Present         (1)     Nisha Nath Ojha,   

                              District & Sessions Judge (Retd.)                                                                                         President

                    (2)     Smt. Karishma Mandal,

                              Member

Date of Order :  29.02.2016

                    Nisha Nath Ojha

1. In the instant case the Complainant has sought for following reliefs against the Opposite party:-

1. To direct the opposite party to award the sum insured of Rs. 1,25,000/- to the complainant.
2. To pay Rs. 1,00,000/- ( Rs. One Lakh only ) as compensation.
3. To pay Rs. 50,000/- ( Rs. Fifty Thousand only ) as litigation costs.

2. Brief facts of the case which led to the filing of complaint are as follows:-

The complainant Nirjula Devi is the nominee of his mother Devmuni Devi ( Demani Devi ). It is the case of the complainant that her mother Demani Devi was insured for Rs. 1,25,000/- with opposite party, L.I.C. for a period of 28.12.2009 to 28.09.2024 and the complainant was nominee in this policy.

It is further case of the complainant that insured continuously paid her premium on regular basis but unfortunately she died on 28.11.2010 ( vide annexure – 2 ). Thereafter this complainant filed claim petition and continued to approach the authority for benefit and thereafter when she failed to get the benefit she engaged a lawyer and gave a legal notice to the opposite party ( vide annexure – 3 ). Thereafter opposite party became furious and repudiated her claim ( vide annexure – 4 ) on flimsy ground.

On behalf of opposite party a counter affidavit has been filed in which it has been asserted that deceased withheld information regarding her earlier policy, age proof and qualification in the proposal form submitted for the policy in question and as such violated the terms and conditions of the policy intentionally.

It has been further asserted that “the deceased had deliberately suppressed facts about her earlier policy in question no. 9 of the proposal form at the time of taking the policy in question. Two policies were taken earlier by the deceased ( life assured ) bearing policy no. 513434836 and 515879264 earlier which were issued on thumb impression at the Barh Branch of the answering opposite party where as the policy in question was taken by the deceased life assured by putting her signature on the proposal form.”

The learned counsel for the complainant has submitted that deceased being illiterate might have got educated by someone and was able to sign.

It has been further submitted that ground on which the claim of the complainant stands repudiated is frivolous and technical in nature.

The counsel for the opposite party vehemently opposed the claim of the complainant and supported the ground mentioned in written statement of opposite party.

We have heard the counsel for the parties and perused the annexures filed by them.

From perusal of Para – 4 of Complaint petition as well as Para – 6 of written statement of opposite party it is crystal clear that the claim of the complainant have been repudiated broadly on two grounds. Firstly the deceased had taken two policies earlier wherein she has put thumb impression at Barh Branch of opposite party whereas in the policy in question she has put her signature on the proposal.

In this connection it is needless to say that the deceased belonged to very poor class of the society and from bare perusal of notice dated 20.01.2014 which has been annexed on page – 11 of the complaint petition it appears that she might have got educated under adult education program and as such she was able to sign later on. So far 2^nd ground of rejection is concerned it goes without saying that the agents who approaches any one for purchasing Insurance policy do not explain everything to the person whom they are going to insure. The deceased who belong to lower strata of the society and come from a rustic family might not have been explained by the agent at the time of purchasing the Insurance Policy because if she would have been informed about the real fact then she would not have purchased another policy and invested her hard earned money in paying the premium.

Apart from it, the insured is no more and the claim has been filed by her nominee who had no hand in the entire episode.

There is no proof that the deceased had deliberately purchased the insurance policy “ INTENTIONALLY ” after knowing the fact that she or her nominee are not going to be benefited from the policy in question.

No purpose will be served in repeating the same fact again and again.

It goes without saying that the L.I.C. aims to help the policy holder/nominee at the time of emergency and as such it has to act in such a way as to help the society and needy instead of acting in mechanical and technical manner.

For the discussion made above, we find and hold that by not allowing the claim of complainant the opposite party has committed deficiency.

Hence we direct the opposite party ( Senior Divisional Manager ) to pay the amount covered under the Insurance Policy i.e. Rs. 1,25,000/- ( Rs. One Lakh twenty Five Thousand only ) to the complainant within the period of two months from the date of receipt of this order or certified copy of this order failing which the opposite party will have to pay an interest @ 12% on the aforesaid amount till its final payment.

We further direct the opposite party to pay Rs. 25,000/- ( Rs. Twenty Five Thousand only ) to the complainant by way of compensation and litigation costs within the period of two months.

Accordingly, this complaint stands allowed to the extent indicated above.

                                        Member                                                                   President