In the matter of an application filed by the complainant alleging deficiency in service by the opposite parties.

The factual matrix of the case is that :-

          The complainant is the father and nominee of the deceased insured Radhakanta Padhan.  Deceased Radhakanta Padhan was an employee of O.P. No. 1 & 2 and O.P. No. 2  is the Drawing and Disbursing Officer of the deceased.  During the life time of Late Radhakanta Padhan he has insured his life with L.I.C. of India under Salary Saving Scheme of Money Back Plan with Profit vide Policy No. 583775395 on regular payment of monthly premium of Rs. 544.00 for sum assured of Rs. 1,00,000/- with accidental benefit of sum assured i.e. one lakh in case of accidental premature death of insured and also he had obtained another insurance policy with L.I.C. of India vide Policy No. 583775932 under Salary Saving Scheme of money back plan with profit for sum assured amount of Rs.55,000/- monthly premium of Rs. 299/- with accidental death benefit of sum assured amount in case of premature accidental death of the insured.  The policy holder Radhakanta Padhan has nominated his father to receive all the insurance benefit under the said two policies in case of his premature death.  Unfortunately the insured met an accident on 27.11.2011 at Tarbod, P.S. Komna, Dist. Nuapada resulting his death on 28.11.2011 and the matter reported to the Komna Police Station in district Nuapada vide F.I.R. No. 128, dated 28.11.2011 corresponding to G.R. Case No. 399/2011 of the Court of S.D.J.M., Nuapada.  The inquest and postmortem report of the insured was conducted by Komna Police Station and submitted final form of the case.  Thereafter, the complainant had claimed the insurance benefit before the O.P. No. 3 & 4 which is partly accepted by the L.I.C. of India for which the complainant suffered financial loss and mental agony.  Being asked by  the  O.P. No. 3  &  4 time  to time  the  complainant has

submitted the necessary documents i.e. F.I.R., Final Form, Inquest report, postmortem report of deceased insured and also Bank Passbook, I.D. Proof and all other documents as and when required by the authorities of L.I.C. of India for full and final settlement of the death claim.

          The insurance benefit claim on account of the accidental death of the deceased insured is admitted by the LIC of India as ex-gratia basis and repudiated the claim of accidental benefit under the said two policies taking the plea of gaps as on date of the death of the insured, which is intimated to the claimant on belated stage on 06.03.2015 by O.P. No. 3  to harass the claimant for their financial loss and mental agony.

          It is also stated that LIC of India has arbitrarily and illegally repudiated the accidental death benefit to the complainant on the said two policies is clear instance of negligence, unfair trade practice and deficiency of service on the part of LIC of India.

          The cause of action arose on 06.03.2015 when the LIC of India through O.P. No. 4 repudiated the accidental death benefit claim under said two policies and settled the claim arbitrarily in ex-gratia basis to the complainant.  As such the complainant claim for reliefs as prayed for.

          The complainant has filed the documents in support of their claim as under :-

1. Letter of repudiation of accidental death benefit dated 06.03.2015 issued by the Branch Manager, LIC of India, Cuttack (O.P. No. 4) (Annexure-1).
2. Xerox copy of policy bond vide Policy No. 583775395 as original has been submitted to the O.P. No. 4 (Annexure-2).
3. Xerox copy of policy bond vide Policy No. 583775932 as the original has been submitted to the O.P. No. 4 (Annexure-3).

4. Acknowledgement of receipt of documents from the claimant on 16.08.2012 (Annexure-4).
5. Xerox copy of T.V. Certificate dated 03.10.2012 issued from DDO, SOG, Bhubaneswar as the original is submitted to the O.P. No. 4 (Annexure-5).
6. Letter dated 17.12.2012 relating to Policy No. 583775395 issued from O.P. No. 4 (Annexure-6).
7. Letter dated 17.12.2012 relating to Policy No. 583775932 issued from O.P. No. 4 (Annexure-7).
8. Xerox copy of T.V. Certificate dated 10.07.2015 issued from DDO, SPG. Bhubaneswar (O.P. No.2) as the original is submitted to the O.P. No. 4 (Annexure-8).
9. Xerox copy of letter dated 25.10.2014 issued from P. Sr. Divisional Manager, Claimant Department, Cuttack Divisional Office, LIC of India to the complainant (Annexure-9).
10. Attested xerox copy of FIR in G.R. Case No. 399/2011 (Annexure-10).
11. Xerox copy of Final Form in G.R. Case No. 399/2011 (Annexure-11).
12. Xerox copy Inquest report in G.R. Case No. 399/2011 (Annexure-12).
13. Xerox copy of postmortem report in G.R. Case No. 399/2011 (Annexure-13).
14. Xerox copy of Bank Account of complainant (Annexure-14).
15. Xerox copy of Statement of account (Annexure-15).
16. Xerox copy of Bank account of complainant (Annexure-16).
17. Xerox copy of statement of account (Annexure-17).

All the above documents are related to deceased Radhakanta Padhan.

Being noticed, Government Pleader has appeared on behalf of O.P. No.1.  O.P. No. 2 appeared and filed their written version alongwith xerox copies of document i.e. pay slip from August-2011 to November-2011 (Annexure-1) and Xerox copy of LIC Schedule from August-2011 to November-2011 (Annexure-2).  O.P. No. 2 also stated in their version that he has taken appropriate steps

regarding deduction of LIC Premium from the salary of deceased and he denied the allegation against him.  O.P. No. 3 & 4 neither appeared nor file any written version in this case.  O.P. No. 5 appeared and filed their written version without any documents and he has admitted the double accident benefit as well as the cause of delay of payment to the complainant.

In the above pleadings, the following issues are framed and considered :-

1. Whether the complainant is a consumer or not  ?
2. Whether the complaint is maintainable in the eye of law  ?
3. Whether the Forum has jurisdiction to adjudicate upon and there is cause of action  ?
4. Whether any negligence and deficiency in service on the part of the O.Ps  ?
5. To what relief the complainant is entitled to  ?

ISSUE No. I to IV.

          Since the issues are very much linked up with each other, those are taken up for jointly discussion and findings.

          On the first stage, the question of status of a consumer should be cleared.  On perusal of case records it is found that the complainant is father and nominee of the deceased insured Radhakanta Padhan.  Deceased Radhakanta Padhan was an employee of O.P. No. 1 & 2. 

During the life time of Late Radhakanta Padhan he has insured his life with LIC of India under Salary Saving Scheme of Money Back Plan with Profit vide Policy No. 583775395 on regular payment of monthly premium of Rs. 544/- for sum assured of Rs. 1,00,000/- (Rupees one lakh)  with accidental benefit of sum assured i.e. one lakh in case of accidental premature death of insured and also he  had  obtained  another  insurance  policy  with  LIC  of  India vide Policy No.

583775932 under salary saving scheme of money back plan with profit for sum assured amount of Rs. 55,000/- of monthly premium of Rs. 299/- with accidental death benefit of sum assured amount in case of premature accidental death of the insured.

          In another factual aspect is that the insured met an accident on 27.11.2011 and he died on 28.11.2011 and the matter reported to Komna Police Station in written by the complainant and thereafter the complainant had claimed the insurance benefit before the O.P. No. 3 & 4 and it was partly accepted by the LIC of India for which the complainant suffered financial loss and mental agony though the complainant has submitted the necessary documents before the O.P. No. 3 & 4 in time to time as and when required by them for final settlement of the death claim.

          Further it is seen that the insurance benefit claim on account of the accidental death of the deceased insured is admitted by the LIC of India as ex-gratia basis as per Annexure-1 and repudiated the claim of accidental benefit under the said two policies taking the plea of gap of payment of LIC premium in respect of two policies of the deceased.  But as per the written version as well as the documents of O.P.No.2  it is seen that O.P. No.2 has taken appropriate steps regarding deduction of LIC premium from the salary of deceased Radhakanta Padhan, Ex-C/ 365 regularly  in time without any gap and delay.

          Further it is seen that O.P. No. 5 has stated and admitted in their written version in Para 1 is that “As intimated by Manager (Claims) L.I.C. of India, Cuttack Division the disputed “ DAB (Double Accident Benefit) has been admitted by the competent authority.  He has also admitted in Para 3 of the written version regarding the cause of delay of payment to the complainant.

          In another aspect is that O.P. No. 4 has deposited an amount of Rs. 56547.00+1,03,356.00 = in total Rs. 1,59,903.00 (Rupees one lakh fifty nine thousand nine hundred and three) only in the Savings Bank Account of complainant  in  State  Bank  of  India bearing Account No. 32085782253 dated

19.12.2012 through NEFT as the complainant has admitted the same as per Annexure-6 & 7.

          In another factual aspect is that after institution of the case against the O.Ps, the O.P. No. 4 has again deposited an amount of  Rs.55,000.00+1,00,000.00= in total of Rs. 1,55,000.00 (Rupees one lakh and fifty five thousand) only in the Savings Bank Account of complainant in State Bank of India bearing Account No. 32085782253 dated 21.01.2017 through NEFT as the complainant has admitted the same as per Annexure-15 & 17.

          In another vital point is that O.P. No. 4 has received all the claim documents from complainant on 16.08.2012 as per Annexure-4 but not taken any action properly and the payment of policy to the complainant is inadequate. 

          In another vital point is that the cause of delayed explained by the O.P. No. 5 is squarely unjustified and not satisfactory.  It is asserted that the cause of delayed is purely in purview of O.P. No.  3 to 5 and as such they are vicariously liable for deficiency in service.

          Further it is seen that there is no any negligence or any deficiency in service from the side of O.P. No. 1 & 2 and as such they are not liable in this case.

          In another point is that during the life time of deceased he has done two policy in L.I.C. of India and its policy No. 583775395 and 583775932 as “ Sum Assured” and the term and conditions of the policies clearly speaks in Clause 10 (2) Accident Benefit “ If at any time while this policy is in force for the full sum assured the life assured ”. and in Clause 10 (b) – Death of the Life Assured :- “ To pay an additional sum equal to the sum assured under this policy ”.  the above two policies are Annexure – 2 and 3.).

          In another most vital point is that O.P. No. 4 has received all the necessary documents from complainant on 16.08.2012 as per Annexure – 4 and he acknowledged the same and after verification of the said documents, O.P. No. 4  as  well  as  O.P. No. 3  &  5 are duty bound to pay the entire benefit

amount of the said two policies at a time in one day to the complainant as per the term and conditions of the policies.

          But, here, it is seen that O.P. No. 4 has deposited the money in the account of complainant in two installments in a long gape i.e. 19.12.2012 and 21.01.2017 is delayed around 4 years 5 months and 5 days by the O.Ps are illegal for which the complainant has suffered a lot of financial loss, mental agony and harassment.

          As per Consumer Protection Act, 1986 Section 2(d)(ii)  explain Consumer means any person “ who hires or avails of any services for a consideration which has been paid or promised or partly promised of any system of deferred payment and includes any beneficiary of such services other than commercial purpose ” so the status of consumer cannot be deniable and thereby the maintainability and also Section 1(iv) of the C.P. Act is of wide connotation.

          Here, the complainant is a resident of village – Tarbod, P.S./Dist:- Nuapada as well as the office of O.P. No. 5 at Nuapada, Dist. Nuapada.  So the complaint is within the jurisdiction of the Forum and this Forum has wide jurisdiction to adjudicate the present dispute and the complaint has cause of action.

          The Hon’ble Supreme Court has held in the case of GHAZIABAD DEVELOPMENT AUTHORITY  V/S  BALBIR SINGH  that each and every element of suffering while availing service as a consumer has to be taken into consideration while compensating him for the loss or injury or otherwise suffered by him due to negligence of deficiency in service of the service provider.

          In further the Apex Court has held that the remedy under the Consumer Protection Act is an addition and not in a derogation of any other law.

          It is also seen that the advocate for complainant has filed a written argument and an affidavit in support of their claim and also he has filed an another affidavit and stated that he has not file any complain or any claim in any other Court of Law except this Forum.

Perused the documents of complainant as well as the O.P. No. 2, we found that the claim of complainant is justified and legal and as such taken in consideration.

          Hence, it is apparent from the above issues that there is a deficiency of service by the Opposite Party No. 3 to 5 as not attending properly to the grievance  of the complainant for which the complainant is suffering financial loss and mental agony due to negligence and deficiency of service by the Opposite Party No. 3 to 5.

          So, we are of considered opinion that there is a deficiency in service by the Opposite Party No. 3 to 5.  Thus the Opposite Party No. 3 to 5 are liable for deficiency in service.

          So, accordingly, the issues answered and goes in favour of the complainant.

ISSUE No. V.

          It is clear crystal that the complainant has proved his case and he is entitled to get relief in this case.  Hence, order.

                                            O R D E R.

          In the aforesaid matrix of facts and circumstances, the complaint is allowed and we direct U/s 14 (i) (d) of the Consumer Protection Act, 1986 as below :-

1. We direct the Opposite Party No. 3 to 5 to pay the only interest @ 9%( Nine percent) per annum on the amount of Rs. 3,14,903/- (Rupees three lakhs fourteen thousand nine hundred and three) only from 16.08.2012 to 19.12.2012 to the complainant and also we further direct  the O.P. No. 3 to 5 to pay the only interest @ 9% (Nine per cent) on the amount of Rs. 1,55,000/- (Rupees one lakh and fifty five thousand) only from 19.12.2012 to 21.01.2017 to the complainant within 45 (forty five) days from the date of order, failing which the O.P. No. 3 to 5 are liable to pay the interest @ 12%  (Twelve per cent)  per annum  each  over  the  above  amount  till   payment.

2. We further ddirecty the Opposite partiy No. 3 to 5  to pay Rs. 10,000.00 ( Rupees Ten thousand) only  to the complainant  as compensation  towards  mental agony  and harrassment  and to further pay  Rs. 5,000.00 ( Rupees  Five thousand) only  towards  litigation  cost  within  45 ( Forty five) days  from  the date of order.
3. Failing which the above order, the complainant  is at liberty to take  steps as per process of laws.

          Judgment pronounced in the Open Court of the District Consumer Disputes Redressal Forum, Nuapada, this the 31^st day of October 2017.