O R D E R

AS PER SRI T.SRIRAMA MURTHY, PRESIDENT

This is a complaint filed U/s-12 of C.P.Act seeking the relief to direct the respondents to pay an amount of Rs.50,000/- towards the policy with interest at the rate of 24 percent per annum and to pay Rs.20,000/- towards damages for causing mental agony and to pay costs of the complaint on the following averments:-

The complainant is the son of policy holder by name Appala Naidu who died on 12.05.2011 at Kanipeka. The deceased purchased a policy for Rs.50,000 from the 1^st respondent vide policy No.17740065.  The policy covers the risk for a period of 10 years. The deceased nominated the complainant as his nominee to receive the policy benefits in the event of his death.  Since the deceased died on 12.05.2011 and as the policy was in force as on that day the complainant being his son and nominee made a claim to the OP’s for payment of policy amount and as the 1^st OP did not respond to the request of the complainant the latter made enquiry and learnt that the agent and Sales Manager played fraud on the deceased by issuing a fake policy.  However they have remitted the amount to the company account of respondents.  Since the amount paid by the deceased was lying in the accounts of respondents the complainant got issued a notice to the OP’s. Calling upon them to pay the amount due and though the 1^st OP has received the notice he did not respond to the same.  Since the OP’s were dereliction in their duties and as there is deficiency in service on their part the present complaint is filed seeking the above said relief.  The OP’s filed counter traversing the material allegations made in the complaint and have averred that the deceased having gone through the terms and conditions of the policy has submitted duly signed proposal form for issuance of policy document and accordingly the OP’s having received premium have issued policy bearing no.17740065 and sent the same to the policy holder to his mail address.

It is averred that after death of policy holder the complainant did not make any claim for payment of policy amount.  It is averred that the complaint is prematured   and the claim is made basing on surmises and conjuctures and as such the complaint is liable to be dismissed.

To substantiate the case of complainant the Affidavit evidence of PW1 is filed and exhibits A1 to A3 are marked on his behalf.  Per contra the OP’s filed the affidavit evidence to RW1 and got marked exhibits B1 to B5.

Heard the counsel for respective parties and perused the material placed on record.

Now the point for consideration is whether the complainant is entitled to get the reliefs prayed for.

The learned counsel for the complainant has contended that as seen from the material placed on record the complainant could prove that the deceased Appala Naidu has deposited a sum of Rs.50,000/- towards the policy No-17743365 and after demise of Appala Naidu the complainant being the son of policy holder and nominee has made a claim with the OP’s for the said sum and as the OP’s did not  settle the claim there is any amount of deficiency in service on their part and as such the complainant is entitled to get the reliefs prayed for.  As against the above said contention the learned counsel for the OP’s has contended that the complainant did not approach the OP’s for settlement of claim with the relevant documents and as the complainant himself was at fault for not making proper claim, his claim for the policy amount was not settled and as the OP’s were not dereliction in their duties and as there is no deficiency in service the complaint is liable to be dismissed.

To substantiate the claim of complainant the complainant filed his Affidavit evidence and also got marked the zerox copy of policy schedule, copy of death certificate of Appala Naidu, copy of legal notice and got the same marked as exhibits A1 to A3.  As seen from above said documents it is manifest that the deceased Appala Naidu has paid Rs.50,000/- towards the policy and when he died on 12.05.2011 the complainant being the son and nominee of the deceased got issued a notice calling upon the OP’s to settle the claim.  In the counter filed by the OP’s it is averred that the complainant did not approach them and did not make any claim as per terms and conditions of the policy and IRDA regulations and as he did not file the relevant document his claim could not be settled.  As seen from the contents of written statement the OP’s did not dispute about receipt of 50,000/- from the deceased                         towards the insurance policy.  The only contention of the OP’s is that the complainant did not submit the relevant documents and did not make any claim as per law.  The OP’s miserably failed to prove the above said fact to the hilt.  As seen from the contents of exhibit A3 notice dated 27.12.2011 after demise of the deceased the complainant made a claim to the OP’s to pay the policy amount but the OP’s did not heed to his request.  The OP’s have received the above said notice but they did not issue any reply to the same. If the OP’s are true in their contention they would have got issued a reply to exhibit A3 notice.  Since the OP’s did not pay the policy amount to the complainant and as they have failed to prove that no claim was made by the complainant in this regard they are liable to pay the policy amount along with other benefits to the complainant.

Since the OP’s did not settle the claim of complainant and made him to make correspondence and to approach the Forum to get his grievances redressed we are of the considered opinion that the complainant must have suffered mental agony and discomfort to get the amount from the OP’s.

In the result the complaint is allowed partly and the OP’s are directed to pay Rs.50,000/- with interest at 9% per annum from the date of the complaint till date of realization and also to pay Rs.5,000/- towards damages and Rs.2,000/- towards cost which includes the Advocate fee of Rs.1,000/-.  The OP’s are directed to comply this order within two months from today.

Dictated to the Steno, transcribed by him, corrected by me and pronounced by us in the open Forum, this the 6th day of January, 2014.

MEMBER                                  PRESIDENT

C.C.No.13 / 2014

APPENDIX OF EVIDENCE

WITNESSES EXAMINED

For complainant:-                   For opposite parties:-

PW 1                                   RW1  &  RW2

DOCUMENTS MARKED

For Compainant:-

Ex.A-1 Reliance Life Insurance Copy.

Ex.A-2 Certificate of Death.

Ex.A-3 Postal acknowledgement copy.

For OP’s:-

Ex.B-1 Reliance Life Insurance Copy.

Ex.B-2 Reliance Life Insurance Copy.

Ex.B-3 Reliance Statement copy.

Ex.B-4 Reliance Statement Copy.

Ex.B-5 Reliance Life Insurance Medical Copy.

                     President