The Branch Manager, LIC of India, Raichur V/S Malamma W/o. Late Shivaraj - Consumer Court Case

Karnataka

Raichur

CC/09/75

Malamma W/o. Late Shivaraj - Complainant(s)

Versus

The Branch Manager, LIC of India, Raichur - Opp.Party(s)

Sri. Siddalingappa

26 Feb 2010

ORDER

DIST. CONSUMER DISPUTES REDRESSAL FORUM
DIST. CONSUMER DISPUTES REDRESSAL FORUM,DC Office Compound, Sath Kacheri
consumer case(CC) No. CC/09/75

Malamma W/o. Late Shivaraj						...........Appellant(s)
Vs.
The Branch Manager, LIC of India, Raichur Susheelamma W/o. Late Timmayya,						...........Respondent(s)

BEFORE:

Complainant(s)/Appellant(s):

OppositeParty/Respondent(s):

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ORDER

JUDGEMENT By Sri. Gururaj Member:- This is a complaint filed U/s. 12 of Consumer Protection Act by the complainant- Mallamma W/o. Late Shivaraj against the two Respondents (1) Branch Manager Life Insurance Corporation of India, Branch Manvi., (2) Susheelamma W/o. Late Thimayya. The brief facts of the case of the complaint are as under:- The complainant is the legally wedded of late Shivaraja. The late Shivaraja was working as a line man in GESCOM on daily wages basis. During the life time he had insured his life with Respondent No-1 in policy No. 663294982 dt. 07-06-04 for an assured sum of Rs. 50,000/-. The said Shivaraja has nominated his mother Susheelamma i.e, Respondent No-2 as nominee to the above said policy. The said Shivaraja husband of the complainant died in accident during the subsistence of policy. In this regard the case has been registered before the Sirwar Police Station under Crime NO. 129/09 and FIR No. 290/09 on 04-06-09 on the file of JMFC, Manvi same has been intimated by the Respondent No-2 to the Respondent No-1 and claimed death claim benefit behind the back without intimating the same to the complainant who is the legally wedded wife of assured Shivappa S/o. late Thimappa. Further it is the case of the complainant that behind her back the Respondent No-2 has submitted her claimed before the Respondent No-1. The same was came to the knowledge of the complainant much later and when the complainant claimed her right to share in the said amount the Respondent No-2 has flatly refused and denied for any share in the said death claim and benefits. Later on the complainant made representation to the Respondent No-1 on 02-09-09 for payment of 50% of death benefits of her husband as she has got equal right to share the amounts out of the above said policy. Further contended that there are no issues to the complainant out of the wedlock with her husband late Shivaraja S/o. Thimappa and there are no other legal heirs to claim the amount except the complainant and Respondent No-2, therefore she is entitled for 50% of the amounts payable out of the above said policy amount. Further it is the case of the complainant that the Respondent No-1 in response to the representation made by the complainant replied through letter dt. 02-09-09 stating that as per valid nominee and in-view of policy condition and Insurance Act would not pay benefits to the complainant and will pay benefits to the Respondent NO-2 the nominee of late Shivaraja only. The complainant received to the said letter on 14-09-09. The complainant being the legally wedded wife and heir of assured late Shivaraja is entitled for 50% of the amount payable out of said policy and denial of the same by the Respondent No-1 through letter dt. 02-09-09 is nothing but deficiency in service on the part of the Respondent No-1. Hence sought the direction against Respondent No-1 for payment of 50% of the total benefits payable out of policy No. 663294982 dt. 07-06-04 for an assured sum of Rs. 50,000/- along with 12% interest p.a. on total amount till realization after deduction of any loan over said policy and Rs. 5,000/- towards cost of the proceedings. 2. In response to service of notice Respondent No- 1 & 2 have appeared through their respective counsel. Respondent No-1 has filed written version contending that the complainant is not the nominee therefore she has got no rights to claim in-respect of the policy benefits of late Shivaraja. Hence there is no binding and liability on the part of Respondent No-1 to pay any amount to the complainant. The Respondent No-2 is the mother of the policyholder and she has been named as nominee in the policy by late Shivaraja and as such the question of payment of benefit amount to the complainant does not arise. Further it is contended that, the complainant has made representation on 02-09-09 and objected to release the death benefits payable to the Respondent No-2 for which the opposite insurance company rightly answered and replied that as per valid nominee made by assured in policy and in view of section 39 of Insurance Act the Respondents Insurance Company under bounded to pay the benefits to nominee only and the said nominee is the person who can give a valid discharge to this Respondent therefore this Respondent replied complainant regarding the payment to be made in favour of nominee only. After receiving all documents as per requirements, if claim is found to be admissible. The admissibility of the claim will be decided only after receipt of all required documents from the nominee/claimants, as claim has arisen within two years from the date of renewal of the policy. The death benefit is not paid till this day due to non production of documents as sought by this Respondent. It is further contended that, the death benefits are arising out of the policy are :- Basic sum assured Rs. 50,000/- vested bonus for 4 years. Rs. 8,700/- Interim bonus for 1 year Rs. 2,100/- Double Accident Benefit Rs. 50,000/ -------------------------- Gross amount payable Rs. 1,10,800/- Less Loan dt. 7-03-09 Plus loan interest from 7-03-09 to 4-6-09. Rs. 8,500/- -------------------------- Net amount payable Rs. 1,02,115/- --------------------------- The above amount are payable subject to production of valid documents basing on admissibility of claim and proof of cause of death i.e, accident and production of DL of the deceased and policy papers regarding accident. That immediately after the receipt of the claim from the complainant we have answered categorically hence there is no deficiency on the part of the Respondent No-1 hence sought for dismissal of the complaint. 3. During the course of enquiry the complainant has filed her sworn affidavit by way of examination-in-chief reiterating the averments of the complaint and she has got marked (6) documents as Ex.P-1 to Ex.P-6. In rebuttal the Respondent No-1 has filed sworn affidavit of P.S. Markendeshwara, Manager Legal & HPF of LIC of India, D.O. Raichur. The Respondent No-2 has not filed her sworn-affidavit by way of examination-in-chef. The Respondents have not produced any documents hence no documents were marked on behalf of the Respondents. 4. Heard the arguments of both sides and perused the records. The following points are arises for our consideration and determination: 1. Whether the complainant prove deficiency in service by the Respondent No-1 as alleged.? 2. Whether the complainant is entitled for the reliefs sought for.? 5. Our finding on the above points are as under:- 1. In the Negative 2. As per final order for the following REASONS POINT NO.1:- 6. There is no dispute that the late Shivaraja had life assured policy No. 663294982 dt. 07-06-04 for an assured sum of Rs. 50,000/- with the Respondent No-1, the Respondent No-2 is the nominee to the said policy and not in dispute that the complainant-Smt. Mallamma is the legally wedded wife of late Shivaraja. It is also not in dispute that the late Shivaraja was died in accident and case has been registered before the Sirwar Police Station under Crime NO. 129/09 and FIR No. 290/09 dt. 04-06-09 on the file JMFC, Manvi. 7. It is the case of the complainant that since she is the legally wedded wife and legal heir of the late Shivaraja she is entitled for 50% of the amounts payable out of the policy death benefits but behind her back the Respondent No-2 moved claim petition before the Respondent No-1without any intimation. After coming to know about the same the complainant requested the Respondent No-1 to pay 50% of the death benefits, but the Respondent No-1 refused to pay 50% of the death claim amount is nothing but a deficiency on the part of the Respondent No-1. 8. Further it is the case of the Respondent No-1 that the Respondent No-2 is the nominee of the policy of late Shivaraja hence they cannot pay the death claim benefit amount to the complainant and they are suppose to pay only to the nominee. As per section 39 of Insurance Act the nominee is entitled to receive the same and it is their bounded duty to pay all the death benefits under the policy to nominee only. 9. The complainant has filed during the course of enquiry in all six documents namely: (1) True copy of the application under R.I. Act dt. 11-09-09 is marked at Ex.P-1 (2) Status Report of the policy marked at Ex.P-2, (3) Xerox copy of the FIR and complaint marked at Ex.P-3, (4) Copy of voter list pertaining to complainant marked at Ex.P-4, (5) Copy of objection letter dt. 02-09-09 marked at Ex.P-4, (6) Letter of Respondent No-2 dt. 02-09-09 marked at Ex.P-5. 10. From the perusal of the pleadings of the parties, evidence and documents filed by the complainant. Particularly from the close perusal of the Ex.P-2 Status Report of policy No. 663294982 it appears that Smt. Susheelamma i.e, Respondent No-2 is the nominee of the above said policy. As contended by the Respondent No-1 and as per the section 39 of Insurance Act the nominee is entitled to receive the proceeds of the policy in case of death of the policyholder before the maturity of the policy. In case the insured is alive on the maturity of the policy the nominee has no right to receive the money. Further it is very clear that in case the nominee and policy holder dies before the maturity of the policy the legal heirs of the nominee will be entitled to receive the policy amount but not by the heirs of the policyholder. Further the Act specifies that, if at all the heirs of the policy holder wants to claim their rights over the policy amount they are suppose to appear before the civil court which has got ample power to pass appropriate order in respect of the rights over the policy money is concerned. Here it is not the case of the complainant that she has approached the civil court and got the order in this regard and even inspite of that the Respondent No-1 has not paid an amount as she claimed herein. Under these circumstances the Respondent NO-1 has rightly refused the claim of the complainant through Ex.P-6 i.e, letter dt. 02-09-09, hence we do not find any reasons to believe that there is a deficiency in service on the part of the Respondent No-1. 11. Further, no doubt the complainant is the legally wedded wife and legal heir to the life assured Late Shivaraja but she cannot be accepted by the Respondent No-1 as a share holder to the claim amount in the absence of her name in the policy as a nominee and any order of the court as discussed supra. If at all the complainant wants to claim any share in the death benefits comes under the policy as a legal heir, she has to approach to the civil court wherein the claim of the complaint can be considered and determined after full pledged trial on this material aspect and thereby her right against the Respondent No-2 can be decided, then only the Respondent NO-1 is bound to consider the claim of the complainant but not under the facts and circumstances as explained in the complaint by the complainant. Hence there is no deficiency we find on the part of the Respondent NO-1. 12. Further on going through the pleadings of the parties and documents filed by the complainant absolutely there is no case against the Respondent No-2. Hence we hold that there is no claim against the Respondent No-2 therefore the complaint against the Respondent No-2 is dismissed as no claim. In the above circumstances the complainant is totally failed to prove the deficiency on the part of the Respondent NO-1. Hence the Point No-1 is answered in the Negative. The complainant in order to prove her case she has filed two rulings cited in: I 2006 CPJ 21 and II 2006 CPJ Page 280 of Honble State Commission of West Bengal and Honble National Commission respectively. The facts and circumstances mentioned under the said rulings are totally different from the facts and circumstances appearing in the case in hand. Hence with great respect we have not considered the above said rulings to the case of the complainant. POINT NO.2:- 13. In view of our discussion and finding on Point No-1, holding that the complainant has failed to prove deficiency in service on the part of the Respondents so the complainant is not entitled for the reliefs sought for. In the result we pass the following order: ORDER The complaint of the complainant being devoid of merits is hereby dismissed. No order as to cost. Office to furnish certified copy of this order to both the parties forth with free of cost. (Dictated to the Stenographer, typed, corrected and then pronounced in the open Forum on 26-02-10.) Sd/- Sri. Pampapathi, President, District Forum-Raichur. Sd/- Sri. Gururaj, Member, District Forum-Raichur. Sd/- Smt.Pratibha Rani Hiremath, Member.

JUDGEMENT By Sri. Gururaj Member:- This is a complaint filed U/s. 12 of Consumer Protection Act by the complainant- Mallamma W/o. Late Shivaraj against the two Respondents (1) Branch Manager Life Insurance Corporation of India, Branch Manvi., (2) Susheelamma W/o. Late Thimayya. The brief facts of the case of the complaint are as under:- The complainant is the legally wedded of late Shivaraja. The late Shivaraja was working as a line man in GESCOM on daily wages basis. During the life time he had insured his life with Respondent No-1 in policy No. 663294982 dt. 07-06-04 for an assured sum of Rs. 50,000/-. The said Shivaraja has nominated his mother Susheelamma i.e, Respondent No-2 as nominee to the above said policy. The said Shivaraja husband of the complainant died in accident during the subsistence of policy. In this regard the case has been registered before the Sirwar Police Station under Crime NO. 129/09 and FIR No. 290/09 on 04-06-09 on the file of JMFC, Manvi same has been intimated by the Respondent No-2 to the Respondent No-1 and claimed death claim benefit behind the back without intimating the same to the complainant who is the legally wedded wife of assured Shivappa S/o. late Thimappa. Further it is the case of the complainant that behind her back the Respondent No-2 has submitted her claimed before the Respondent No-1. The same was came to the knowledge of the complainant much later and when the complainant claimed her right to share in the said amount the Respondent No-2 has flatly refused and denied for any share in the said death claim and benefits. Later on the complainant made representation to the Respondent No-1 on 02-09-09 for payment of 50% of death benefits of her husband as she has got equal right to share the amounts out of the above said policy. Further contended that there are no issues to the complainant out of the wedlock with her husband late Shivaraja S/o. Thimappa and there are no other legal heirs to claim the amount except the complainant and Respondent No-2, therefore she is entitled for 50% of the amounts payable out of the above said policy amount. Further it is the case of the complainant that the Respondent No-1 in response to the representation made by the complainant replied through letter dt. 02-09-09 stating that as per valid nominee and in-view of policy condition and Insurance Act would not pay benefits to the complainant and will pay benefits to the Respondent NO-2 the nominee of late Shivaraja only. The complainant received to the said letter on 14-09-09. The complainant being the legally wedded wife and heir of assured late Shivaraja is entitled for 50% of the amount payable out of said policy and denial of the same by the Respondent No-1 through letter dt. 02-09-09 is nothing but deficiency in service on the part of the Respondent No-1. Hence sought the direction against Respondent No-1 for payment of 50% of the total benefits payable out of policy No. 663294982 dt. 07-06-04 for an assured sum of Rs. 50,000/- along with 12% interest p.a. on total amount till realization after deduction of any loan over said policy and Rs. 5,000/- towards cost of the proceedings. 2. In response to service of notice Respondent No- 1 & 2 have appeared through their respective counsel. Respondent No-1 has filed written version contending that the complainant is not the nominee therefore she has got no rights to claim in-respect of the policy benefits of late Shivaraja. Hence there is no binding and liability on the part of Respondent No-1 to pay any amount to the complainant. The Respondent No-2 is the mother of the policyholder and she has been named as nominee in the policy by late Shivaraja and as such the question of payment of benefit amount to the complainant does not arise. Further it is contended that, the complainant has made representation on 02-09-09 and objected to release the death benefits payable to the Respondent No-2 for which the opposite insurance company rightly answered and replied that as per valid nominee made by assured in policy and in view of section 39 of Insurance Act the Respondents Insurance Company under bounded to pay the benefits to nominee only and the said nominee is the person who can give a valid discharge to this Respondent therefore this Respondent replied complainant regarding the payment to be made in favour of nominee only. After receiving all documents as per requirements, if claim is found to be admissible. The admissibility of the claim will be decided only after receipt of all required documents from the nominee/claimants, as claim has arisen within two years from the date of renewal of the policy. The death benefit is not paid till this day due to non production of documents as sought by this Respondent. It is further contended that, the death benefits are arising out of the policy are :- Basic sum assured Rs. 50,000/- vested bonus for 4 years. Rs. 8,700/- Interim bonus for 1 year Rs. 2,100/- Double Accident Benefit Rs. 50,000/ -------------------------- Gross amount payable Rs. 1,10,800/- Less Loan dt. 7-03-09 Plus loan interest from 7-03-09 to 4-6-09. Rs. 8,500/- -------------------------- Net amount payable Rs. 1,02,115/- --------------------------- The above amount are payable subject to production of valid documents basing on admissibility of claim and proof of cause of death i.e, accident and production of DL of the deceased and policy papers regarding accident. That immediately after the receipt of the claim from the complainant we have answered categorically hence there is no deficiency on the part of the Respondent No-1 hence sought for dismissal of the complaint. 3. During the course of enquiry the complainant has filed her sworn affidavit by way of examination-in-chief reiterating the averments of the complaint and she has got marked (6) documents as Ex.P-1 to Ex.P-6. In rebuttal the Respondent No-1 has filed sworn affidavit of P.S. Markendeshwara, Manager Legal & HPF of LIC of India, D.O. Raichur. The Respondent No-2 has not filed her sworn-affidavit by way of examination-in-chef. The Respondents have not produced any documents hence no documents were marked on behalf of the Respondents. 4. Heard the arguments of both sides and perused the records. The following points are arises for our consideration and determination: 1. Whether the complainant prove deficiency in service by the Respondent No-1 as alleged.? 2. Whether the complainant is entitled for the reliefs sought for.? 5. Our finding on the above points are as under:- 1. In the Negative 2. As per final order for the following REASONS POINT NO.1:- 6. There is no dispute that the late Shivaraja had life assured policy No. 663294982 dt. 07-06-04 for an assured sum of Rs. 50,000/- with the Respondent No-1, the Respondent No-2 is the nominee to the said policy and not in dispute that the complainant-Smt. Mallamma is the legally wedded wife of late Shivaraja. It is also not in dispute that the late Shivaraja was died in accident and case has been registered before the Sirwar Police Station under Crime NO. 129/09 and FIR No. 290/09 dt. 04-06-09 on the file JMFC, Manvi. 7. It is the case of the complainant that since she is the legally wedded wife and legal heir of the late Shivaraja she is entitled for 50% of the amounts payable out of the policy death benefits but behind her back the Respondent No-2 moved claim petition before the Respondent No-1without any intimation. After coming to know about the same the complainant requested the Respondent No-1 to pay 50% of the death benefits, but the Respondent No-1 refused to pay 50% of the death claim amount is nothing but a deficiency on the part of the Respondent No-1. 8. Further it is the case of the Respondent No-1 that the Respondent No-2 is the nominee of the policy of late Shivaraja hence they cannot pay the death claim benefit amount to the complainant and they are suppose to pay only to the nominee. As per section 39 of Insurance Act the nominee is entitled to receive the same and it is their bounded duty to pay all the death benefits under the policy to nominee only. 9. The complainant has filed during the course of enquiry in all six documents namely: (1) True copy of the application under R.I. Act dt. 11-09-09 is marked at Ex.P-1 (2) Status Report of the policy marked at Ex.P-2, (3) Xerox copy of the FIR and complaint marked at Ex.P-3, (4) Copy of voter list pertaining to complainant marked at Ex.P-4, (5) Copy of objection letter dt. 02-09-09 marked at Ex.P-4, (6) Letter of Respondent No-2 dt. 02-09-09 marked at Ex.P-5. 10. From the perusal of the pleadings of the parties, evidence and documents filed by the complainant. Particularly from the close perusal of the Ex.P-2 Status Report of policy No. 663294982 it appears that Smt. Susheelamma i.e, Respondent No-2 is the nominee of the above said policy. As contended by the Respondent No-1 and as per the section 39 of Insurance Act the nominee is entitled to receive the proceeds of the policy in case of death of the policyholder before the maturity of the policy. In case the insured is alive on the maturity of the policy the nominee has no right to receive the money. Further it is very clear that in case the nominee and policy holder dies before the maturity of the policy the legal heirs of the nominee will be entitled to receive the policy amount but not by the heirs of the policyholder. Further the Act specifies that, if at all the heirs of the policy holder wants to claim their rights over the policy amount they are suppose to appear before the civil court which has got ample power to pass appropriate order in respect of the rights over the policy money is concerned. Here it is not the case of the complainant that she has approached the civil court and got the order in this regard and even inspite of that the Respondent No-1 has not paid an amount as she claimed herein. Under these circumstances the Respondent NO-1 has rightly refused the claim of the complainant through Ex.P-6 i.e, letter dt. 02-09-09, hence we do not find any reasons to believe that there is a deficiency in service on the part of the Respondent No-1. 11. Further, no doubt the complainant is the legally wedded wife and legal heir to the life assured Late Shivaraja but she cannot be accepted by the Respondent No-1 as a share holder to the claim amount in the absence of her name in the policy as a nominee and any order of the court as discussed supra. If at all the complainant wants to claim any share in the death benefits comes under the policy as a legal heir, she has to approach to the civil court wherein the claim of the complaint can be considered and determined after full pledged trial on this material aspect and thereby her right against the Respondent No-2 can be decided, then only the Respondent NO-1 is bound to consider the claim of the complainant but not under the facts and circumstances as explained in the complaint by the complainant. Hence there is no deficiency we find on the part of the Respondent NO-1. 12. Further on going through the pleadings of the parties and documents filed by the complainant absolutely there is no case against the Respondent No-2. Hence we hold that there is no claim against the Respondent No-2 therefore the complaint against the Respondent No-2 is dismissed as no claim. In the above circumstances the complainant is totally failed to prove the deficiency on the part of the Respondent NO-1. Hence the Point No-1 is answered in the Negative. The complainant in order to prove her case she has filed two rulings cited in: I 2006 CPJ 21 and II 2006 CPJ Page 280 of Honble State Commission of West Bengal and Honble National Commission respectively. The facts and circumstances mentioned under the said rulings are totally different from the facts and circumstances appearing in the case in hand. Hence with great respect we have not considered the above said rulings to the case of the complainant. POINT NO.2:- 13. In view of our discussion and finding on Point No-1, holding that the complainant has failed to prove deficiency in service on the part of the Respondents so the complainant is not entitled for the reliefs sought for. In the result we pass the following order: ORDER The complaint of the complainant being devoid of merits is hereby dismissed. No order as to cost. Office to furnish certified copy of this order to both the parties forth with free of cost. (Dictated to the Stenographer, typed, corrected and then pronounced in the open Forum on 26-02-10.) Sd/- Sri. Pampapathi, President, District Forum-Raichur. Sd/- Sri. Gururaj, Member, District Forum-Raichur. Sd/- Smt.Pratibha Rani Hiremath, Member.