JUDGEMENT By Sri. Pampapathi President:- This is a complaint filed by the complainant Smt. Hussainamma against the Opposite LIC of India U/sec. 12 of Consumer Protection Act for to direct the opposite to pay the accidental benefit and accrued bonus etc., to the extent of Rs. 40,000/- with 12% interest, damages, expenditure with other reliefs as deems fit to the circumstances of this case. 2. The brief facts of the complainant case are that, her son by name Khaja Bhande Nawaz took policy bearing No. 663418221 of maturity value of Rs. 40,000/- as on its maturity date 24-12-2021 with premium of Rs. 1,318/- payable on half yearly, she is the nominee under the said policy. Her son died on 12-11-07 in motor vehicle accident in the limits of Manvi, P.S. where a criminal case was registered under crime No. 294/07 due to death of her son, she filed claim petition before the opposite LIC under the said policy, but LIC paid only policy amount without payment of bonus, interim bonus and accident benefits etc., she requested to opposite to make such under the policy but it not paid, LIC opposite under negligent in making payment of the said amount to her and thereby it found under deficiency in its service, accordingly she filed her complaint against opposite for the reliefs as prayed in her complaint. 3. Opposite LIC of India appeared in this case through its Advocate filed written version by admitting the fact that Khaja Bhande Nawaz insured his life vide policy for assured sum of Rs. 40,000/- under New Janaraksha Policy which is going to be matured on 24-02-2021, his mother Hussainamma is a nominee under the said policy. The said policyholder Khaja Bhande Nawaz died on 12-11-07 in the vehicle accident and a case was registered under crime No. 294/07 in Manvi P.S. It is contended that the basic amount under the policy with bonus accrued was paid to the nominee to the extent of Rs. 45,199/- on 22-05-08 and the D.A.B. not paid to the nominee as the policyholder was not having valid driving licence to drive the Auto rikshaw bearing No. KA-36/5690, therefore the policyholder violated the terms and conditions of the policy. Hence the amount has claimed in this complaint not paid to nominee there was no deficiency in service and prayed for to dismiss the complaint among other grounds. 4. In-view of the pleadings of the parties. Now the points that arise for our consideration and determination are that: 1. Whether the complainant proves that, she being the nominee under the accident benefit policy taken by her deceased son Khaja Bhande Nawaz who died in motor vehicle accident on 12-01-07, thereafter she filed claim petition before the opposite but opposite LIC paid only basic amount under the policy to the extent of Rs. 45,199/-, but not paid bonus accrued interest, interim bonus accident benefit etc., in spite of several oral and written requests its negligent in settling her genuine claim and thereby opposite LIC found guilty under deficiency in its services.? 2. Whether complaint is entitled for the reliefs as prayed in her complaint.? 3. What order? 5. Our findings on the above points are as under:- (1) In the affirmative. (2) As discussed in the body of this judgement and as noted in the final order. (3) In-view of the findings on Point Nos. 1 & 2, we proceed to pass the final order for the following : REASONS POINT NO.1 & 2:- 6. To prove the facts involved in these two points, affidavit-evidence of complainant was filed, she was noted as PW-1. The documents Ex.P-1 to Ex.P-5 are marked. On the other hand the affidavit-evidence of Manager, Legal HPF of opposite was filed, he was noted as RW.1. The documents Ex.R-1 to Ex.R-5 are marked. 7. In the instant case, deceased Khaja Bhande Nawaz insured his life at his life time by subscribing new Janaraksha policy bearing No. 663418221 for assured sum of Rs. 40,000/- as on 24-12-2005 which is going to be matured on 24-02-21 are not in dispute. The complainant being the nominee under the said policy is also not in dispute. The death of insured Khaja Bhande Nawaz as on 12-11-07 in vehicle accident and registering a criminal case under crime No. 294/07in Manvi PS are also not in dispute. Further it is a fact that after the death of insured this complainant being a nominee filed claim petition before opposite LIC and it prayed for Rs. 45,199/- as a basic amount under the policy to the complainant. 9. Now the DAB amount was not paid by the Insurance Company only on one ground that the deceased Khaja Bhande Nawaz was not having valid and effective driveling licence to drive the vehicle at the time of accident, generally opposite took the defence regarding the breach of the terms and conditions of the policy, it is its duty to prove it. In the instant case the learned advocate for opposite placed reliance on two rulings reported in 2009 CJ 836 (SC) National Insurance Company Ltd., V/s. J. Maheshwaramma and (2) (I) 2008 CPJ 33 (SC) Oriental Insurance Company ltd., V/s. Prithviraj. 10. The first case referred by the learned advocate for opposite is a case where the driving licence was fake and fabricated. In the second case, Oriental Insurance Company was succeeded to prove that licensing authority have not issued licence to the deceased. 11. Keeping in view of the principles of the said two rulings, now we have to appreciate the case of complaint. Admittedly the complainant filed five documents in support of her case, among those documents Ex.P-1 is copy of FIR, Ex.P-2 is the policy copy, Ex.P-3 is the Letter written by opposite to the complainant, Ex.P-4 is the copy of the legal notice issued to opposite and Ex.P-5 is the postal acknowledgement. 12. In the instant case the complainant Hussainamma is village rustic lady, she might not in possession of driving licence of her son deceased Khaja Bande Nawaz, in the circumstances stated above, we have referred a ruling of the Honble Supreme Court Jeetendra Kumar V/s. Oriental Insurance Company Ltd., and also the ruling of the Honble High Court of Karnataka reported in IV 2006 ACC 31 K.S. Usha V/s. Life Insurance Company Ltd, In the said two rulings, their lordships have observed as details of licence held by deceased may not be in their knowledge, the claim is based on accidental benefit insurance policy. Hence it has to be allowed, under such circumstances, we are of the view that the facts and circumstances discussed by their lordships of the Honble Supreme court in the rulings referred by the learned advocate for opposite are different to the facts of the present case on hand. In the instant case opposite LIC of India not contended that the licence of deceased was fake and fabricated, as such with great respect to their lordships of the Honble Supreme Court we have not applied those principles to the present case. 13. The facts and circumstances discussed by their lordships of the Honble Supreme Court in Jeetendra Kumar V/s. Oriental Insurance Company Ltd., and by the Honble High Court of Karnataka are made applicable to the case on hand as those facts are similar to the facts of the present case. In the light of the circumstances discussed above, non making payment of accidental benefits under the said policy to the complainant on that ground is deficiency in service, accordingly we answered Point No-1 in affirmative. 14. As per the case of complainant, his claim is for accidental death benefit, vested bonus and interest accrued thereon but not shown the amount in detail under different heads, as such we have directed the opposite LIC of India to calculate and make the payment of the amount in detail for which the complainant is entitled for accidental benefit under the said policy, vested bonus, accrued interest and other benefits etc., within one month from the date of this judgment. 15. We have noticed the deficiency in service on the part of opposite for denial of the legal claim of complainant, as such we have granted a lumpsum amount of Rs. 3,000/- recoverable by the complainant from opposite under this head, a lumpsum amount of Rs. 2,000/- is awarded towards cost of this litigation. 16. The complainant is entitled for to recover 9% interest p.a. on the total sum under the heads accidental benefit, vested bonus, accrued interest etc., and on Rs. 5,000/- from the date of this judgment till realization of the full amount, accordingly we answered Point Nos. 1 & 2. POINT NO.3:- 17. In view of our finding on Point Nos.1 & 2 we proceed to pass the following order: ORDER The complaint filed by the complainant is partly allowed with cost. The complainant is entitled to recover accidental benefit, vested bonus, and accrued interest etc., on the Insurance policy of Khaja Bande Nawaz and also he is entitled to get an amount of Rs. 5,000/- from the opposite LIC of India. The complainant is also entitled to recover interest at the rate of 9% p.a. on accidental benefit, vested bonus, and accrued interest etc., and on Rs. 5,000/- from the date of this judgment till realization of the full amount. Opposite LIC of India is directed to calculate and to pay accidental benefit, vested bonus, and accrued interest etc., and an amount of Rs. 5,000/- with interest within one month from the date of this judgment. Intimate the parties accordingly. (Dictated to the Stenographer, typed, corrected and then pronounced in the open Forum on 23-12-09) Sd/- Sri. Pampapathi, President, District Forum-Raichur. Sd/- Sri. Gururaj, Member, District Forum-Raichur. Sd/- Smt.Pratibha Rani Hiremath, Member. District Forum-Raichur.
Consumer Court Lawyer
Best Law Firm for all your Consumer Court related cases.
