Karnataka

Kolar

CC/55/2022

Smt.M.V.Anjali - Complainant(s)

Versus

Life Insurance Corporation of India - Opp.Party(s)

10 Mar 2023

ORDER

Date of Filing: 30/11/2022

Date of Order: 10/03/2023

BEFORE THE KOLAR DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, OLD D.C. OFFICE

PREMISES,KOLAR – 563 101.

Dated: 10^thDAY OF MARCH 2023

SRI.SYED ANSER KALEEM, B.Sc., B.Ed., LL.B., …… PRESIDENT

SMT.SAVITHA AIRANI,B.A.L., LL.M., …..LADY MEMBER

CONSUMER COMPLAINT NO :: 55 OF 2022

Smt. M.V. Anjali @ Anjamma,

Aged About 30 Years,

W/o. Late Narayanaswamy,

R/at: Nichanagunte Village,

Koladevi Post, Duggasandra Hobli,

Mulbagal Taluk, Kolar District,

PIN-563131.

(Rep. by Sri. P.n. Krishna Reddy, Advocate)             ….  Complainant.

- V/s -

Life Insurance Corporation of India,

Bangalore D.O. II, “Jeevan Jyothi”,

Indiranagar Stage-II, Bangalore

-560038, Phone No.080-22966818,

                           …. Opposite Party.

-: ORDER:-

BY SRI. SYED ANSER KALEEM, PRESIDENT

01.   That the complainant has filed this complaint Under Section 35 of the Consumer Protection Act 2019 against the OP – insurance company alleging deficiency in service and pray to direct the OP to pay a sum of Rs.15,00,000/- and Rs.3,00,000/- being sum assured with bonus and applicable interest and to grant such other reliefs as this Hon’ble Commission deems fit.

2)  The brief facts of the complaint petition is that, the complainant is the wife of Late N.R. Narayanaswamy who was working as Senior Laboratory Supervisor, Department of Health and Family Welfare, Government Hospital, Mulbagal.  Further during the life time of husband of the complainant he obtained two LIC policies i.e., Jeevan Labh policy bearing No.609774592 for an assured sum of Rs.15,00,000/- and another LIC policy Aadhaar Stambh (with profits) bearing No.609774593 for an assured sum of Rs.3,00,000/- and the complainant is the nominee in both the policies.  The insured was regularly paying the premiums whenever due and there is no any balance of premium amount to the OP.  The insured N.R. Narayanaswamy was died on 20.12.2020 and the said policies were in force during the death of the said N.R. Narayanaswamy.  It is stated that, after the death of the insured and the complainant approached the OP and submitted death claim form.  The OP issued letter on 10.01.2022 to produce some documents and complainant submitted all the documents on 28.02.2022.  The OP has issued letter dated: 26.04.2022 stating that, the deceased was under treatment/Palliative Chemotherapy before admission to the hospital for which the complainant has given written reply.  The OP issued letter DO II/Claims/Repudiation/616/03.04/2022-23 dated: 10.06.2022 stating that, the OP has been decided to repudiate all the liability under the aforesaid policy and all the money received by the OP towards polices stand forfeited and option was given to the complainant that, if she disagree she may send representation to the Zonal Manager, LIC of India, Hyderabad.  The complainant sent requisition on 20.07.2022 through Registered post with documents and the said articles was delivered on 26.07.2022.  Thereafter the complainant did not receive any response from OP side and hence alleged that, the repudiation made by the OP amounts to deficiency of service.  Hence this complaint.

03.   On issuance of notice from this Commission the OP – Insurance Company appeared through its counsel and filed its version. 

04.   In the version the OP – Insurance Company has contended that, the complaint is not maintainable either in law or on facts and the same is liable to be dismissed.  On rejection of claim at Divisional level claimant appealed to Zonal Manager i.e., Next higher authority for appeal and after going through the file the said grievance Redressal Committee admitted the claim under both policies and payment was already made on 04.01.2023 as shown below:-

1) Policy No.609774593 – Rs.3,00,000/- M.V. Anjali Alias Anjamma on 04.01.2023.

2) Policy No.609774592 – Rs.16,32,000/- M.V. Anjali Alias Anjamma on 04.01.2023.

Payment details including discharge receipt given by the complainant are submitted for verification of the Hon’ble Commission.  Amount paid to the Nominee/petitioner account No.34655489298 of State Bank of India.  The complainant has discharged for the amount due under the policy by submitting discharge receipt and the same was paid.  Hence complaint becomes infectious and needs to be dismissed.

05.   In order to prove the case of the parties, both complainant and OP – Insurance Company have filed their affidavit evidence along with supporting documents.

06.        On the basis of the available pleadings on record the following points will arise for our consideration:-

(1) Whether the complainant is proved deficiency in service on the part of OP – Insurance Company?

(2) Whether the complainant is entitled for the relief as sought for in the complaint?

(3) What Order?

07.   Heard arguments of both parties.

08.   Our answer to the above points are:-

             POINTS (1) & (2):-     Are in the Negative

             POINT No.(3):-        As per the final order

                                           for the following :-

09.   POINT NOs.(1) & (2):- These points are taken up together for common discussion, for brevity, for the sake of convenience and to avoid repetition of facts and these points are taken up together for common discussion.

10.   On perusal of the pleadings of the parties and the affidavit evidence placed on record it is not in dispute that the husband of the complainant while working in the Department of Health and Family Welfare, Government Hospital, Mulbagal, and who obtained the two insurance policies bearing No.609774592 for a assured sum of Rs.15,00,000/- and policy bearing No.609774593 for an assured sum of Rs.3,00,000/-.  It is also not in dispute that the complainant is the nominee of the above two said policies.  Further that the husband of the complainant was died during the currency of the policies. 

11.   It is the a specific allegation of the complaint is that, subsequent to the death of the husband of the complainant and the complainant filed all the claim papers to the OP insurance company, but initially the OP-insurance company repudiated the claim on 10.06.2022 and thereafter complainant sent all the necessary required papers on 20.07.2022 through registered post to the Zonal Manager, LIC of India, South Central Zonal Office situated at Hyderabad,  but the complainant alleged that, despite approaching the Zonal Office they have not taken any steps to settle the claim.  Hence complainant filed this complaint.

12.   Per contra, OP-insurance company by filing version and the affidavit evidence brought to the notice of this Commission that they already honoured the claim of the complainant i.e., in respect of policy No.609774592 and paid Rs.16,32,000/- and in respect of policy No.609774593 and paid Rs.3,00,000/- to the complainant as a nominee.  Further the complainant also disclosed the receipt of the above said payments made to her in her affidavit evidence. 

13.   It is worth to note that, as per the saying of the complainant all the required papers sent to the Zonal Office on 20.07.2022 and the papers sent through post to the Zonal Office situated at Hyderabad and it usually take some time and the said papers will receive initially at the Tapal Section and thereafter by making entry in the inward register the concerned person will send to the papers to the concerned branch.  Further the counsel for OP-insurance company argued that, initially the OP-insurance company had repudiated the claim based on Chemotherapy treatment taken by the husband of the complainant, hence the OP-insurance company themselves advised the complainant to send all papers to the Zonal Office if she had any grievances and the same is admitted by the complainant.  Further according to the advice given by the OP-insurance company and the complainant accordingly sent papers to the Zonal Office, hence in the Zonal Office they have to review all the papers submitted by the complainant and the papers of OP Branch office in respect of initial repudiation.  Hence we will having no hesitation accept the arguments of the OP counsel to the effect that, for reviewing the papers and to form opinion and it takes time.  Further LIC is the public institution and the public money is involved and hence LIC being the trustee of the people they have to work out all possible remedies for its customers by weighing the pros and cons. and then only they will work out the remedy and hence for all these steps it takes time.  However the complainant without waiting for the decision of the Zonal Office that the complainant filed the present complaint on 30.11.2022, whereas the OP-insurance company settled the claim within a couple of months i.e., on 04.01.2023 and honoured the claim of the complainant to the extent of sum insured as evident from the insurance policies.  From the above discussion we reached to conclusion that, complainant failed to prove any kind of the deficiency in service on the part of the OP-insurance company and hence complainant is not entitled for the relief as sought in the complaint.  Accordingly we answered Point Nos.1 & 2 are in the Negative.

14.   POINT NO.3:-  In view of our finding on Point Nos.1 & 2 and the discussions made thereon, we proceed to pass the following:-

ORDER

01.   The complaint is dismissed.  No order as to costs.

02.   Send a copy of this order to both parties free of cost.

(Dictated to the Stenographer, transcribed by him, corrected and then pronounced by us on this 10^th DAY OF MARCH 2023)

   LADY MEMBER                          PRESIDENT