::BEFORE THE DISTRICT CONSUMER DISPUTES  REDRESSAL FORUM, AT BIDAR::

                                                               C.C. No.10/2018.

                                                            Date of filing: 20.02.2018.

                                                                   Date of disposal: 05.11.2018.

P R E S E N T:-    

                              (1) Shri. Jagannath Prasad Udgata,                                                                                                                                                                                                                     B.A., LL.B.,

                                                                                                President

                             (2) Shri. Shankrappa (Halipurgi),

                                                                                 B.A.LL.B.,

                                                                                           Member.

COMPLAINANT/S:    1.   Tulsamma W/o Shivappa,                                                       
                                            Age:68 years,  Occ: House hold,

                                            R/o Bagdal-585226, Tq and Dist: Bidar.                                                                                      

                                         ( By Sri.S.M.Shetkar.,Adv.)                                                  

                                                                 VERSUS

OPPONENT/S:        1)         The Branch Manager,

                                             Life Insurance Corporation of India,

                                            Branch Office, Near Railway Station,

                                             Jeevan Beema Road, Bidar-585401.                                            

                                    2).       The Senior Divisional Manager,

                                             Life Insurance Corporation of India,

                                             Divisional Office,

                                            “AMRUT PRAKASH” Raichur-584101.

                                          (By. Sri.Baswarja Udgir., Adv.)

::   J UD G M E N T  ::

By Shri. Jagannath Prasad Udgata, President.

The complainant herein invoking the jurisdiction of this Forum has filed complaint u/s 12 of the Consumer Protection Act, 1986, alleging deficiency of service against the opponents.  The sum total of her complaint is as follows:-

2.           That, her son Late Vishwanath then a junior Lineman working in GESCOM had obtained L.I.C. Policy bearing No.364807255 date.10.06.2011 for sum assured of Rs.2,00,000/- under caption New BIMA GOLD with accidental benefit from branch office of L.I.C. at Madinaguda branch.  Hyderabad.  The premiums were to be paid half yearly @ Rs.5018 later, the same was transferred to Bidar branch.  The complainant was nominee in the policy.  During subsistence of the policy her son died due to Road Traffic Accident on 06.01.2017 on N.H.9, near Khandsari Sugar Factory of Magdal Village.  After the death, the complainant lodged her claim by enclosing death certificate so also Criminal case documents in the corresponding Crime No.1/2017 of the jurisdictionall Bemalkheda Police Station which was investigating the case.  Following several visits, the L.I.C. on 11.07.2017 remitted the Basic sum assured of Rs.2,00,000/- but did not pay the accidental benefit cover of similar amount for which legal notice was got issued on 30.12.2017 to which on 12.01.2018 a reply was sent by the opponents that, the policy was admitted for death claim payment as the death occurred during auto cover period and the policy being under lapse condition (the last premium payable being June 2016) accidental death benefit was denied.  The Deceased insured had paid premium o n 18.04.2016  and the policy being money back one, on 13.07.2016 amount of Rs.30,000/- having accrued to him, a sum of Rs.5256/- was deducted towards the premium payable in the month of June 2016 and the balance was paid to him.  So, the Insured had to pay premium in the month of December 2016 i.e., 10.12.2016.  A grace period of 30 days is available to the policy holder which was up to 10.01.2017 but the policy holder died on 06.01.2017 and hence the death happening during the grace period, the policy was in force, entitling g the nominee to claim Accidental death benefit.  Committing a breach, according to the complainant, the opponent have indulged into deficiency of service and she seeks reimbursement of the said sum with other benefits.

3.          The opponents entering appearance have filed detail written version, in which it is claimed that, the premium due for June 2016 had remained unpaid throughout and death occurring on 06.01.2017.  The Policy was in lapsed condition on that day.  Hence, the basic sum assured even though was paid owing to the auto cover period, the accident benefit rider would not be available.  The opponents have urged shifting of onus to the complainant to prove the validity of the policy.  The version is replete with many other jugglery of words not necessary for the determination of the core of the case.

 4.        Both sides have submitted documents, most of which are of no significance to the present proceedings, listed at the end of the order.  Have filed evidence affidavits and written arguments and were heard in length.  In course of oral arguments, the learned Counsel for the complainant has canvassed before us that, the deceased policy holder having died in a sudden violent accident, the complainant is handicapped to produce all the premium paid receipts. We find force in such submission.

5.         Taking into consideration the rival Contentions of  the parties at dispute, the following points arise for our consideration.

1. Does the complainant prove deficiency of service?
2. What orders?

6.         Our answers to the points raised are as following:-

1. In the affirmative.
2. As per final orders, owing to the following:-

                                       :: REASONS ::

7.         Point.No.1: From out of the documents produced, the one as Annexure-C is primus enter pares.  It is a status report generated by the computer of the L.I.C. from the component-CLAIM/SURRENDER HISTORY RECORD, placed towards the bottom of this document, it is seen a sum of Rs.5256/- as premium due for the month of June 2016 was collected from the sum of Rs.30,000/- accrued to the Life Assured as per the terms of the policy.  Hence, the fact remains, the next due was on 10.12.2016 webbed with a grace period of thirty days during which the policy cannot be stated to be under lapse condition.  The L.I.C. ignoring such a vital document of their own, denying accidental death benefit, deficiency of service and unfair trade practice is glaring at the face and thence we answer this point accordingly.

8.         Point.No.1: Though we concur that, the complainant deserves to be paid the accident benefit of Rs.2,00,000/- we find his claim of compensation to the tune of Rs.50,000/- in flated.  Further, adequate interest is being awarded to the complainant.   Hence we proceed to pass the following:-

ORDER.

1. The complaint is allowed in part.
2. The opponents are jointly and severally directed to pay the complainant a sum of Rs.2,00,000/- together with interest @ 12% p.a. calculated from the date of claim i.e., 15.02.2017 till realisation;
3. There would be no order as to compensations or costs.
4. Four weeks time granted to comply this order.

 (Typed to our dictation then corrected, signed by us and then pronounced in the open Forum on this 05^th day of November 2018).

Sri. Shankrappa H.                                             Sri. Jagannath Prasad                                  

Member.                                                                President.                                                                                         

Documents produced by the complainant

1. Annexure.A- Original premium paid receipt for the month of 
                             December 2014.
2. Annexure.B– Original premium paid receipt for the month of June-       
                            2015.
3. Annexure.C- Computerised printout of status report policy 
                             No.364807255.
4. Annexure.D–Copy of affidavit executed by the complainant.
5. Annexure.E-  Copy of the claim application.
6. Annexure.F- Copy of death certificate of Late Vishwanath.
7. Annexure-G- Copy of F.I.R. and complaint in Crime No.1/2017
                            Bemalkhed Police Station Bidar District.
8. Annexures.H- Copy of inquest report in Crime No.1/2017 of  
                              Bemalkhed Police Station.
9. Annexure.J(I-omitted)- Copy of post-mortem report on the body of
                               Vishwanath (late).
10. Annexure-K- Copy of charge sheet in Crime No.1/2017 of
                             Bemalkhed Police Station.
11. Annexure-M- Copy of driving licence of Late Vishwanath.
12. Annexure-N and P (O-omitted)- Original postal receipts.
13. Annexure-Q- Original reply of L.I.C. to the legal notice.
14.  Annexure.R-Premium paid certificate for the year 2012-13
                              of L.I.C.

 Document produced by the Opponents.

1. Annexure.R.1- Copy of policy bearing No.364807255.
2. Annexure.R.2- Copy of terms and conditions of the policy.

Witness examined.

Complainant.

1. P.W.1- Smt. Tulsamma W/o Shivappa.(complainant).

Opponent.

1. R.W.1- Sri C.K.Ravikumar S/o Late Krishnakumar Manager L.I.C. of India.

Sri. Shankrappa H.                                             Sri. Jagannath Prasad                                  

       Member.                                                                      President.