BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM RAICHUR.
COMPLAINT NO. DCFR. 82/11.
THIS THE 16th DAY OF FEBRUARY 2012.
P R E S E N T
1. Sri. Pampapathi B.sc.B.Lib. LLB PRESIDENT.
2. Sri. Gururaj, B.com.LLB. (Spl) MEMBER.
3. Smt. Pratibha Rani Hiremath,M.A. (Sanskrit) MEMBER
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COMPLAINANT :- Ranganath S/o. Late Mahadevappa Adakai, Age
20 years, Occ: Coolie, R/o. Karadakal village, Tq.Lingasugur, Dist:Raichur.
//VERSUS//
RESPONDENTS :- 1. Life Insurance Corporation of India, represented by Branch Manager, LIC office, Sindhanor, Dist: Raichur.
2. Life Insurance Corporation of India, represented by Divisional Manager, Divisional Office, Raichur.
CLAIM :- Sought the reliefs of Rs. 50,000/- towards death
claim amount and its vested bonus, interest at the rate of 12%, and mental agony shock damages etc., of Rs. 5,000/- and cost of this proceedings.
Date of institution :- 16-11-11.
Notice served :- 17-11-11.
Date of disposal :- 16-02-12.
Complainant represented by Sri. Mallangouda, Advocate.
Respondent Nos.1 & 2 represented by Sri.T. Keshavacharya, Advocate.
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This case coming for final disposal before us, the Forum on considering the entire material and evidence placed on record by the parties passed the following.
By Sri. Gururaj, Member
JUDGEMENT
This is a complaint filed U/s. 12 of Consumer Protection Act by the complainant Ranganath S/o. late Mahadevappa, against the two Respondents (1) Life Insurance Corporation of India, represented by Branch Sindhanoor, (2) Life Insurance Corporation of India represented by its Divisional Manager, Divisional Office, Raichur. The brief facts of the complaint are as under:
The complainant is the son of Smt. Shankaramma W/o. Late Mahadevappa Karadakal. The said Shankaramma had obtained LIC policy bearing No. 665061575 for assured sum of Rs. 50,000/- under New Janaraksha Plan with profits (with accident benefits) commencing from 19-03-2009 for a period of 16 years. The complainant is the nominee and legal heir for the said policy. The said Shankaramma died in the Government Hospital, Lingasugur on 12-05-2009. After her death the complainant has submitted death claim application along with all required documents to the Respondent No-1 for getting the death claim amount of Rs. 50,000/- and available bonus and benefits from the above said policy of late Shankaramma. After the receipt of the death claim application the Respondent No-1 has not settled the matter and even not cared to reply and without any enquiry and offering any opportunity of hearing to the complainant, all of a sudden the Respondent No-1 rejected the claim through his letter dt. 09-02-2011 stating that, the policy is in lapsed condition. Hence death claim cannot be payable on the above said policy. Even in spite of several requests and demands made by the complainant Respondent Nos. 1 & 2 have not settled the claim. The say of the Respondent regarding policy condition is concoted story only in order to avoid the payment they have rejected the claim the complainant has no knowledge with regard non payment of premium amount of the said policy. The act of the Respondents is gross deficiency in service and because of this complainant has sustained huge loss, mental agony, pain, torture and hardship. Hence he sought the reliefs of Rs. 50,000/- towards death claim amount and its vested bonus, interest at the rate of 12%, and mental agony shock damages etc., of Rs. 5,000/- and cost of this proceedings.
2. The Respondent Nos. 1 & 2 have appeared through their counsel. The Respondent Nos. 1 & 2 filed their written version through counsel. In the written statement the Respondent Nos. 1 & 2 have admitted that late Shankaramma the life assured had taken Janaraksha Plan Policy bearing No. 665061575 dt. 19-03-2009 for assured sum of Rs. 50,000/ and about the complainant’s nomenclature, death of the said Shankaramma on 12-05-2010 and submission of the claim form along with relevant records to the Respondent No-1.
The Respondent Nos. 1 & 2 in their written version mainly contended that, the policy was under lapsed condition at the time of her death, and the policy in question is an ordinary cash policy, quarterly premiums due from December-2009. Further it is contended that, in usual practice of the LIC of India in the premium receipt himself the next date for the payment of premium is mentioned and as such non separate intimation will be given to the policy holder. However Respondent No-1 has sent the premium notice and default intimation as a reminder to the deceased life assured. The life assured was not paid the premium dues within the grace period. The Respondent have rightly repudiated the claim for non payment of the premiums and the same was intimated through letter dt. 09-02-2011 about the repudiated the claim, hence the Respondents are not responsible for any claim of the complainant further there is no any deficiency in service so the Respondents are not responsible for to pay Rs. 5,000/- as damages and claim made under the policy and sought for dismissal of the complaint with exemplary cost.
3. During the course of enquiry the complainant has filed his sworn-affidavit by way of examination-in-chief. In-rebuttal on behalf of Respondent Nos. 1 & 2 the sworn-affidavit of one Sri. Sanjeeva.H. Manager, L&HPF Department LIC of India, Divisional Office, Raichur and noted as RW-1.
4. The complainant has filed (4) documents at Ex.P-1 to P-4 which are (1) Attested Xerox copy of LIC Bond at Ex.P-1, (2) Attested xerox copy of certificate of hospital treatment (Death certificate) marked at Ex.P-2, (3) letter from Respondent No-1 office dt. 09-02-2011 marked at Ex.P-3, and (4) True copy of Death Certificate marked at Ex.P-4. Similarly three documents filed by the Respondent Insurance Company they are marked as Ex.R-1 to Ex.R-3 namely (1) Certified copy of the LIC Policy at Ex.R-1, (2) Proposal Forum marked at Ex.R-2 and (3) Status of the policy at Ex.R-3.
5. Heard the arguments of both sides and perused the records. The following points arise for our consideration and determination:
1. Whether the complainant proves deficiency in service by the Respondents in not settling his claim under the policy, as alleged.?
2. Whether the complainant is entitled for the reliefs sought
for?
6. Our finding on the above points are as under:-
1. In the affirmative.
2. As per final order for the following.
REASONS
POINT NO.1:-
7. There is no dispute that late Shankaramma W/o. Late Mahadevappa mother of complainant had obtained LIC policy bearing No. 665061575 for assured sum of Rs. 50,000/- under New Janaraksha Plan with profits (with accident benefits) commencing from 19-03-2009 for a period of 16 years and the said Shanakaramma died on 12-05-2010 leaving behind her son i.e, complainant as legal heir. It is not disputed by the Respondents that the complainant is the nominee of the LIC policy in question. Further it is also not in dispute that, the complainant has filed death claim before the Respondent No-1 and same was repudiated and intimated by the Respondents through letter dt. 09-02-2011 on the ground that is for non payment of premiums from December 2009.
8. After going through the pleadings of the parties, and documents filed by them, now the only point for our consideration is:
1. Whether the repudiation in respect of claim under the policy made by
the Respondent Nos. 1 & 2 is proper one or not.
9. It is the case of the Respondent Nos. 1 & 2 that, the deceased Shankaramma was not paid the premium from December-2009 and same were due even inspite of repeated requests. The next due was also made available through the premium paid receipt but even inspite of that, deceased life assured has not paid the premiums due hence the policy of the deceased is under lapsed condition. Regarding the lapsed of the policy and repudiation of the claim has been intimated to the complainant through letter dt. 09-02-2011 by the Respondent No-1. Under the above circumstances, there was no deficiency on their part and nothing is payable to the complainant and they have taken decision for to repudiate the claim of the complainant under the policy. On perusal of the Ex.P-1 = Ex.R-1 the deceased Shankaramma has taken the policy on 19-03-2009 and as per Ex.P-4 she died on 12-05-2010. These two documents are clearly goes to show that, the deceased Shankaramma has died after 10 months from the date of obtaining the policy. Further, on perusal of the Ex.R-3 the last premium was due on December-2009 it means from December-2009 no further premiums have been paid by the mother of the complainant i.e, deceased life assured this fact is also clearly mentioned under the policy statement i.e, Ex.R-3 and written statement filed by the Respondents. Further, the repudiation dt. 09-02-2011 is also speaks about the reason for repudiation of the claim on the ground that, the policy premiums were due. No doubt on the ground of non payment of the policy has been lapsed but though the Respondents in their written version contended that, they have intimated about the premiums due to the deceased life assured but we do not find any iota of evidence to show that, the Respondents have intimated the complainant about the premiums due and for its consequences, further we do not also find any single piece of evidence to show that, the last premium paid receipt will show about the next date of premium to be paid by the policyholder. Under such circumstances the version of the Respondents cannot be accepted. Hence, we have rejected the defence of the Respondents in this regard.
10. It is not the case of the Respondents that, the death of the policyholder is against the policy terms and conditions and the claim submitted by the complainant is premature one. But the termination of the claim is only on the ground of the non payment of the premiums but for which the LIC of India has not showed any interest in intimating the non payment of the premiums by the complainant’s mother. Under such circumstances when they are admitting the policy and they have also admitted the death of the policyholder they cannot reject the claim of the complainant by their own mistakes, this act of the Respondents are nothing but a deficiency in service on their part because they have not intimated about the premium due. Hence from viewing all the angles the complainant has proved his case.
11. Under the above circumstances and viewing from all the angles the contention taken by the Respondent Nos. 1 & 2 regarding repudiation of the claim of the complainant is concerned, holds no good, hence we have rejected the same. So, to this extent we hold that the complainant has proved deficiency in service on the part of the Respondent Nos- 1 & 2. Hence Point No-1 is answered in the affirmative.
POINT NO.2:-
12. In view of our discussions and finding on Point NO-1 holding that the claim under policy is proper one, hence the complainant is entitled for to get death claim amount of Rs. 50,000/- and along with accrued bonus, other benefits along with future interest at the rate of 9% from the date of this complaint till realization of the full amount.. Further, we have decided to award an amount of Rs. 3,000/- towards cost of the proceedings and Rs. 2,000/- towards mental agony and hardship etc., in this view of the matter we pass the following order:
ORDER
The complaint of the complainant is allowed in part.
The Respondent Nos.1 & 2 shall pay Rs. 50,000/- in respect of death claim amount of the policy bearing No. 665061575 along with interest at the rate of 9% from the date of this complaint till realization of the full total sum of Rs. 55,000/-.
The Respondent Nos. 1 & 2 shall comply this order within (6) weeks from the date of receipt of copy of this order.
Office to furnish certified copy of this order to both the parties forth with free of cost.
(Dictated to the Stenographer, typed, corrected and then pronounced in the open Forum on 16-02-11)
Smt.Pratibha Rani Hiremath, Sri. Gururaj Sri. Pampapathi,
Member. Member. President,
Dist.Forum-Raichur. Dist-Forum-Raichur Dist-Forum-Raichur.
