Tripura

StateCommission

A/19/2017

Life Insurance Corporation of India - Complainant(s)

Versus

Smti. Ranjani Debbarma - Opp.Party(s)

Smt. Puspita Chakraborti

30 May 2017

ORDER

Tripura State Consumer Disputes Redressal Commission, Agartala.

 

 

Case No.A.19.2017

 

 

1. Life Insurance Corporation of India Ltd.,

Agartala Branch No.1,

Paradise Chowmuhani, (Hospital Road Extension),

P.S. West Agartala,

District - West Tripura, Agartala.

 

2. Life Insurance Corporation of India Ltd.,

Silchar Divisional Office,

Jeevan Prakash, Meherpur,

Silchar - 15, State of Assam,

[Both are represented by the Manager, Administrative].

 

… … … … … … Appellant/Opposite parties.

 

•  

 

1. Smt. Ranjani Debbarma,

W/o Late Aghore Debbarma.

 

2. Sri Runu Debbarma,

S/o Late Aghore Debbarma.

 

3. Sri Sukumar Debbarma,

S/o Late Aghore Debbarma.

 

4. Smt. Anjana Debbarma,

D/o Late Aghore Debbarma.

 

5. Smt. Baishakhi Debbarma,

M/o Late Aghore Debbarma.

… … … … … … Respondent/Complainants.

 

Present

Mr. Justice U.B. Saha,

President,

State Commission, Tripura.

 

Mrs. Sobhana Datta,

Member,

State Commission, Tripura.

 

Mr. Narayan Ch. Sharma,

Member,

State Commission, Tripura.

 

For the Appellants:                                              Ms. Puspita Chakraborty, Adv.

For the Respondents:                                          Mr. Bijan Saha, Adv.           

Date of Hearing & Delivery of Judgment:            30.05.2017.

J U D G M E N T [O R A L]

 

U.B. Saha,J,

The instant appeal is filed by the appellants, Life Insurance Corporation of India Ltd. represented by its Manager Administrative against the judgment dated 08.02.2017 passed by the Ld. District Consumers Disputes Redressal Forum (hereinafter referred to as District Forum), West Tripura, Agartala in Case No. C.C. 89 of 2016 along with an application for condoning the delay of 30 days in preferring the appeal.

3. Heard Ms. Puspita Chakraborty, Ld. Counsel appearing for the appellants, Life Insurance Corporation of India Ltd. (hereinafter referred to as opposite party/Insurance Company/LICI) on the application for condoning the delay for filing the instant appeal. Heard also Mr. Bijan Saha, Ld. Counsel appearing on behalf of the respondents (hereinafter referred to as complainants) who has no objection to the prayer for condonation of delay. 
4. We have gone through the reasons for delay as explained in the condonation petition. According to us, the delay has been properly explained. Thus, the delay of 30 days in preferring the appeal is condoned. The condonation petition is disposed of.
5.  As agreed to by the Ld. Counsel appearing for the parties, the appeal is taken up for final disposal at this admission stage itself.
6. Heard Ms. Chakraborty, Ld. Counsel appearing on behalf of the opposite party-Insurance Company as well as Mr. Saha, Ld. Counsel appearing for the respondent-complainants.
7. Facts needed to be discussed are as follows:-

The complainants five in numbers filed an application under Section 12 of the Consumer Protection Act before the Ld. District Forum alleging that the husband of respondent-complainant no.1 and the father of respondent-complainant nos. 2 to 4 and the son of respondent-complainant no.5, Aghore Debbarma purchased one insurance policy, being policy No.492929701 which commenced from 24.05.2012 for Rs.15 lacs. During the existence of the policy on 03.01.2013, the aforesaid Aghore Debbarma died. Complainant-respondent no.2 being the nominee along with other complainants as legal heirs had approached for the death claim of their predecessor before the opposite party-Insurance Company, but the opposite party-LICI did not take step for satisfying the claim. Thereafter, a demand notice was served upon the opposite party in the year 2016. In spite of the demand notice, the opposite party-Insurance Company did not fulfil/settle the claim.

Being aggrieved by the action of the opposite party-Insurance Company, the complainants filed the aforesaid complaint case for the assured amount along with other benefits and also Rs.50,000/- for mental pain and agony as well as the cost of litigation.

Opposite party, LICI appeared and filed written statement denying the claim. It was contended that original policy certificate was not produced till 18.01.2016 and ultimately, they submitted and when it was produced, then the claim was under process and it would be satisfied soon. It was also contended that the complainants had given false statement at the time of purchasing the policy. The deceased assured disclosed his age as 38 years at the time of purchasing policy, but as per postmortem report, his age was 50 years at the time of his death. It was an early claim where death occurred after six months from the date of commencement of the policy. Thus, some query was done by the opposite party. Hence, there was no deficiency of service.      

8. Ms. Chakraborty, Ld. Counsel submits that admittedly, the opposite party-Insurance Company in its written statement specifically stated that the claim of the complainants for the assured amount would be satisfied soon. She also submits that the findings of the Ld. District Forum that the age in the postmortem report is not the proof of age, cannot be accepted. According to her, the grievance of the opposite party-Insurance Company is not for the assured amount, but regarding the direction of the District Forum so far the payment of Rs.10,000/- to the complainants for deficiency of service and Rs.3,000/- as cost of litigation.
9.   Mr. Saha, Ld. Counsel appearing for the respondents-complainants while supporting the impugned judgment would contend that assured Aghore Debbarma did not make any false statement at the time of purchasing the policy, which would be evident from the cross-examination of opposite party-Manager Administrative of LICI, Agartala, as in his cross-examination, he specifically stated that they had collected the age proof of the deceased insured from his employer and found that his age was 38 years at the relevant time. He further submits that after getting the information of death of the assured, the opposite party-Insurance Company was supposed to complete their necessary enquiry within three months from the date of receipt of the claim, but the same was also not done.
10. We have gone through the impugned judgment as well as the evidence on record. It appears from paragraph-3 of the written statement, wherein the opposite parties distinctly stated that “the claim is under process of consideration and the opposite party is waiting for some information from the employer of the deceased life assured for which the opposite party informed them by letter dated 05.09.2016 and also the reminder dated 25.11.2016. So, there is no deficiency on the part of the opposite party as alleged by the complainant”. Before the Ld. District Forum, the opposite parties specifically stated that they could not settle the matter, as original policy certificate was not produced by the respondent-complainants and not only that, there was also a dispute regarding the age of the deceased assured. The Ld. District Forum in paragraph - 9 & 10 of its judgment clearly stated that the opposite parties in their evidence stated that the policy certificate was not produced and it was lost in the year 2014 and later, it was received. Original policy certificate is not required as the copy of the same is preserved by the LICI. Regarding the dispute of age of the deceased assured, the Ld. District Forum very rightly said that postmortem report cannot be treated as a proof of age, particularly, when the opposite party LICI collected the age proof of the deceased assured from his employer. It is also admitted position that the Insurance Company had no point of time repudiated the claim of the complainants, but took some time for enquiry of the facts raised by the complainants.  
11. In view of the above, the Ld. District Forum rightly directed the appellant-Insurance Company to pay the sum assured amounting to Rs.15 lacs to the nominee of the policy, Runu Debbarma who is to distribute the amount to four other legal heirs equally. But so far findings regarding the deficiency of service, we are of the opinion that, when the original policy certificate was not available initially, but subsequently, the same was received and also regarding the age of the deceased, there was some disputes for which the opposite party-Insurance Company had to go for some enquiry, but that should not go beyond three months from the submission of the claim petition before the opposite party-Insurance Company. Thus, there was some deficiency of service, but according to us, the amount of Rs.10,000/- as ordered by the District Forum is higher in side, it should be Rs.5,000/- instead of Rs.10,000/-. We are not interfering with the direction regarding cost of litigation, as the opposite party-LICI not only dragged the respondent-complainants to the District Forum, but also to this Commission by way of preferring the appeal.
12. In view of the above, we direct the opposite party-LICI to pay the sum assured of Rs.15 lacs to the nominee of the policy, Runu Debbarma. Then the amount shall be distributed among the five legal heirs i.e. the nominee of the policy and four other legal heirs equally within one month from the date of receipt of the amount. We also direct the opposite party-LICI to pay Rs.5,000/- to the complainants for deficiency of service and also to pay Rs.3,000/- as cost of litigation in addition to Rs.15 lacs along with other benefits, if any. The amount is to be paid within six weeks from today, if not paid it will carry interest @9% per annum from the date of the judgment delivered by the Ld. District Forum.

Accordingly, the judgment of the Ld. District Forum is modified to the extent as indicated above. Appeal is partly allowed.      

Send down the records to the Ld. District Forum, West Tripura, Agartala.

 

 

MEMBER State Commission Tripura MEMBER State Commission Tripura PRESIDENT State Commission Tripura