This case is coming for final hearing on 27.02.2015 in the presence of Sri K.Jagannadham Advocate for Complainant and of Sri N.V.N.Raju Advocate for Opposite Parties and having stood over till this date, the Forum delivered the following:

: O R D E R :

(As per Smt. K.V.R.Maheswari, Honourable President(FAC) on

behalf of the Bench)

1.       The case of the complainants is that the 1^st complainant is legally wedded wife of P.V.R.Prasad who was the deceased policy holder who obtained insurance policy from the opposite parties vide Unit Linked Policy No.694468225 with Rs.2,00,000/- risk cover commencing from 09.03.2007 and paid Rs.35,000/- towards premium.  Sri P.V.R.Prasad i.e., husband of 1^st complainant also obtained two other policies vide policy Nos.693598827 and 694051013 in which the name of the 1^st complainant is mentioned as nominee.  The 2^nd complainant Smt.P.Satyavathi who is the nominee of the policy NO.694468225 was added as per the orders in I.A.No.232/2012 dated 20.09.2012 and then, the complaint was amended and the complainants filed neat copy.  The husband of the 1^st complainant and the son of 2^nd complainant was died on 03.01.2008 and then, the complainant submitted the death claim to the 1^st opposite party and the opposite parties paid the claim amount under two policies those are policy Nos. 693598827 and 694051013 out of three polices to the 1^st complainant after long process of representation, requests. The amount under policy No.694468225 was repudiated inspite of several requests made by the complainants.  Then, the 1^st complainant issued a letter on 02.12.2010 to the opposite parties under Right to Information Act and the  said authorities sent a reply vide their letter dated 20.12.2010 wherein they confirmed the payment of claim under two polices and the repudiation against the policy No.694468225, subsequently, the complainant filed an objection before the Authority of Insurance Ombudsman Committee, Hyderabad vide complaint No.L-21-001-1167-2010-11 and the said authority rejected the claim vide its order dated 03.08.2011 without considering the oral facts and issued partial orders on the ground that the signatures are not tallied.  The 1^st complainant stated that she is legally wedded wife of deceased policy holder and that too she already received the claim under two policies, but the present policy claim was repudiated by the opposite parties without a proper reason and cause severe mental agony and financial loss to the complainants.  Hence, this complaint to direct the opposite parties;

a)      to pay the claim amount of Rs.2,00,000/- towards death claim under Policy No.694468225 to the complainants with 18% p.a. interest from the date of claim till the date of payment.

b)      to pay Rs.50,000/- towards compensation besides costs of Rs.10,000/-.

2.       On the otherhand, the 3^rd opposite party filed its counter and 1^st opposite party and 2^nd opposite party adopted the same.  The opposite parties pleaded that the husband of the complainant i.e., P.V.Raja Prasad the life assured is an employee of Jindal Steel Plant Bellary who obtained policy No.694468225 through proposal dated 09.03.2007 for a sum assured Rs.2,00,000/- and he died on 03.01.2008, when the nominee submitted the documents to the opposite parties the claim under the said policy was repudiated as the proposal shows that it was signed at Rajam on 09.03.2007, but the life assured was on duty on 09.03.2007 at Bellary and was not on leave and further the signature of the life assured on the proposal of the policy valid with those of the signatures pertaining to the two other policies obtained by the life assured.  It is evident that the deceased life assured himself did not sign on the proposal form on 09.03.2007 as such there is no contract of insurance at all.  Consequently, the claim under that policy was repudiated, but settled other two claims.  The repudiation of the claim was intimated to the concerned but however the bid value of units under the policy Rs.25,959.54p.s. is payable and the same was communicated to the nominee, however the consent and discharge are awaited for payment of Rs.25,959.54p.s but the complainant not mentioned these facts in her complaint.  The other plea of the opposite parties is that the complainant is not a nominee for the policy NO.69668225 and consequently, the complainant has no locus standie to file the present complaint. 

3.       The award passed by the Insurance Ombudsman clearly speaks about the true nature of the conflicts and complications involved in the matter.  Though, the complainant was given an opportunity to submit the papers for verification and tallying of the signatures of the life assured, the complainant has not choosen to submits papers to the insurance ombudsman.  Consequently, the repudiation of the claim by the Life Insurance Corporation of India was upheld.  The Insurance Ombudsman in its award dated 03.08.2011 observed that “I have verified the signatures of the life assured on the proposal dated 09.03.2007 with the signatures on the earlier proposals dated 16.08.2005 and 28.03.2006 and I am convinced with the signatures on 09.03.2007 varied widely in style and character with the signatures on the earlier proposals”.  Thus, there is no valid contract between the complainant and opposite parties as that proposal form was not signed by the life insured himself, hence he is not a consumer and the opposite parties are not liable to the policy amount of Rs.2,00,000/- to the policy No.694468225 and further submits that the dispute reveals around to various questions on relating to non tallying of signatures and the submission of policy, while in fact the life assured was on duty on the relevant date and thus the matter imbibed with the issues of civil nature between the parties.  Hence, it is submitted that the matter thus requires to be tried and decided in full, on merits, by a civil court, and cannot be tried and decided summarily before this Honourable Forum. Hence, the complaint is to be dismissed. 

4.       At the time of enquiry, the complainant filed evidence affidavit along with documents which are marked as Exhibits A1 to A15.  On the other hand the opposite party NO.3 filed its counter and opposite parties 1 & 2 filed their memo adopting the counter of 3^rd opposite party and evidence affidavit along with documents which are marked as Exhibits B1 to B5.  Both the parties filed their additional evidence affidavit.  Heard the complainant who reiterated its version as there is no representation even after imposing costs, treated it heard for the opposite parties and I.A.No.44/2015 was filed by the opposite party to reopen the matter for hearing opposite parties.  Heard the opposite parties who reiterated their version. 

5.       In view of the respective contentions, the point that would arise for determination is:-

Whether there is any deficiency in service on the part of the opposite parties, if so can the complainant entitle for the reliefs prayed for?

6.       Ex.A1 is the death certificate of deceased policy holder issued on 15.02.2008 wherein, the date of death was mentioned as 03.01.2008.  Ex.A2 is the certificate given by Tahsildar, Yelamanchili wherein, Smt.P.Satyavathi i.e., 2^nd complainant has given his consent in favour of wife of deceased i.e., P.Rajeswari i.e., the 1^st complainant to receive amounts from the Steel Plant such as P.F and pension and life insurance, postal department deposited by the deceased person.  Sl.No.2 & 3 in the Certificate are minor daughter and minor son of deceased policy holder and 1^st complainant.  Ex.A3 is the registered letter issued by the 3^rd opposite party to the 1^st complainant on 20.12.2010 mentioning the claim was repudiated and not admitted for payment.  Ex.A4 is the Ombudsman Ward dated 03.08.2011. Ex.A5 is the status report of policy No.694468225 wherein, the nominee’s name was mentioned as Satyavathi i.e., the 2^nd complainant.  Ex.A6 is the letter issued by the Insurance company dated 24.04.2010 to the 1^st complainant by mentioning the three policies numbers and intimating about the claims are in the process.  Ex.A7 is the application by the 1^st complainant seeking information under RTI Act dated 08.01.2011.  Ex.A8 is the reply letter furnishing the information by the opposite parties under RTI on 17.01.2011.  Ex.A9 is the RTI application by the complainant to CPIO, LIC of India, RTI Department.  Ex.A10 is the information given by the RTI department of Opposite parties on 07.02.2011.  Ex.A11 is the letter issued by the complainant to Public Information Officer, LIC of India seeking information under RTI and Ex.A12 is the information given by the opposite parties on 29.08.2011.  Ex.A13 is the notarized affidavit of 1^st complainant and her deceased husband dated 27.12.2007. Ex.A14 is the Inland letter written by the deceased policy holder to his brother P.Apparao dated 19.07.2007 and Ex.A15 is a letter by the deceased policy holder to his brother on 20.01.2007. 

7.       The version of the opposite parties is that the deceased policy holder had three policies and two policies were settled, but in this present policy, the signature of the life assured on the proposal form are varied from other two policies which were already settled and that too that proposal form was signed at Rajam on 09.03.2007 and on same day the life assured was on duty at Bellary.  But, in our view, it is not compulsory, that the life assured should be on leave at the time of signature in the proposal form and it is not compulsory for the life assured to be staying in the branch area.  Hence, this plea is not taken into consideration by this Forum. 

8.       The other plea of the opposite parties is that the complaint filed by the wife of life assured who is not a nominee, after that the nominee who is the mother of the policy was added as complaint NO.2.  But the opposite parties contention is that as per Ex.A2, the 1^st complainant get the consent of her family members to receive the amounts from life assured corporation, but except the mother-in-law of the 1^st complainant there are two minors i.e., daughter and son of 1^st complainant, but the complainant not added her minor son and daughter as parties.  Thus, the complaint is non-joinder of necessary parties.  We also opined that if the complaint is filed by the nominee, there is no necessity of adding all the family members as complainants, but here the 1^st complainant is not a nominee and after that the 2^nd complainant who is nominee was added as per the Family Certificate and other two minor children not added as parties, who are the legal heirs as per law and whose rights are also the matter of concern even as per law and need to be ascertained by a civil court, because being L.Rs of the deceased. 

9.       Ex.A4 is the order of Ombudsman wherein they mentioned that the signatures on the proposal form are varied widely in style and character with the signatures on the earlier proposals the strokes of the signatures correspond to the other writing in the proposal form and they also gave opportunity to the complainant to prove the signature of the life assured by filing any document.  But at the time of hearing on 26.07.2011, when asked for any document signed by the life assured, the representative of the complainant did not produce any document and stated that the signatures might vary from time to time. At the time of hearing, the complainant filed three documents which are marked as Exhibits A13 to A15.  Ex.A13 is notarized affidavit dated 27.12.2007 and Ex.A14 and Ex.A15 dated 19.07.2007 and 20.01.2007 respectively are the letters issued by the life assured.  Whereas, the proposal form which is in dispute was signed on 09.03.2007.  Hence, the Forum, is of the opinion that all these signatures are in the year 2007 only by the life assured.  But with a naked eye, it can observe that variation of the signature in Ex.B1 i.e., proposal form comparatively with Ex.A14 and Ex.A15. Thus, the dispute revolves around the various questions relating to non-tallying of signatures.  Moreover, the award passed by the Insurance Ombudsman which was not satisfied by the complainant, this Forum is not an Appellate authority as the claim itself is with conflicts and complications and this matter requires to be tried and decided in full on merits by civil court because the discrepancy regarding the signatures of the life assured involved and an expert opinion is required and it cannot be tried and decided summarily before this Forum. 

10.     The opposite parties in their counter as well as in the evidence affidavit admitted about the refund of bid value of units under the policy of Rs.25,959.54p.s which is payable, hence the opposite parties have to refund that amount to the complainant with 9% interest from the date of repudiation letter i.e., 20.12.2010 till the date of payment.   The opposite parties repudiated the claim because this matter to be tried and decided in full on merits by civil court as disputes revolves around the various questions relating to non tallying of signatures and submission of policies, while in fact the life assured was on duty on the relevant date and the claims by the complainants of whom one is not at all the nominee nor the consumer and leaving of other legal heirs to the claims all go to the emphasis that the matter is imbedded with the issues of civil nature between the parties.  Hence, the repudiation by the opposite parties is justified, as such the complainant cannot entitle for compensation and costs.

          Accordingly, this point is answered.

11.     In the result, the complaint is partly allowed directing all the opposite parties to pay the bid value of the units under the policy in a sum of Rs.25,959.54p.s. within 30 days to the complainant, failing which to pay the same with 12% p.a. interest till the date of payment.  No order as to compensation and costs. 

Dictated to the Shorthand Writer, transcribed by her, corrected and pronounced by us in the open Forum on this the 12^th day of March, 2015.

   Sd/-                                                                        Sd/-

Member                                                                 President (FAC)

                                                                   District Consumer Forum-I 

                                                                             Visakhapatnam

APPENDIX OF EVIDENCE

Exhibits Marked for the Complainant:

Consumer Complaint No:15/2012

Exhibits Marked for the Opposite Parties:

   Sd/-                                                                        Sd/-

Member                                                                  President (FAC)

                                                                   District Consumer Forum-I

                                                                             Visakhapatnam

//VSSKL//