Before the District Consumer Disputes Redressal Commission, Rohtak.
Complaint No. : 674
Instituted on : 02.12.2019
Decided on : 06.03.2024
Sombir age 37 years years s/o Mahinder Singh r/o village-Chamaria Tehsil & District Rohtak.
……….………….Complainant.
Vs.
- Life Insurance Corporation of India, SCO 3-4-5 Sector-1 HUDA Rohtak through its Marketing Manager.
- Office of Insurance Ombudsman(Insurance) SCO No.101-103, Batra Building, 2nd Floor, Sector-17D Chandigarh.
...........……Respondents/opposite parties.
COMPLAINT U/S 12 OF CONSUMER PROTECTION ACT.
BEFORE: SH.NAGENDER SINGH KADIAN, PRESIDENT.
DR. TRIPTI PANNU, MEMBER.
DR. VIJENDER SINGH, MEMBER
Present: Sh.O.P.Parmar, Advocate for the complainant.
Sh. Sameer Gambhir, Advocate for the opposite party No.1.
Opposite party No.2 given up.
ORDER
NAGENDER SINGH KADIAN, PRESIDENT:
1. Brief facts of the case as per the complainant are that he had taken a policy bearing no.504643508 from the opposite party for his legally wedded wife Smt. Shalu on 08.07.2016. The date of commencement of policy was 08.07.2016 and date of maturity is 08.07.2036. He has two children namely Kesu daughter and Abhi son. After the death of his wife complainant submitted an application for payment of insurance policy amount of Rs.1 lac with interest. . The wife of the complainant took some sort of poison and it came to the notice of the complainant. He took her to the Life Care Hospital on 30.09.2017 and despite of all the efforts made by the doctor she could not survive. Complainant deposited all the documents for claiming the insured amount. Opposite party demanded the order of the court of Hon’ble ACJM, Rohtak as referred to in final report filed by the police and opinion regarding the cause of death, which is pending for want of chemical analysis/viscera report as referred to in the PMR. The complainant submitted the report of Regional Forensic Science Laborary, Haryana dated 20.09.2018 and also submitted cancellation of FIR No.0464 dated 01.02.2017 with the respondents. But inspite of submitting all the documents alongwith the application, opposite parties did not pay the insured amount. The act and conduct of the respondents of not disbursing the amount of claim is illegal and there is deficiency in service on the part of the respondents. Hence this complaint and it is prayed that respondents/opposite parties may kindly be directed to pay the insurance claim amount alongwith interest @ 18% p.a. and also to pay Rs.200000/- as compensation on account of deficiency in service and Rs.11000/- as litigation expenses to the complainant.
2. After registration of complaint, notices were issued to the opposite parties. Opposite party No.1 in its reply has submitted that FIR has been lodged in this case and as per FIR the nominee i.e. Sh. Sombir(complainant) husband of life assured(Smt.Shalu) is involved in her death(suicide/murder) and police had filed challan u/s 173 CrPC in the Court of ACJM Rohtak. Judgement order of Hon’ble Court of ACJM is required to consider the said claim but complainant has not provided the court order. The opposite party has demanded the said requirement from complainant through registered letter dated 01.09.2018 and verbally but respondent has not received the said requirement. Complainant has not submitted the documents inspite of many oral as well as written requests. Complainant has submitted wrong facts. Copy of orders from the court of Hon’ble ACJM, Rohtak as referred in the Police report is still awaited and complainant has not provided the requisite documents to process the claim. Opposite party prayed for directing the complainant to provide the requisite documents. All the other contents of the complaint were stated to be wrong and denied and opposite party No.1 prayed for dismissal of complaint with costs. However, opposite party No.2 did not appear and sent a reply through post submitting therein to delete its name from the list of respondents. The complainant vide his statement dated 01.12.2021 has given up the opposite party No.2.
3. Ld. counsel for complainant in his evidence has tendered affidavit Ex.CW1/A, documents Ex.C1 to Ex.C27 and closed his evidence on dated 15.03.2023. Ld. Counsel for opposite party No.1.has tendered affidavit Ex.RW1/A, document Ex.R1 to Ex. R4 and closed his evidence on dated 19.05.2023.
4. We have heard learned counsel for the parties and have gone through material aspects of the case very carefully.
5. In the present case, the last premium alongwith interest was paid by the complainant on 21.09.2017 for the month of 7/2017. Premium receipt is placed on record as Ex.C23 and as per this receipt the next premium was due on 10/2017 but the life assured died on 30.09.2017 during the policy period. The respondent has placed on record 4 documents in his evidence i.e. letters Ex.R1 to Ex.R4 issued by the department to Sombir s/o Sh Mahender i.e. complainant for submitting : “The order from the court of ACJM , Rohtak as referred to in the final report filed by the police for consideration of death claim”.
6. We have minutely perused the documents placed on record by both the parties. The complainant replied the letter dated 22.05.2019 issued by the officials of the opposite party on dated 18.07.2019 which is placed on record as Ex.C15. Through this letter the complainant has submitted the cancellation report issued by the police officials and submitted before the Hon’ble Court. This document has been received by the respondent officials on dated 18.07.2019. Against this letter Ex.C15, respondent officials wrote two more letters dated 28.07.2019 and 13.09.2019. Through these letters the respondent officials have demanded the final report issued by the Court. As per our opinion the respondent has not placed on record detailed terms and conditions of the insurance policy in which it has been mentioned that the final report as admitted by the Court is required for the settlement of the claim of the complainant. In fact the life assured died and regarding her death, an FIR was got registered. After investigation police officials submitted a cancellation report in the Hon’ble court. The cancellation report is placed on record by the complainant as Ex.C18 and other relevant documents are also placed on record by the complainant. Nothing is pending towards the complainant for settlement of claim of the complainant. As per our opinion complainant is entitled for claim. Perusal of documents i.e. policy Ex. C4 shows that the sum insured is of Rs.One lac. Hence the complainant is entitled for the alleged amount. As per para no.4 of the complaint, complainant has two children namely Keshu(daughter) and Abhi(son). As such they are also entitled for the claim amount.
7. In view of the facts and circumstances of the case we hereby allow the complaint and direct the opposite party No.1 to pay the amount of Rs.100000/-(Rupees one lac only) alongwith interest @ 9% p.a. from the date of filing the present complaint i.e 02.12.2019 to till its realization to the L.Rs of deceased Shalu i.e. to pay Rs.50000/-(Rupees fifty thousand only) to the complainant namely Sombir, Rs.25000/-(Rupees twenty five thousand only) to daughter of deceased namely Keshu and Rs.25000/-(Rupees twenty five thousand only) to son of deceased namely Abhi . Opposite party No.1 is further directed to pay Rs.5000/-(Rupees five thousand only) as compensation on account of deficiency in service and Rs.5000/-(Rupees five thousand only) as litigation expenses to the complainant. It is made clear that if the children of complainant namely Keshu and Abhi are minor, in that situation the alleged awarded amount shall be deposited in their name in any nationalized bank in the shape of FDRs till the age of majority and shall be paid to them on attaining the age of majority.
8. 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:
06.03.2024
........................................................
Nagender Singh Kadian, President
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Tripti Pannu, Member.
……………………………….
Vijender Singh, Member
