Order
The complainant has filed her case on 23-09-2015 with claim of Rs. 10,99,989/- sum assured amount, and Rs. 1,00,000/- for mental, physical, harassment as well as litigation cost with interest @ 18 %.
The case of complainant appears from his complaint petition supported with an affidavit that her Husband Boonilal Ram has purchased policy from opposite party on 08-03-2014 bearing no.-70215474 and has paid first premium amount Rs. 99,999/- in which the complainant was made nominee as wife of D.L.A. The aforesaid insurance company used to take premium through direct debit i.e auto deduct from the account of Mr. Bunilala Ram exhisted in Axis Bank. Company has issued the premium receipt and bond in the name of her husband Boonilala Ram and started risk coverage of life of Boonilal Ram from 15-04-2014. The premium amount was annual. He has further alleged that the husband of complainant began to suffer from abdominal ache and dehydration from 29-07-2014 . He was treated by Dr. Y.K. Thakur at has clinic who has referred to P.M. C.H. Patna but unfortunately in the way he died on 30-07-2014 in insurance covered period, accordingly the complainant has filed death claim to the company with all relevant documents but the company has repudiated her claim on baseless, immaterial ground as such she has filed this case with aforesaid claim and prayed that the opposite party be directed to credit amount of her claim in the name of complainant bearing account no.- 940503. In District Consumer Forum Muzaffarpur.
The complainant has filed Xerox copy of policy schedule, insurance premium receipt dated 15-04-2014 for Rs. 99,999/-, death certificate issued on 13-09-2014 by Panchayat Secretary showing date of death is 30-07-2014, certificate of death dated 13-09-2014 from Mukhiya and Sarpanch, Dr. certificate dated 14-11-2014, the deceased was referred to P.M. C.H., Pan card and letter of repudiation dated 13-03-2015 on the ground that the L.A. had not discloses the other policies like SBI life for Rs. 3,57,500/- dated 15-07-2013 and ICICI prudential life Insurance company for Rs. 726178.80 dated 18-07-2013 which was latter on detected and it was also detected that L.A. has taken police from various insurance companies including Max life Insurance company of total sum assured Rs. 39/- lakh approximately. And decisions of Orissa State Consumer Dispute Redressal Commission published in III (2007) CPJ 246 and acknowledgement of income tax return receipts A.Y. 2012-13 & 2013-14 which are annexure- 1 to 6.
The complainant has filed written argument mentioning the same fact as alleged in her complaint petition only new fact has been added that the deceased has submitted his in come tax return for 2012-13 and 2013-14 which shows his income is Rs. 1,91,400/- and 2,18,200/- respectively.
In this case notice was issued to the opposite party for their appearance through registered post on 30-09-2015 and the notice was not returned unserved as such after given sufficient time the case was proceeded for Ex. Party hearing vide order dated 05-02-2016.
Accordingly heard the complainant only as Ex. Party.
Considering the facts, circumstances, material available with the record, it appears from the letter of repudiation dated 31-03-2015 that the opposite party has admitted the policy, sum assured amount as well as deposited of premium amount only the claim was repudiated. On the ground that D.L.A has not discloses the other policies which he had taken the opposite party not appeared and filed any objection as such we have no any other fact to discuss which goes to disbelieve the case of claimant.
Accordingly the case is allowed and the opposite party No.-1 is directed to pay Rs. 10,99,989/- insured sum amount with interest @ 8 % opposite party No.-1 is further directed to pay Rs. 25000/- and physical mental harassment as well as litigation cost. Both the payment should be made is A/c no.- 940503 through cheque in the name of complainant within 30 days of the order otherwise the complainant is entitle to get it recover from the process of law.
