BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, MYSORE-570023

CONSUMER COMPLAINT NO.225/2015

DATED ON THIS THE 20^th January 2017

      Present:  1) Sri. H.M.Shivakumara Swamy

B.A., LLB., - PRESIDENT   

    2) Smt. M.V.Bharathi                    

                                   B.Sc., LLB., -  MEMBER

                     3) Sri. Devakumar.M.C.                  

                                                          B.E., LLB.,    - MEMBER

Sri DEVAKUMAR.M.C,

Member

1.     The complainant has filed the complaint under section 12 of the C.P.Act, 1986, against the opposite party, alleging deficiency in service and seeking a direction to pay Rs.59,137/- the sum assured, death benefits and accrued bonus in respect of the insurance policy, Rs.50,000/- for the deficiency in service, Rs.50,000/- towards mental agony and harassment, Rs.20,000/- towards cost of proceedings, with such other reliefs.
2.     The complainant’s son taken a life insurance policy from opposite parties, on payment of premium of Rs.6,650/- on 12.09.2012.  The policy term was 15 years.  The policy sum assured was Rs.59,137/- and the minimum death benefit was Rs.59,137/-.  The complainant was appointed as nominee to the policy. The life insured died on 06.07.2013.  Claim was made under the policy.  The opposite party neither complied the claims nor repudiated.  A legal notice issued on 02.09.2014, to both the opposite parties, calling upon to settle the claims, but in vain.  Hence, the complaint, seeking reliefs.
3.    The opposite parties filed common version denying the allegations as false.  They submits the complainant has not made the death claim along with necessary documents to process the policy claims in accordance with the policy terms and conditions.  The complaint is not maintainable as the same filed belatedly after the lapse of stipulated period.  The complainant never informed these opposite parties about the death of the insured, thereby the complainant deprived the opposite parties to investigate the cause of death of the insured and has come up with this complaint to defraud the opposite parties. Further, the opposite party prays for a direction to the complainant, to submit the death claim documents before the nearest branch office, so as to process the same as per the terms and conditions of the policy.  Hence, claims there is no deficiency in service and not liable to pay any damages and prays for dismissal of the complaint with cost. 
4.     To prove the facts, the complainant filed affidavit with documents.  The opposite party lead the evidence by filing affidavit.  Complainant filed written arguments and submitted oral arguments.  Perusing the material on record, matter posted for orders.
5.      The points arose for our consideration are:-

1. Whether the complainant establishes the deficiency in service on the part of opposite parties in not settling the death claim of the insured and thereby she is entitled for the reliefs sought?   
2.  What order?

6.    Our findings on the aforesaid points are as follows:

Point No.1 :- In the negative.

Point No.2:- As per final order for the following

:: R E A S O N S ::

7.    Point No.1:- The deceased son of the complainant, had taken a life insurance policy by name “Bajaj Allianz Cash Gain Economy” on 18.09.2012, the term of the policy was 15 years and the sum assured was Rs.59,137/-.  The complainant paid premium of Rs.6,650/- with annual payment mode.  The minimum death benefit was Rs.59,137/- only.  The maturity benefits under the policy was, 50% of basic sum assured + accrued bonus and death benefit was, minimum death benefit + accrued bonus.  The complainant has been appointed as the nominee to the policy.  The life insured died on 06.07.2013.  The death intimation was given to the opposite parties and sought for settlement of claims by submitting relevant documents.  The opposite parties never attempted to settle the claims.  Legal notice issued to the opposite parties calling upon to settle the insurance claims, but in vain.  Hence, the aggrieved complainant filed the complaint and sought for the reliefs.
8.    The opposite party contended that, the death of the insured has not been communicated to them, until the claim under policy was made.  So they were deprived of ascertaining the facts causing death of the insured, since the insured died within one year from the date of commencement of the policy.  Further, the opposite party urged to direct the complaint to submit the death claim with documents to the nearest branch office to process the claims in accordance with the terms and conditions of the policy.  Submission of original policy before this Forum, clearly establishes that, the complainant has not produced all the necessary documents to process the claims.  Hence, the allegation of deficiency in service in not settling the death benefits is denied as false and it is not liable to pay any compensation as sought.  As such, prays for dismissal of the complaint.
9.    On perusal of the material on record, the complainant established that her deceased son had taken an insurance policy from opposite parties.  The sum insured was Rs.59,137/- and the minimum death benefit payable was 50% of sum assured with accrued bonus.  The insured died within a year of commencement of the policy. The complainant never placed any evidence to establish that, she had informed the opposite parties regarding the death of her son.  Further, the complainant failed to establish that she had submitted the claim form along with all the necessary documents to the opposite parties, to process and to settle the claims in accordance with the policy terms and conditions.  Further, being an early claim the opposite parties were to investigate the cause of the death.  This opportunity has been deprived, as there was no information about the death of the insured.  Further, the original policy has been filed before this Forum along with this complaint.  This clearly established that, the complainant had not submitted all the relevant documents to process the claims, to the opposite party.  In view of the same, we opine that, the complainant failed to establish that there is deficiency in service on the part of opposite parties and she is not entitled for the reliefs sought.   Accordingly, point No.1 is answered in the negative.
10. Point No.2:- In view of the above observations, we proceed to pass the following

:: O R D E R ::

1. The complaint is hereby dismissed.
2. Give the copies of this order to the parties, as per Rules.

 (Dictated to the Stenographer transcribed, typed by her, transcript corrected by us and then pronounced in open court on this the 20^th January 2017)

                          (H.M.SHIVAKUMARA SWAMY) 

                                      PRESIDENT     

(M.V.BHARATHI)                           (DEVAKUMAR.M.C.)

      MEMBER                                         MEMBER