Complaint is filed on 27-7-2009
Compliant disposed on 2-9-2010
BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM
::AT:: KARIMNAGAR
PRESENT: HON’BLE SRI K. DEVI PRASAD, B.Sc., LL.B., PRESIDENT
SMT. E. LAXMI, M.A.,LL.M.,PGDCA (CONSUMER AWARENESS), MEMBER
SRI. K. CHANDRA MOHAN RAO, B.Com., LL.B., MEMBER
THURSDAY, THE SECOND DAY OF SEPTEMBER, TWO THOUSAND TEN
CONSUMER COMPLAINT NO. 115 OF 2009
Between:
Kumbala Laxmi, W/o. Late Laxmaiah, Age 45 years, Occ: Housewife, R/o. H.No.14-2-252, Ambedkarnagar, 5 Incline area, Godavarikhani mandal Ramagundam, district Karimnagar.
… Complainant
AND
Life Insurance Corporation of India, Ramagundam branch, NTPC “X” Roads, Jyothingar, Ramagundam proper and mandal, district Karimnagar, R/by it’s Manager .
…Opposite Party
This complaint is coming up before us for final hearing on 12- 8 -2010, in the presence of Sri B.Srinivas and Smt. B. Geetharaini, Advocates for complainant and Sri J. Sri Ramulu, Advocate for opposite party, and on perusing the material papers on record, and having stood over for consideration this day, the Forum passed the following:
:: ORDER ::
1. This complaint is filed under Section 12 of C.P.Act, 1986 seeking direction to the opposite party to pay an amount of Rs.70,000/- towards the sum assured under two policies along with bonus, interest, damages and costs.
2. The brief averments of the complaint are that the husband of the complainant Kumbala Laxmaiah obtained Life Insurance Policies bearing no.682440326 for Rs.15,000/- and 682456420 for Rs.20,000/- under Salary Deduction Scheme from the opposite party as he was working in SCC Ltd. As per the terms and conditions of the policy in case of natural death of the policy holder the nominee will be paid basic sum and in case if the policy holder dies accidentally the nominee would get double the sum assured. The policy holder nominated the complainant as his nominee under the said two policies. On 17.5.2006 the policy holder died due to Sun Stroke. The Police, Godavarikhani II Town registered a Crime bearing no.59 of 2006 on 17.5.2006. The Postmortem examination report disclosed that the policy holder died due to “Cardio Respiratory Arrest due to heat hyper pyrexia”. Immediately after his death the complainant submitted a claim to the opposite party for payment of the sum assured with accident benefit coverage by enclosing all the documents, but the opposite party failed to settled the same. Therefore, the complainant got issued a Legal Notice Dt: 9.7.2009 calling upon the opposite party to pay the sum assured, but inspite of service of notice the amount is not paid. Therefore, the complainant sought direction for payment of Rs.70,000/- along with bonus, interest and costs.
3. The opposite party filed counter submitting that the complaint is time barred as it is filed beyond the period of two years as provided under Sec 24 of C.P.Act. It is further submitted that the policy holder obtained policy no.682440326 for Rs.15,000/- on 28.1.1997 and policy no.682456420 for Rs.20,000/- was obtained on 28.3.1998. After the death of policy holder the complainant submitted a claim for payment the sum assured. She has also issued a discharge voucher acknowledging the receipt of the total sum assured. Accordingly the opposite party settled the death claim on 19.9.2006. As per the said settlement an amount of Rs.21,651/- is paid towards the policy no.682440326 through a cheque no.780876 Dt: 19.9.2006 and Rs.29,120/- towards policy no.682456420 under cheque no.780876 was paid to the complainant towards the sum assured with eligible benefits. The complainant did not submit any proof that the death of the policy holder was an accidental one and she did not make claim during the last three years. In the complaint it is alleged that the opposite party did not settle the claim till today. Infact the death claim was settled on 19.9.2006 it self as such there is no deficiency of service on the part of the opposite party. Therefore, the opposite party prayed for dismissal of the complaint with costs.
4. The complainant filed Proof Affidavit reiterating the averments made in the complaint and filed documents which are marked as Ex.A1 to A9. Ex.A1 & A2 are the Status Reports issued by opposite party Dt: 1.7.2009. Ex.A3 is the photo copy of F.I.R. Dt: 17.5.2006. Ex.A4 is the photo copy of letter from Sr. Security Officer, S&PC Dept. RG-I & III addressed to Station House office, Police Station NO.II Town, Godavarikhani Dt: 17.5.2006. Ex.A5 is the photo copy of PME Report Dt: 18.5.2006. Ex.A6 is the photo copy of Inquest Report Dt: 18.5.2006. Ex.A7 is the photo copy of letter from S.I. of Police, Kadavarikhani addressed to Executive Magistrate (MRO) of Karimnagar Dt: 18.5.2006. Ex.A8 is the Legal Notice issued by counsel for complainant addressed to opposite party Dt: 9.7.2009. Ex.A9 is the Professional Courier Receipt Dt; 12.7.2009.
5. The opposite party filed Proof Affidavit of it’s Administrative Officer reiterating the averments made in the counter and filed documents which are marked as Ex.B1 to B4. Ex.B1 and B2 are Status Reports issued by opposite party Dt: 18.9.2006. Ex.B3 is the Statement of Account issued by State Bank of Hyderabad Dt: 12.7.2010. Ex.B4 is the photo copy of cheque for Rs.50,771/- Dt: 19.9.2006.
6. The Points for consideration are:
(1). Whether there is any deficiency of service on the part of opposite party?
(2). If so, to what relief the complainant is entitled?
7. Heard both sides.
8. It is contended by the complainant that the opposite party failed to pay the sum assured under the policies covered by Status Reports under Ex.A1 and A2. It is further contended that the policy holder died on 17.5.2006 due to Sun Stroke at DCP 3 Godavarikhani and a case is registered in Crime No.59 of 2006 under Ex.A3 FIR. The Postmortem Report under Ex.A5 and Inquest Report under Ex.A6 and Final Report under Ex.A7 discloses that the policy holder died due to Sun Stroke. It is contended that inspite of submitting claim to the opposite party the sum assured is not paid and the opposite party is under an obligation to pay the same which amounts to deficiency of service. As per the terms and conditions of the policy the nominee is entitled to receive the basic sum assured and also additional amount as the death of the policy holder is an accidental one. The counsel for the complainant relied on a judgment of Hon’ble National Commission reported in 2008 CTJ page no.22.
9. It is contended by the opposite party that it is filed beyond the period of limitation and that the complainant suppressed the real facts to make a false claim. It is further contended that on receipt of death claim the complainant was asked to submit a discharge voucher for payment of the sum assured. Accordingly the complainant submitted discharge voucher towards full satisfaction of the claim. Therefore, the opposite party paid a sum of Rs.50,771/- through a cheque under Ex.B4 towards the sum assured with eligible bonus under two policies. Out of the said amount of Rs.21,651/- is paid for policy no.682440326 and Rs.29,120/- for policy no.682456420 and the same is credited to the account of the complainant as shown in Ex.B3. Inspite of receipt of the amount the complainant filed the false claim. Since there is no deficiency of service, the opposite party prayed for dismissal of the complaint.
10. The admitted facts of the case as per the contents of the complaint and counter are that the husband of the complainant Kumbala Laxmaiah obtained two Life Insurance Policies for Rs.15,000/- and Rs.20,000/- and Rs.20,000/-. The complainant claimed that inspite of submitting claim for payment of the sum assured under the two policies, the opposite party failed to settle the claim and therefore, she filed the present complaint. But a perusal of the Status Reports under Ex.B1 and B2 it is clearly disclosed that the opposite party settled the death claim by paying Rs.50,771/- through a cheque under Ex.B4 on 19.9.2006 towards the sum assured under two policies. The Status Report under Ex.B1 discloses that the opposite party settled the claim for Rs.21,651/- in respect of policy no. 682440326 towards the basic sum assured with eligible bonus. Ex.B2 discloses that the opposite party settled the claim for Rs.29,120/- in respect of policy no. 682456420 towards the basic sum assured with eligible bonus. The complainant having received the cheque under Ex.B4 for Rs.50,771/- deposited the same in her account with SBH Vittalnagar Branch, Godavarikhani on 25.9.2006 which is disclosed by the Statement of Account Ex.B3 and the said amount is credited to her account.
11. In this case the complainant prayed for an order for payment of Rs.70,000/- towards the sum assured under two policies without deducting the amount already received from the opposite party on 25.9.2006. In the complaint and Proof Affidavit filed by her she did not mention anything about payment of the amount and even after filing of the documents under Ex.B1 to B4 by the opposite party, the complainant did not come forward informing about receipt of the amount. The complainant has not given any reasons as to why she did not make any protest for payment of some assured under accidental death coverage when she submitted discharge voucher in the month of Sept 2006. After lapse of three years the present complaint is filed by suppressing the material information and she id not approach this FORUM with clean hands. As the opposite party settled the death claim within four months of death of the policy holder, there is no deficiency of service on the part of the opposite party. The complainant cannot make a claim after three years without filing delay condonation petition. The Legal Notice under Ex.A8 Dt: 9.7.2009 is issued after the prescribed period of limitation which will not save the limitation. As the complainant already received the sum assured under the two policies she is not entitled for the relief sought in this case. Hence the complaint deserves to be dismissed.
12. In the result the complaint is dismissed without costs.
Typed to my dictation by Stenographer after correction the orders pronounced by us in the open court this the 2ND day of September, 2010.
Sd/- Sd/- Sd/-
MEMBER MEMBER PRESIDENT
NO ORAL EVIDENCE HAS BEEN ADDUCED ON EITHER SIDE
FOR COMPLAINANT:
Ex.A1 & A2 are the Status Reports issued by opposite party Dt: 1.7.2009.
Ex.A3 is the photo copy of F.I.R. Dt: 17.5.2006.
Ex.A4 is the photo copy of letter from Sr. Security Officer, S&PC Dept. RG-I & III addressed to Station House office, Police Station NO.II Town, Godavarikhani Dt: 17.5.2006.
Ex.A5 is the photo copy of PME Report Dt: 18.5.2006.
Ex.A6 is the photo copy of Inquest Report Dt: 18.5.2006.
Ex.A7 is the photo copy of letter from S.I. of Police, Kadavarikhani addressed to Executive Magistrate (MRO) of Karimnagar Dt: 18.5.2006.
Ex.A8 is the Legal Notice issued by counsel for complainant addressed to opposite party Dt: 9.7.2009.
Ex.A9 is the Professional Courier Receipt Dt; 12.7.2009.
FOR OPPOSITE PARTIES:
Ex.B1 and B2 are Status Reports issued by opposite party Dt: 18.9.2006.
Ex.B3 is the Statement of Account issued by State Bank of Hyderabad Dt: 12.7.2010.
Ex.B4 is the photo copy of cheque for Rs.50,771/- Dt: 19.9.2006.
Sd/- Sd/- Sd/-
MEMBER MEMBER PRESIDENT
