ORDER
(Passed on 03 /02/2020)
PER SHRI.ATUL D.ALSI, PRESIDENT.
The complainant has filed this complaint U/s 12 of the Consumer Protection Act,1986 alleging non disbursement of her insurance claim for the reason of non submission of affidavit in respect of difference in surname. 2.
2. The facts in short giving rise to this petition are that the complainant is the wife and nominee of life assured Mr.Bhaurao Ramchandra Kulsinge who was insured with the OP Insurance Company under policy bearing No.9742255154. Said Bhaurao died on 4/1/2019. Hence the complainant filed insurance claim under the said policy alongwith requisite documents such as Pancard, Adharcard, Death certificate, leaving certificate, Bank passbook etc. with the OP. However, the OP failed to disburse the insurance claim for the reason of difference in surname of the insured in the policy and that appearing in the death certificate issued by the Municipal Corporation, Chandrapur. However, the Development Officer of the OP had clarified that though there is difference in the name appearing in the policy is Kulsinge and that appearing in the death certificate is Kulsange, the person who died is one and the same. However, despite of that the OP failed to disburse the insurance claim. Hence the complainant issued legal notice to the OP on 20/6/2019 through Adv.Ramesh Pimpalshende but the OPs did not pay any heed to the said notice. Hence, the complainant has filed this complaint.
3. The complaint is admitted and notice was served on the OP. The OP filed its reply and thereby denied allegations against it and submitted that while processsing the insurance claim it was found that there is difference in the name appearing in the policy which mensions the surname of assured as Kulsinge and that appearing in the death certificate as Kulsange. Hence the OP issued notices to the complainant on 26/6/2019 and 7/8/2019 calling upon her to file affidavit in respect of difference in the surname though both the documents are pertaining to the same person. However, the complainant did not comply and hence her insurance claim could not be disbursed. If the complainant filed such affidavit, the OP is ready and willing to disburse the insurance amount. The OP submitted that in such cases, filing of affidavit is mandatory and the certificate issued by Development Officer is not sufficient. As the claim could not be granted due to non compliance by the complainant despite notice, no liability can be fastened as against the present OP and the complaint is liable to be dismissed.
4. Counsel for the complainant argued that the complainant had submitted all the requisite documents alongwith the insurance claim and thereafter as and when required by the OP. However, the OP, at no point of time, directed her to file the affidavit in respect of difference in surname of the assured in the policy and in the death certificate. As there is no communication by the OP to the complainant in this regard, non disbursement of her insurance claim on this ground amounts to deficiency in service. Therefore the petition may be allowed as prayed.
5. Counsel for the OPs argued that the OP had issued notices to the complainant on 26/6/2019 and 7/8/2019 calling upon her to file affidavit in respect of difference in the surname though both the documents are pertaining to the same person. However, inspite of issuance of notices, the complainant did not comply and hence her insurance claim could not be disbursed. Hence there is no negligence in service and the complaint deserves to be dismissed.
6. We have gone through the complaint, written version filed by OP, affidavit, documents and WNA filed by the parties. We have also heard the oral arguments advanced by parties.
Points Finding
1. Whether there is deficiency in service on the part of
OP ? Yes
2. What order ? As per final order..
As to issue No.1
7. The complainant’s status as the Consumer of OP is undisputed. However, the dispute revolves around the letter alleged to have been issued by the OP to the complainant calling upon her to file affidavit in respect of difference in surname of the deceased policy holder in the policy document and that appearing in the death certificate. The OP has claimed that it had issued notices to the complainant on 26/6/2019 and 7/8/2019 calling upon her to file affidavit in respect of difference in the surname of the deceased as appearing in policy and that in death certificate issued by Municipal Corporation which is filed at Exh.6, and that both the documents are pertaining to the same person. However, the complainant has denied to have received any such notice from the OP. In such circumstances, it was incumbent on the part of OP to produce evidence substantiating service of alleged notices on the complainant. However, the OP did not file any proof in that respect on record. Hence for want of reliable evidence, contention of OP that the complainant failed to file affidavit though it was mandatory requirement, could not be accepted. Further, the complainant has filed affidavit sworn before Executive Registrar, Chandrapur on 29/11/2019 at Exh.29 in respect of difference in the name of deceased. Therefore, there is no laxity on the part of complainant in complying the mandatory requirement for disbursement of claim amount. Therefore in our considered view, the petition is liable to be allowed.
As to issue No.2
8. In view of our observations as above, we pass the following order..
Final order
- The Complaint is partly allowed.
2. The OP is directed to pay the sum assured under the policy alongwith all accrued benefits, if any, alongwith further Rs.10,000/- towards compensation for mental torture and cost of litigation.
3. Copy of the order be furnished to both the parties free of cost.
(Smt.Kalpana Jangade (Kute) (Smt.Kirti Vaidya (Gadgil) (Shri.Atul D.Alsi)
Member Member President
