Complaint Case No-40/2013,             Consumer Complaint                    Date of Pronouncement: 14.09.2022

IN THE COURT OF DISTRICT CONSUMER DISPUTE REDRESSAL COMMISSION WEST SINGHBHUM AT CHAIBASA

Date of institution: 21.10.2013

Date of Final hearing: 07.09.2022

Date of Pronouncement: 14.09.2022

C. C. Case No. 40/2013

IN THE MATTER OF

Smt. Sudha Verma, W/O Sri. Rajendra Prasad, thethen R/O Civil Court Seraikella, District Seraikella-Kharsawan .Jharkhand ……………………………..….................Complainant

                  Advocate for Complainant………........Sri P.K Ghosh, Advocate.

Vs.

Life Insurance Corporation of India Chaibasa Branch………………..Opposite Party

Advocate for Opposite Party…….....…Sri Amresh Kumar Sao, Advocate.

CORAM

                 1. Sri Vijai Kumar Sharma, President,

                 2. Sri Rajiv Kumar, Member,

                 3. Smt. Deoshree Choudhary, Member.

Present: -

                 1. Sri Vijai Kumar Sharma, President,

                 2. Sri Rajiv Kumar, Member,

                 3. Smt. Deoshree Choudhary, Member.

PER:  Sri Vijai Kumar Sharma, President.

JUDGEMENT

Present case has been filed by the complainant Sudha Verma W/O Rajendra Prasad, At present Resident of Europian Quarter Chaibasa P.O & P.S Chaibasa, District West Singhbhum against O.P life insurance Corporation Ltd for an award of Rs: 72410/- along with interest compensation and cost of litigation showing deficiency in service by O.P.

Briefly stated Complainant, named above,has made allegation against O.P that life insurance policy number 555313939 was taken in the name of her son Vishal Raj on 01.01.2009. Further that Vishal Raj met a road accident by unknown vehicle and succumbed injuries. Further that Policy Bond was taken for double benefit and in this regard complainant has made correspondence with O.P for obtaining insured amount and double benefit amount as being nominee. After that complainant was given only Rs. 72410.00 but O.P has not paid double benefit amount which is covered under the policy. Further that as per term and condition of insurance policy complainant is entitled to get equal amount as already paid to her by the Opposite party due to accidental death of insured i.e her son. After several correspondence when O.P did not pay double benefit amount equal to insured sum then instant case has been filed for an award of above mentioned, amount.

After notice O.P has appeared through counsel and petition dated 31.03.2015 showing grounds for contest has been filed on behalf of Opposite Party mentioning several legal grounds which includes violation and none compliance of the terms and conditions of the policy insured by Opposite Party. So far as legal ground is concerned it has been mentioned that complainant has not filed succession certificate in view of section -213,214 of the Indian Succession Act. Further that as per rules governing the life insurance Corporation since policy was issued in favour of minor so, accidental benefit of policy can't be given in respect of minor unless and until insured minor becomes major and furnished declaration in form no. 3772(R) regarding attaining of majority and subject to payment of extra premium, which has not been done in this case by the insured Vishal Raj, which should have been done after 05.03.2009 by the deceased cum insured Vishal Raj and in such situation claim of accidental benefit under the policy in question cannot be granted and accordingly prayer has been made to dismiss the case of the complainant.

The parties have adduced oral and documentary evidences in support of their case and during hearing of the learned counsels of respective parties following issues have been determined for adjudication.

Issue

1. Whether insured Vishal Raj has furnished required information/ declaration under the provision of form -3772(R) as mentioned by the Opposite Party?

2. Whether the complainant has to produce a succession certificate under Indian Succession Act before O.P for required relief?

3. Whether case of the complainant is maintainable showing deficiency of service by the Opposite Party?

4. Whether Complainant is entitled for any relief?

FINDING

Issue (i)

On perusal of the case record we find that the complainant has made averement in the complaint petition that a policy bearing life insurance policy number 555313939 was taken in the name of her minor son Vishal Raj and the nature of the Policy was double benefit scheme meaning there by if the insured expires due to accidental death then in addition to sum assured benefit of accident will be given to the nominee equal to sum assured in the policy. Further that death of her son took place due to an unknown motor vehicle accident date of commencement of the policy was 01.01.2009 and this fact was informed by the complainant to O.P after completing all formalities for claiming the double benefit scheme and after completing process O.P has paid complainant only Rs. 72410.00 through account payee cheque but benefit of accident i.e Rs. 72410.00 equal to assured amount and was under the life covering scheme was not paid. Further that since all premium have been paid before death of Vishal Raj and complainant is nominee, so, complaint is entitled for death benefit under double benefit scheme of the policy and conduct of the opposite party was not satisfactory and despite several correspondence made by the complainant when amount of accident death was not paid then complainant was forced to file case against opposite party showing deficiency in service.

Complainant has substantiated her averement by filling affidavited evidence as well as documentary evidence. On the other hand the case of the O.P is that, when policy was taken by the parents of insured cum deceased Vishal Raj then as per the document  of birth insured person was minor, because as per the CBSC board examination certificate Date of birth of Vishal Raj was mentioned as 5 March 1992 and since on the date of commencement of the policy Vishal Raj was minor and he became major on 05.03.2009 and as per the provision of rule 3772 for obtaining the double accidental benefit the person whose life was assured in the policy he has to declare in above mentioned form that he is agreed to the terms and conditions of double benefit scheme and also double benefit scheme of corporation and also subject to the payment of extra premium.

Since such declaration has not been made by the insured cum deceased Vishal Raj after obtaining majority, the complainant cannot claim the facility of double benefit in the same policy. So it is compulsory for the assured cum deceased to perform above mentioned formalities as per the rules framed by Government of India, governing the life insurance Corporation, the claim of complainant cannot be accepted. Further that sum assured under the policy scheme has already been paid to the complainant, without making delay, so, there is no deficiency in service on behalf of O.P.

During argument Learned counsel for the O.P has raised noncompliance of rule 3772 framed by Government of India governing life insurance Corporation and submitted that since deceased cum insured has not complied with the above declaration before his death and after obtaining majority, so, facility of double benefit of such  policy can't be provided to the complainant. On the other hand learned counsel of the complainant fairly conceded that there is no evidence on the record which can show that such compliance was done by the deceased cum insured Vishal Raj.

Admittedly the first benefit has already been provided by the Opposite Party in favour of complainant and accidental benefit was not provided on the ground that essential formalities through declaration in form no.3772(R) were not performed by the insured Vishal Raj after obtaining majority and in this regard there is no any evidence to show that such compliance was done by the above named insurer. So in such circumstances and keeping in view of above rules of Government of India governing life insurance Corporation we are of the view that the complainant is not entitled for the facility of double accidental benefit, and accordingly this issue stands decided against the complainant.

 Issue (ii)

Opposite Party has made averement through petition dated 31.03.2015 that claim of the complainant is based on nomination agreement with the O.P and since she being the nominee only, no amount is payable as per her claim, in view of the fact that a nomination is not succession rather claimant has to produce succession certificate under the provisions of section -213,214 of the India Succession Act and no any relief can be given by the complainant in favour of the claimant in absence of such certificate or letter of administration duly obtained from a competent court of law.

Learned counsel for the complainant has argued that O.P has earlier paid to the complainant sum assured i.e Rs. 72410.00 without seeking such certificates as claimed in para 2 of petition dated 31.03.2015, so in the subsequent proceedings O.P cannot raise ground for not producing succession certificate and he is estoppel from the provision of rule of estoppel. On this point learned counsel for the O.P has not replied convincingly.

On perusal of the averement of the parties it is admitted fact that O.P has paid first sum assured to the complainant without seeking such succession certificate, so, keeping in view the rule of estoppel he cannot be allowed to take such ground in the similar proceeding. So this issue stands disposed of accordingly.

Issue no. (iii)& (iv)

Although complainant has claimed in the complaint petition that by not paying facility of double benefit in this case, O.P has caused deficiency of service and she is entitled for an award of  Rs. 72410.00 along with compensation and litigation cost @12% per anum, but keeping in view in the finding given in issue no. (i) & (ii) we are of the view that O.P has not committed any deficiency in service, further that complainant is not entitled for any relief.

Accordingly it is therefore

ORDER

The case of the complainant is here by dismissed on contest but without cost. Further application pending if any, stands disposed of in terms of the aforesaid judgement. Further a copy of this judgement be provided to both parties free of cost for their information.

Further the judgement be uploaded forthwith on the website of the commission for the perusal of the parties.

    (Rajiv Kumar)                  (Deoshree Choudhary)               (Vijai Kumar Sharma)

        Member                                   Member                                         President

Pronounced On: 14.09.2022