Haryana

Sonipat

CC/383/2015

Smt. Sunita Alias Sunita Devi W/o Jitender - Complainant(s)

Versus

The Branch Manager Life Insurance Corporation Of India - Opp.Party(s)

B.S. Malik

29 Feb 2016

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM,

SONEPAT.

 

                             Complaint No.383 of 2015

                             Instituted on:09.10.2015

                             Date of order:29.02.2016

 

Sunita alias Sunita Devi wife of late Sh. Jitender, r/o H.No.309/4, Mohalla Kot, near old post office, Sonepat.

 

                                      ...Complainant.

                      Versus

 

1.The Branch Manager, LIC of India, plot no.16, Sector 1, DSIDC near ITI Bhorgarh, Narela, Delhi-40 (service to be effected through Branch Manager LIC Sector 15, Sonepat.

2.The Senior Divisional Manager, LIC of India, 11, 9^th floor,Scope Minar Laxmi Nagar, Delhi-92 saervice to be effected through Branch Manager, LIC of India, plot no.16, sector 01, DSIDC near ITI Bhorgarh, Narela, Delhi-40.

 

                                      ...Respondents.

 

COMPLAINT UNDER SECTION 12 OF

THE CONSUMER PROTECTION ACT,1986

 

Argued by: Shri BS Malik, Adv. for complainant.

           Shri OP Wadhwa,Adv. for respondents.

         

BEFORE-  NAGENDER SINGH, PRESIDENT.

        SMT.PRABHA WATI, MEMBER.

        D.V.RATHI, MEMBER.

 

O R D E R

 

         Complainant has filed the present complaint against the respondents alleging therein that  her husband was insured  with the respondents vide policy no.126230226 for Rs.9,95,000/- and unfortunately, he has expired on 6.11.2012 as a natural death.  The completed all the formalities and has submitted all the required documents and lastly vide letter dated 17.6.2015 which was received by the complainant on 14.7.2015, the respondents have repudiated the claim of the complainant on false and baseless grounds.  The complainant has alleged the repudiation of his claim to be wrong and illegal and it has caused unnecessary mental agony and harassment to the complainant. So, she has come to this Forum and has filed the present complaint.

2.       In reply, the respondents have submitted that the complainant’s claim has been repudiated on account of the deceased having suppressed the true and correct information.  They have denied the fact that the deceased LA had died due to natural death due to heart attack with complain of chest pain as reported by the complainant in her statement upon form no.3783 as the same has not been supported by any medical cause of death.  The deceased LA was self employed and was simply a Pujari and was having only small income of Panditai and was not having sufficient source to pay the quarterly premium amount regularly.  The insurance policy has been taken with malafide intention to defraud the respondents as the death occurred within 3 months 5 days and second quarterly premium was deposited one day before his death meaning thereby the deceased LA was not in good health and his habits were found to be not sober and his income was found to be disproportionate and thus, the complainant’s claim was rightly repudiated by the respondents and there is no deficiency in service on the part of the respondents while doing so and thus, prayed for the dismissal of the present complaint.

3.       We have heard the arguments of both the learned counsel for the parties at length and we have also gone through the entire relevant material available on the case file carefully & minutely.

4.       Ld. Counsel for the complainant has submitted that the respondents in order to harass and humiliate the complainant, has repudiated her legal and genuine claim, whereas she is legally entitled to get the claim amount in respect of the policy of her deceased husband.

         On the other hand, ld. Counsel for the respondents have submitted that the complainant’s claim has been repudiated on account of the deceased having suppressed the true and correct information.  They have denied the fact that the deceased LA had died due to natural death due to heart attack with complain of chest pain as reported by the complainant in her statement upon form no.3783 as the same has not been supported by any medical cause of death.  The deceased LA was self employed and was simply a Pujari and was having only small income of Panditai and was not having sufficient source to pay the quarterly premium amount regularly.  The insurance policy has been taken with malafide intention to defraud the respondents as the death occurred within 3 months 5 days and second quarterly premium was deposited one day before his death meaning thereby the deceased LA was not in good health and his habits were found to be not sober and his income was found to be disproportionate and thus, the complainant’s claim was rightly repudiated by the respondents and there is no deficiency in service on the part of the respondents while doing so.

         But we find no force in the contentions raised by the ld.counsel for the respondents since the respondents have not placed any document with the written statement affidavit.

         The bare perusal of the letter dated 17.6.2015 itself shows that the claim of the complainant was repudiated on some flimsy grounds without any base.  As per this letter, the deceased has no adequate income to deposit the installment and he has also not good health. In this letter, it is also contended that the habits of the deceased were not sober.  These allegations were made against the deceased without any base and effective evidence.  So, it is held that the respondents have repudiated the claim of the complainant wrongly and illegally. Thus, we hereby direct the respondents to make the payment of the claim amount in respect of the policy of the deceased Jitender, within a period of 45 days from the date of passing of this order, failing which, the claim amount shall fetch interest at the rate of 9% per annum from the date of passing of this order till its realization.

           With these observations, findings and directions, the present complaint stands allowed.

          Certified copy of this order be provided to both the parties free of cost.

File be consigned to the record-room.

 

 

(Prabha Wati Member) (DV Rathi Member)     (Nagender Singh-President)

DCDRF, Sonepat.      DCDRF Sonepat         DCDRF, Sonepat.

 

Announced 29.02.2016