This C.C. is coming on before us for hearing; the complainant appeared in-person and in the presence of Sri. K. Jagan Mohan Rao, Advocate for opposite parties No.1 & 2; upon perusing the material papers on record; upon hearing and having stood over for consideration, this Forum passed the following:-

O R D E R

(Per Sri. P. Madhav Raja, President)

This complaint is filed under section 12(1) of the Consumer Protection Act, 1986. 

2.      The brief facts mentioned in the complaint are that the complainant is the sister of the deceased/policy holder, Pitta Ravi S/o. Chinamalliru resident of Mallemadugu hamlet of Nellipaka village.   The deceased/policy holder was died due to heart attack on 31-10-2005 at his house and the nominee is the complainant Bandaru Vijaya. On 28-11-2011 through former Insurance agent, the complainant came to know that her brother/deceased had obtained an insurance policy for sum of Rs.1,00,000/- under the plan of Jeevan Anand by paying insurance premium of Rs.2,874/- vide policy bearing No.687269504, with profits and Accident benefit and the date of commencement of policy is 27-10-2005.  On that the complainant has submitted insurance claim papers to the opposite party No.1 for settlement of the insurance claim. As per  IRDA Regulations,2002 an Insurance claim shall be  settled not later than six months and being the nominee of the insurer the complainant was not informed about the delay in the settlement of the policy and not paid the policy amount with all the benefits.  On      20-11-2014 the complaint got issued legal notice to the opposite parties No.1 and 2.  Even after receipt of the legal notice the opposite parties did not choose to invoke any response, Hence the complainant filed this complaint.

3.      In support of her case the complainant filed the documents, which are marked as Exhibits A-1 to A-7.

4.      On receipt of the notice opposite parties corporation appeared through their counsel and filed written version. In their written version they contended that the complaint is not contained in original text of the consumer Act and it averred in the complaint that immediately after death of the policy holder the complainant/nominee has submitted claim form to the authorities and in another averment she was not aware of the taking Insurance policy by her brother and through the erstwhile insurance agent she came to know about the insurance policy is self contradictory. The complainant without any specific date  of arising cause of action and not produced any document proof of claim intimation and also neither claim date nor original policy bond, which amounts to  EX Nihilo, Nihil  Fit i.e. out of nothing nothing comes. The furnished status report of the Policy No.687269504 contains no noting/Endorsement of the Ops stating that claim is still pending with the Insurance Company and the status report shows as LAPSED-WOUT which implies that Lapsed without acquiring any Paid up value. The life assure was died on 31-10-2005 and  the duration of the policy /period of run of the policy is just for days and the said claim is classified as very early claim and would have caused investigation in to the bonafides of the claim, all these years since 2005 to 2014 i.e. over period of 9 years the evidence  of medical treatment/pre-proposal illness of the said life assured would have been destroyed and  as per the rules of the Ops corporation the Lapsed without acquiring paid up value policy files are destroyed after a period of 5 years  from the date of first un paid premium, and  to counter delay part the  Ops have relied on the judgment of The Hon’ble Supreme Court of India in  Civil Appeal NO.1166 of 2006 of Balwanth Singh (Dead) V/s Jagadish Singh & Ors.

5.       The opposite parties No. 1 & 2 have filed written arguments.

6.      In view of above circumstances, now the point that arose for consideration is,

Whether the complainant is entitled for the claim?

Point:-       

          The complainant is being a nominee of his brother Pitta Ravi Kumar who has procured a policy number 687269504 by name Jeevan Anand with profits and Accident benefit for sum of Rs.1,00,000/- from the Ops on 27-10-2005 by paying an installment premium of Rs.2,874/- and  died on 31-10-2005 in his house at Mallemadugu village due to sudden death due to heart attack.  She came to know about this policy on 28-11-2011 through erstwhile Insurance agent and in the Para No G of the complaint she averred that immediately after death of the policy holder, the complainant/nominee has submitted claim form to the authorities. The complainant self contradicts with her averments in her complaint and the complainant has failed to prove that the policy claim was made immediate death after the policy holder. As per the Ex.A-2 Computer printout Status report of Policy number687269504 issued by the Life Insurance Corporation of India printed at branch: 64R shows that LAPSED-WOUT which implies that Lapsed without acquiring any Paid up value. It means that the policy holder has not paid up to the value of the premium, the complainant has failed to prove that the policy premium was paid in total. The life assurer was died on 31-10-2005 and  the duration of the policy /period of run of the policy is just for days and the said claim is classified as very early claim and would have caused investigation in to the bonafides of the claim all these years since 2005 to 2014 i.e. over period of 9 years the evidence  of medical treatment/pre-proposal illness of the said life assured would have been destroyed, and  as per the rules of the Ops corporation the Lapsed without acquiring paid up value policy files will be  destroyed after a period of 5 years  from the date of first un paid premium.  It is not possible to trace out the said documents due to lapse of time. She has relied the citation of Hon’ble National Commission for limitation but has failed to substantiate her plea about the delay and limitation period for filing the claim. The ops have relied on the judgment of the Hon’ble Supreme Court of India in Civil Appeal No.1166 of 2006 Balwanth Singh (Dead) V/s Jagadish Singh & Ors. in counter of her plea. In her legal notice dated 20-11-2014 issued to The Branch Manager LIC of India, Bhadhrachalam, Khammam district i.e. Ex.A-4  she stated that basing on the  official receipt bearing the number 0342502 dated 25-10-2005 either settle the claim or repudiate the claim and even in legal notice dated 10-01-2015 issued to The Senior Divisional Manager LIC of India, Balasamudram, Hanmakonda, Warangal district i.e. Ex.A6 also shows that to order the branch either to  settle or repudiate the claim  and it is to be settle the claims within 6 months as per the IRDA Rules  which are not substantiating any of her contentions  in respect of her prayer. In view of the above circumstances we are of the opinion that the opposite parties are not entitled to pay the said policy amount to the complaint and are not having any deficiency of the service on their part, as such this point is answered against the complainant. 

7.      In the result complaint is dismissed.  No costs.

          Typed to dictation, corrected and pronounced by us in the open forum, on this the 21^st day of July, 2017.

Member                   Member               President

                                                          District Consumer Forum,

Khammam.

APPENDIX OF EVIDENCE

WITNESSES EXAMINED:-

For Complainant                                                    For Opposite party  

       None                                                                          None

DOCUMENTS MARKED:-

For Complainant                                                    For Opposite party

Member                   Member               President

                                                          District Consumer Forum,

Khammam.