidental benefit may be kept pending till the enquiry of police is completed as she was in dire need of money. Manager of Opposite party No. 2 told that where cause of death is disputed one, Life Corporation of India pays ordinary claim which otherwise would have been payable i.e. in case of natural death. Accidental benefit is paid on determination and completion of police enquiry. Complainants have given the instance of one Smt. Kamlesh Rani now deceased, holder of LIC Policies No. 161169979 dated 15.1.99 and 161352460 dated 28.2.01. Smt. Kamlesh Rani had died on 28.5.06. Her death was disputed one, but ordinary claim was paid to her nominee Vas Dev. After 8.9.06 complainant received letter with enclosures of Forms No. 3783 and 85 from opposite party No. 1 requiring her to complete and submit them. Letter dated 23.09.06 was received by her on 28.9.06. After completing the formalities, forms were submitted on 28.9.06. Promise was made orally that ordinary claim amount which could be Rs. 7.25 Lacs would be paid within a fortnight, but to no effect. On 13.11.06, complainant No. 1 received letter dated 30.11.06 from opposite party No.2 allegedly sent through registered post, but actually it was received in ordinary post. Through it she was asked to send copies of the documents i.e. Daily Diary Report and Post Mortem report after getting them attested from the concerned authorities i.e. Daily Diary Report from the Police Department and Post Mortem Report from the hospital authorities. It was their delaying tactics. She submitted the required documents on 14.11.06 and raised protest against the delaying attitude of the opposite parties. Request was made by her for making payment of the ordinary claim and keeping accidental benefit pending till final investigation by the police or as per situation which would arise. Opposite parties paid no heed. They are delaying the payment on one pretext or the other. She alleges that she is facing financial crunch as their only bread winner is no more in this world. Opposite parties charge interest @9% P.A. which is also being charged concerning one of the policies which is of Rs. 2.00 Lacs and as such, equally she is entitled to receive interest on entire accrued claim amount from the date of death i.e. 21.8.06 till payment. Apart from this, she claims Rs. 90,000/- as damages/compensation for mental tension and agony. According to the complainants opposite parties are deficient in providing services.<br /> 4. On being put to notice, opposite parties filed reply of the complaint taking legal objections that complaint is not maintainable in the present form; complainants are estopped from filing the complaint by their act and conduct; intricate and contentious questions of law and facts are involved which cannot be adjudicated before this forum in summary proceedings; complaint is pre-mature; complaint has not been filed in the proper form; nature of the relief sought by the complainant is beyond the scope and jurisdiction of this Forum and complaint is false and frivolous. They admit that insurance policies of Rs. 2.00 Lacs and Rs. 1.00 Lac were issued in favour of Krishan Lal Chawla. They do not deny specifically that complainant No. 1 was the nominee in policy No. 300050360 whereas in second policy No. 300222792 complainant No. 2 is the nominee. They further admit that as per information received from complainant No. 1 Krishan Lal Chawla has died on 21.8.06. As per record and news published, case was of suicide. They are seeking the report of Chemical Examiner about Viscera from the complainants since 30.10.06, but complainant No. 1 has failed to produce the same. Complainant No. 1 had submitted the documents on 14.11.06. As per law certain time period is required for investigation. Vide cheques No. 930218 dated 19.2.07 for Rs. 6,03,294/- and No. 930217 dated 19.2.07 for Rs. 97,206/- basic sum assured has been paid. It was received by the complainants before this forum. Claim with respect to accident benefit is pending investigation. Without determining cause of death accident benefit cannot be decided. There is no delay in the settlement of the claim. Complainants are not entitled to any interest. They deny the remaining averments in the complaint.<br /> 5. In support of their averments contained in the complaint, complainant have produced in evidence affidavit of complainant No.1 (Ex. C-1), photocopy of policy with terms and conditions (Ex. C-2), photocopy of DDR (Ex. C-3), photocopy of Post Mortem Report (Ex. C-4), photocopy of Death Certificate (Ex. C-5), photocopy of application dated 7.9.06 (Ex. C-6), photocopy of Claimant's statement (Ex. C-7), photocopy of letter dated 23.9.06 (Ex. C-8), photocopy of Claimants Statement (Ex. C-9), photocopy of certificate of Identity and Burial or Cremation (Ex. C-10), photocopies of letter dated 30.10.06 (Ex. C-11 & Ex.C-12) , photocopy of letter dated 14.11.06 (Ex. C-13), photocopy of application dated 13.11.06 (Ex. C-14), photocopies of cheques (Ex. C-15 & Ex. C-16), photocopy of Pronote and receipt (Ex. C-17), photocopy of receipt dated 26.2.07 (Ex. C-18), photocopy of Pass Book (Ex. C-19) and photocopy of account statement (Ex. C-20).<br /> 6. In rebuttal, on behalf of the opposite parties affidavit of Sh. Shanti Lal Yadav, Manager (Ex. R-1), photocopies of cuttings of newspapers (Ex. R-2 & Ex. R-3), photocopy of policy (Ex. R-4), photocopy of Form No. 5198 (Ex. R-5), photocopy of Policy No. 300222792 (Ex. R-6), photocopy of application for first loan (Ex. R-7), photocopies of cheques (Ex. R-8 & Ex. R-9) and photocopies of letters dated 17.2.07 (Ex. R-10 and Ex. R-11) have been tendered in evidence.<br /> 7. We have heard learned counsel for the parties. Besides this, we have gone through the record and written briefs of arguments submitted on behalf of the parties.<br /> 8. Some facts do not remain in dispute. They are that Krishan Lal Chawla who was the husband of complainant No. 1 and father of complainant No. 2 had purchased two insurance policies, copies of which are Ex. R-4 and Ex. C-2 respectively. In Insurance policy No. 300050360, complainant No. 1 is the nominee whereas in the other policy No. 300222792 complainant No. 2 is the nominee. Krishan Lal Chawla has expired on 21,8,06 as is evident from Ex. C-5 which is the copy of death certificate. An intimation regarding his death was given by complainant No. 1 on 7.9.06 to opposite party No. 1 by way of application, copy of which is Ex. C-6. Basic sum assured/ordinary claim has been paid by the opposite parties on 20.2.07 through cheques dated 19.2.07, copies of which are Ex. R-8 & Ex. R-9 respectively. Alongwith cheques covering letter was issued by the opposite parties, copy of which is Ex. R-11.<br /> 9. It is the version of the complainants that Daily Diary Report No. 10 dated 22.8.06 was recorded in Police Station, Thermal Plant, Bathinda. Police had initiated proceedings U/S 174 of the Code of Criminal Procedure. Copy of Daily Diary Report is Ex. C-3. Doctor who conducted autopsy did not declare the cause of death. He observed that cause of death would be determined after report from the Chemical Examiner Government of Punjab, Patiala is received. Admittedly report from the Chemical Examiner has not so far been received. Accidental benefit is to be paid on determination of cause of death and completion of police enquiry. On the basis of application moved to S.H.O. Police Station, Thermal Plant, Bathinda, endorsement has been made on 13.11.06 that report from Chemical Examiner has not so far been received. Learned counsel for the parties conceded before this forum that only ordinary claim/basic sum assured can be paid at this stage. Claim regarding accidental benefit cannot be determined.<br /> 10. Now question arises as to whether there is deficiency in service on the part of the opposite parties on account of the fact that as per terms and conditions of the policies basic sum assured i.e. Rs. 6,03,294/- and Rs. 97,206/- has been paid on 20.2.07 through cheques copies of which are Ex. R-8 & Ex. R-9 respectively.<br /> 11. Contention of the learned counsel for the complainants is that payment of the ordinary claim/basic sum assured has been made with delay whereas Mr. Baghla learned counsel for the opposite parties argued that documents were submitted by the complainants on 14.11.06 and as such, as per provisions of law some period is required for investigation and after processing the claim, basic sum assured has been paid through cheques dated 19.2.07.<br /> 12. Respective arguments have been considered by us.<br /> 13. Intimation regarding the death of Krishan Lal Chawla was given by complainant No. 1 on 7.9.06 through application, copy of which is Ex. C-6. Claimant's statement was submitted by complainant No. 1 on 8.9.06 and copy of the same is Ex. C-7. Alongwith this statement, attested copies of the Daily Diary Report, Post Mortem Report and Death Certificate were sent. Original Policy of Rs. 1.00 Lac was also sent. Opposite parties were further informed that original insurance policy of other insurance was already with them concerning loan obtained by the assured. Letter dated 23.9.06 copy of which is Ex. C-8 was received by complainant No. 1 from the opposite parties with which claim forms No. 3783-R and 3785-R were sent. Complainant No. 1 was directed to return them duly completed at an early date. Complainant No. 1 completed those forms and submitted them to the opposite parties on 28.9.06. Copies of forms No. 3783-R and 3785-R sent to the opposite parties are Ex. C-9 & Ex. C-10 respectively. Again opposite parties sent letter dated 30.10.06, copies of which are Ex. C-11 & Ex. C-12 after more than one month asking complainant No. 1 to submit photocopy of FIR/DDR, PIR/Panchnama duly attested by Policy Authority, Chemical Examination Report duly attested by the Hospital Authority and photocopy of PMR duly attested by the issuing authority. As discussed above, claim was submitted by complainant No. 1 on 7.9.06. Vide letter dated 23.9.06, opposite parties sent Forms No. 3783-R and 3785-R. Compliance of the letter dated 23.9.06 was made on 28.9.06. Prior to 30.10.06 opposite parties did not inform complainant No. 1 that photocopies of the DDR and Post Mortem Report should be sent duly attested by police authority and by issuing authority respectively. Even in the letter dated 23.9.06, complainant No. 1 was not apprised of this fact. Copies of the Daily Diary Report and Post Mortem Report were already submitted to the opposite parties on 23.9.06. Since FIR in this case has not been recorded, the question of sending copy thereof did not arise. Report of Chemical Examiner has not so far been received. Police has proceeded under Section 174 of the Code of Criminal Procedure and is awaiting report of Chemical Examiner. Hence, there is no FIR/Panchnama except Daily Diary Report. Complainant No. 1 made her position clear through letter, copy of which is Ex. C-13. Despite this, she sent copies of the DDR and Post Mortem Report duly attested by Police Authority and issuing officer of Civil Hospital respectively although copies of them duly attested by Notary Public were already submitted to the opposite parties.. Complainant made the opposite parties aware through letter dated 14.11.06 that they were causing her harassment without any fault on her part. In these circumstances, whatever compliance could be expected from the complainants is deemed to have been made on 28.9.06 particularly when opposite parties did not challenge genuineness of the duly attested copy of the Daily Diary Report and Post Mortem Report already submitted by complainant No. 1 on 28.9.06. Opposite parties were required to take decision about the settlement of the claim of the complainants within the reasonable period which in this case is three months from 28.9.06 onwards. In this view of the matter we get support from the observations of the Hon'ble State Commission of Punjab in the case of Bhagwati Rice Mills Sangrur Vs. United India Insurance Company Limited and Others 2005(1) CPC 479 They were required to settle the claim regarding the basic sum assured i.e. ordinary claim upto 28.12.06. They did not do so. Delay on their part in not settling the claim of basic sum assured till 28.12.06 amounts to deficiency in service. To the contrary they paid basic sum assured on 20.2.07 through cheques dated 19.2.07.<br /> 14. Various legal objections have been raised in the reply of the complaint by the opposite parties but none out of them was pressed before this forum at the time of arguments. It being so, they are deemed to have been waived.<br /> 15. Now question arises as to which relief should be accorded to the complainants. A sum of Rs. 6,03,294/- and Rs. 97,206/- has been paid by the opposite parties through cheques dated 19.2.07 referred to above. Had the claim regarding basic sum assured been settled by the opposite parties within the reasonable time of three months i.e. upto 28.12.06, the amount could be invested by the complainants and they could earn interest atleast @ 9% P.A. Submission of the learned counsel for complainant No. 1 is that complainant No. 1 was in dire need of money as her husband had borrowed a sum of Rs. 10,000/- from Sh. Manohar Lal at the rate of interest of 2.25 per mensum on the basis of pronote dated 27.5.06, copy of which is Ex. C-17 which was returned by complainant No. 1 after his death alongwith interest at this rate and as such, complainants are entitled to interest from the opposite parties at this rate, cannot be accepted, There are no pleadings of the complainants to this effect. Moreover, opposite parties have nothing to do with the alleged transaction of borrowing the amount by husband of complainant No. 1 from Sh. Manohar Lal and concerning the rate of interest agreed to be paid by him. In the case of Bhagwati Rice Mills (supra), Hon'ble State Commission, Punjab, allowed interest @ 9% P.A. on delayed settlement. Accordingly, we hold that direction deserves to be given to the opposite parties to pay interest @ 9% P.A. on Rs. 6,03,294/- and Rs. 97,206/- from 29.12.06 till 19.02.2007. Complainant are craving for damages/compensation to the tune of Rs. 90,000/- for mental tension and agony. There is no case to allow it in the face of the relief going to be accorded as above, particularly in view of the authority in the case of Life Insurance Corporation of India Vs. Miss Bhupinder Kaur (Minor) and others 2002(2) CLT 646, wherein Hon'ble State Commission of Punjab held that interest is not granted within the contract between the insured and insurer, but within the provisions of Section 14(1)(d) of the Act on deficiency in rendering service being established for compensating the complainant. Held accordingly. Other relief claimed by the complainants is that benefit be paid to complainant No. 2 on her attaining the age of majority/at the time of maturity of policy of Rs. 1.00 Lac and that right of accidental benefit of policies as per final investigation be reserved.. No case is made out for giving direction to this effect by this forum particularly when complainants and opposite parties are bound by the terms and conditions of the policies which are not in dispute.<br /> 16. No other point was urged before us at the time of arguments.<br /> 17. In the premises written above, complaint is partly allowed against the opposite parties with cost of Rs. 1,000/-. Opposite parties are directed to do as under :-<br /> i) Pay interest @ 9% P.A on Rs. 6,03,294/- and Rs. 97,206/- with effect from 29.12.06 till 19.02.2007.<br /> Compliance of this order be made within 30 days from the date of receipt of copy of this order. Copy of this order be sent to the parties concerned free of cost and file be consigned.<br /> Pronounced :<br /> 16-05-2007 (Lakhbir Singh )<br /> President<br /> <br /> (Hira Lal Kumar)<br /> Member<br /> <br /> (Dr.Phulinder Preet)<br /> Member<br /> .<br /> <br /> <br />