DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION-II

Udyog Sadan, C-22 & 23, Qutub Institutional Area

(Behind Qutub Hotel), New Delhi- 110016

Case No.623/2012

Smt. Gyanwati

W/o Late Shri Shantram

H.No.-54, Old Mehrauli Road,

Raj Nagar, Palam Colony,

New Delhi-110045

….Complainant

Versus

Life Insurance Corporation of India

Through its Directors

18-A/2, Desu Road, Mehrauli,

New Delhi

Also at:-

Nehru House, 4 Bahadur Shah Zafar Marg,

Delhi-110002

        ….Opposite Party

 Date of Institution    :     20.11.2012  

 Date of Order           :     11.04.2023

Coram:

Ms. Monika A Srivastava, President

Ms. Kiran Kaushal, Member

Sh. U.K. Tyagi, Member

ORDER

Member: Ms. Kiran Kaushal

1.       Briefly put, Complainant’s husband took a Life Insurance policy on 07.03.2003 from Life Insurance Corporation of India (hereinafter referred to as OP) for sum insured of Rs.1 lac along with accidental death coverage.

2.      It is stated that Complainant’s husband, a Rickshaw Puller regularly paid the insurance premium, met with an accident on 24.12.2007 and was declared brought dead by Doctors of DDU Hospital. FIR regarding the accident was lodged in Dwarka police station.  Copy of the FIR and Post Mortem report is annexed as Annexure-B & C respectively.

3.      Complainant being nominee in the policy lodged the claim with OP and received a cheque of Rs. 1,26,800/- in April, 2008. It is stated that the Complainant is an illiterate lady who was told by the agent of OP that remaining claim of accidental benefit shall be given after completion of investigation and after verifying the facts of the death.   Believing the agent of OP, complainant received the above said amount. It is further stated that Complainant in May 2008 visited the office of OP again and requested to pay the balance amount of Rs. 1 lac along with bonus on which the concerned official of OP asked the Complainant to submit the final report/charge sheet submitted by I.O. before the concerned Court. The Complainant contacted the Investigation Officer and came to know that investigation is still going on and they will inform the Complainant at the time of submission of final report/charge sheet.

4.      It is further stated that Complainant received the untraced report from IO in November, 2010 and submitted the same with OP. Despite the submission of requisite documents, OP failed to pay the claim of the Complainant. Thereafter the Complainant kept chasing OP for balance payment and again visited the office of OP on 16.10.2012 but to no avail.

5.      Thus aggrieved Complainant approached this Commission with prayers for directions to OP to pay Rs. 1 lac towards insurance claim along with bonus ;to pay interest @ 4 % p.a. on the said sum from 24.12.2007 and 1 lac towards harassment, mental agony and Rs. 20,000/- towards the cost of litigation.

6.      OP filed its written statement stating inter alia that in the present case death of the life insured occurred on 24.12.2007 and OP paid sum of Rs. 1,26,000/- vide its letter dated 26.03.2008 . Present complaint is filed almost five years from the date of death of the life assured and almost four years six months from the date of payment, therefore the present complaint is filed beyond the limitation period as prescribed under the Consumer Protection Act, 1986.

7.      It is next stated that OP in accordance with Clause 10 of the policy, sought documents from the Complainant to process the claim for accidental   benefit which the Complainant failed to deliver. It is further stated that OP has not repudiated the claim and only requested the Complainant to provide the document so that the claim for accidental benefits may be processed.

8.      It is further submitted that OP has already paid basic death claim along with bonus amounting to Rs. 1,26,800/- which was admittedly received by the Complainant in April, 2008. To process the claim for accidental benefit OP required-    Copy of the Final Police Inquest Report, Post Mortem Report and MLC No. 283689/2007, which were not required by the complainant.

9.      OP repeatedly sought the abovementioned documents. OP vide letter dated 03.11.2009 sought the said documents but the same has not been provided by the Complainant till date (till filing of the complaint). It is stated that OP is bound to scrutinize and conduct through enquiry with regard to the circumstance of the death before disbursing the claim. It was the Complainant who failed to provide the documents hence no deficiency can be alleged on behalf of OP. Therefore it is prayed that the complaint be dismissed with cost.

10.    Complainant filed the rejoinder reiterating the averments made in the complaint. Evidence by way of affidavit and written arguments are filed on behalf of parties. Pursuant to filing of the written arguments Complainant filed an application under Order 7 Rule 14 (3) of CPC to file documents which were not with the complainant at the time of filing the complaint. Copy of an Untraced report/Cancellation Report of Additional Chief Metropolitan Magistrate-I, Dwarka Court Complex, New Delhi dated 09.02.2011 has been filed.

11.    Submissions made on behalf of the Complainant are heard. Material placed on record is perused.

12.    The preliminary objections raised by OP that the Complaint is barred by limitation is rejected. As one of the requisite documents for processing of the claim i.e Cancellation report was accepted by Court on 09.02.2011 and the instant complaint has been filed on 20.11.2012.  Therefore the complaint is very well within the time .

13.    OP is not found to be deficient in service as the requisite documents for processing the claim of the Complainant was not provided to OP. However this Commission has not lost sight of the fact that the Complainant is illiterate and deceased husband of the Complainant was a Rickshaw puller. Therefore we think it appropriate that Complainant be given a chance to provide the requisite documents to OP and OP is directed to process the claim as per the insurance policy.

14.    Accordingly, Complainant is directed  to provide the requisite documents, if not already submitted with OP within a month from the receipt of the order. Thereafter, OP is directed to process the claim within two months after receiving the requisite documents from the Complainant. In view of the aforesaid discussion the complaint is disposed of.

  File be consigned to the record room after giving a copy of the order to the parties as per rules. Order be uploaded on the website.