Sri Purna Chandra Mishra, President
Complainant Sobharam Satnami @ Ugre has filed this case alleging deficiency in service on the part the OPs for non-payment of the death claim in respect of Rajesh Satnami @ Ugre inspite of repeated approaches and praying therein for a direction to the OPs to pay the insured amount Rs.2,00,000/- with pendalited and future interest @18% P.A from the date of accident till its realization , Rs.50,000/- as compensation for mental agony , financial hardship and deficiency in service and a sum of Rs.10,000/- towards cost of litigation.
1. Brief fact leading to the case is that the complainants are the dependants of one Late Rajesh Ugre @ Satnami who had obtain an insurance policy from the OP No.2 bearing proposal No.18335 dtd.15.03.2013. He was paying his premium regularly. During the force of the policy the insured Rajesh died of electrocution on 14.03.15 and the complainants came to know about the incident on 15.03.2015. Autopsy was conducted on the body of the deceased and a case was also registered in Beltukri PS corresponding to P.s Case No.10(1) dtd 14.03.2015 which was subsequently converted to CT No.15 of 2015 pending in the file of Ld. S.D.J.M, Nuapada. The complainant being the father, mother and brother are the legalheirs of the deceased and they are entitled to the benefit of the insurance policy. The complainant applied for the insured value along with all the relevant documents and the original policy bond but the OP is sitting over the claim till date for which, he has been compelled to knock at the doors of the Commission for the reliefs as discussed above.
2. After receipt of notice the OP No.3 appeared through his advocate and filed his written statement. The OP No.1, & OP No. 2 preferred not to appear or contest the case in any manner. The OP No.3 in his written statement stated that one Rajesh son of Sobharam of village Singhpur P.s-Beltukri had taken a policy bearing proposal No.18335, Policy No- 187034952, Plan 165 and for a term of 10 year commencing for 05.03.2013 under Salary Saving Scheme from Vijayanagar Branch of Ajmer Division of L.I.C of India and it is not true that Rajesh Ugre @ Satnami was the policy holder of this policy. They also can’t tell whether the complainants are his legal heirs or not? He was not paying him premium regularly and the premium was received and adjusted to 06-2014 with gap for 10-2013 and 04-2014. They have no knowledge of information about death of Rajesh Ugre. It is further pleaded that the policy of the life assured Rajesh was in lapsed condition without acquiring paid up value on 14.03.2015. It is the duty of the claimant who lodged the claim before the policy issuing branch that is OP No.2, with all his relevant documents which has not been done. As one Jagamoti Bai is the nominee in the policy, she has also not intimated regarding the death of the policy holder. As there is no deficiency in service on his part the case be dismissed with cost.
3. The complainant in support of his case has filed Copy of FIR, Copy of Charge Sheet, Copy of Inquest Report of insured deceased, Copy of P.M. Report, Copy of Dead Body Challan for P.M, Copy of Voter ID of Complainant, Copy of voter ID of insured deceased , Copy of identity card of insured deceased issued from RSWM Ltd, Rajasthan, Copy of Insurance Policy Bond vide Proposal No.18335 dated 15.03.2013 & Copy of Death Certificate & Copy of Aadhar Card Jagamoti Satnami. On the other hand the OP party has filed the copy of LIC Policy No.187034952 of Rajesh S/o: Sobharam issued by the Manager claims LIC of India, Ajmer.
4. In view of the pleadings and counter pleadings of the parties the only point on which the whole case revolves is whether the petitioners are entitled to get the benefit by the policy of late Rajesh.
5. It is seen from the documents on record that the name of the policy holder has been mentioned as Rajesh S/o: Sobharam. The same has been mentioned in the proposal form. But in the column meant for signature of the proposer, the name has been signed in the two parts. So it is crystal clear from the signature of the applicant that the name of the policy holder is not only Rajesh but it carries a surname also. The OP No. 2 while accepting the proposal form and subsequently before issue of the policy should clearly menention his full name along with the name of his father and his title. In the instant case the agent of the company, the development officer and the Branch Manager have acted in a very careless manner while filing and accepting the proposal form for which the complication has arose after his death. It is admitted by the OP in the written version that the policy bond is available with them. So the statement of the complainant that he filed the original policy bond with the OP is correct. The OP No.3 is only challenging the identity of the deceased on the ground that the policy bond is in the name of Rajesh. When the original policy bond was with the complainants and nobody else has come forward so far to claim the insurance benefits there is no doubt that the complainants are his legal heirs. Since the OPs are illiterate persons, they have submitted all the relevant documents whatever was with them being unable to read or write . There was no doubt that, the OPs could have very well established his identity by calling from his service record from the custody of his employer as this was a policy under Salary Saving Scheme.
6. Under the circumstances the OPs have not at all attempted to enquire either through their officers or through an investigator to ascertain the actual identity of the claimants.
7. It is settled Principle of Law that where the OPs in spite of receipt of notice from this Commission neither appeared not raised any objection to the allegation made by the complainants it is deemed to have been admitted by them. In the instance case the OP No.1 and 2 neither appeared nor challenge the allegation raised against them in any manner.
8. It is seen from the Aadhar Card filed by the mother of the complainant that her name is Jagamoti Satnami W/o- Sobharam Satnami. It is revealed from the copy of the proposal from filed by the OPs that Jagamoti Bai as the nominee of the Policy holder, and her relationship with the deceased policy holder is of mother and son.
9. From the proposal form it is clear Rajesh was the insured, and the name of his father is Sobharam and Jagamoti is the mother of the deceased. So there is a connecting link, between Rajesh and Sobharam and between Rajesh and Jagamoti. So from the documents on record it is well established that the petitioner No.2 was the nominee in the policy. The OPs as discussed earlier have acted in a very careless and haphazard manner while filing and accepting proposal from and have attempted to take advantage of their own wrong which is not permissible under law. It is settled principle of law that the insurance company cannot take advantage of their own wrong for repudiating a genuine claim besides, the OPs wants to defeat the claim of the petition by raising technical questions.
10. The Insurance company filled up the proposal form in a very negligent and haphazard manner, accepted the proposal form, subsequently in a causal manner raised technical questions to defeat the claim of the complainants by taking advantage of their own wrong which is not acceptable in the eyes of Law. The OPs have failed to established that the policy holder Rajesh is a different person and the name of the father and the mother are also of different entities in the same locality under the address given in the proposal form. The OPs also have not uttered a single line, how the original policy bond was made available with the complainants if it is not owned by them. In the absence of all these things the OPs simply can’t deny payment to the complainants.
11. The OPs could have released the payment if they had any doubt regarding the identity of the claimants by asking them to furnish indemnity bonds, which the OPs have not done.
12. In view of the discussion made in the preceeding paragraphs a case of deficiency in service coupled with utter harassment is made out against the OPs and the OPs are liable to compensate the petitioners for the loss and harassment caused to hence the order.
O R D E R
The complaint petition is allowed on contest against OP No.1 and 2 and dismissed against OP No.3. The OP No.1 & OP 2 are made jointly and severally liable for causing deficiency in service and harassment to the petitioners. The OP No.1 & OP 2 are directed to pay a sum of Rs. 2,00,000/- to the complainants with interest @ 9% P.A from the date of claim till it is actually paid to the complainants. The OP No.1 & OP No.2 are further directed to pay a sum of Rs.30,000/- as compensation towards deficiency in service and harassment and a sum of Rs.6,000/- towards cost of litigation. The order is to be complied with in a period of 30 days from the date of receipt of this order.
