SRI JIBAN KRUSHNA BEHERA, MEMBER (I/C)
The complainant has filed this complaint petition, U/s-12 of C.P. Act-1986, (here-in- after called as the “Act”) alleging deficiency-in-service against the Opp. Parties, who are the office bearers of Shriram Life Insurance Company Limited located at different places.
2. The factual matrix of this case is that deceased father of the complainant namely Purna Das (life assured) had purchased two policies from the Ops vide policy No.NP141400016865 & NP141400020542 wherein the complainant was the nominee. The sum assured in respect of the said policies were Rs.1,50,000/- each. The deceased life assured deposited annual premiums to the Ops @ Rs.13,949/- in respect of each policy. Deceased life assured died on 6.7.2014 in his house. After the death of life assured, the complainant, being the nominee, claimed benefits. The office of the Ops issued claim Form A, B, C in favour of the complainant and the complainant submitted the said forms and relevant documents along with policy bond before the Ops. But the Ops intentionally and deliberately did not pay the death benefit to him during the said period even after several approaches and reminders. So, the complainant and his family members have faced both financial loss and mental agony. Finding no other way, the complainant sent legal notice against the Ops, but they remained silent in the matter. Hence, the complainant was constrained to file the present case with the reliefs stated in the complaint.
To substantiate his case, the complainant has relied on the following documents, which are placed in the record, as mentioned hereunder-
- Photocopy of Policy Bond.
- Photocopy of Proposal deposit receipt dated 19.2.2014.
- Photocopy of Death certificate of the life assured.
- Photocopy of Claim Form-A.
- Photocopy of Claim Form-C.
- Photocopy of Application of the complainant to the Ops.
- Photocopy of Cancelled cheque No.786181.
- Photocopy of Advocate Notice dated 30.3.2015.
3. In the present case, the Ops neither appeared nor filed their version. Hence, they were set ex parte.
4. On perusal of the case record, it is seen that both the parties are absent since long for which the case is unnecessarily lingering for ex parte hearing. On the date of hearing also, both the parties remained absent. Hence, taking into consideration the above fact, this Commissions is constrained to dispose of the case on merit.
In view of the above averments of complainant, the points for determination in this case are as follows:-
(i) Whether the complainant is a consumer or not?
(ii) Whether the complainant has cause of action to file this case?
(iii) Whether this consumer case is maintainable?
(iv) Whether there is any deficiency in service on the part of the Ops?
(v) Whether the complainant is entitled to get the relief, as sought for?
(vi) To what other relief(s), the complainant is entitled to?
F I N D I N G S
5. From the averments made in the pleadings of the complainant and the documents filed on his behalf, it is clear that the complainant is the nominee of his deceased life assured father namely Purna Das, who purchased the policy bonds in question from the Ops. The deceased life assured died on 6.7.2014, as reflected from the death certificate vide Annexure-3. After the death of his life assured father, being the nominee, the complainant filed claim form before the Ops vide Annexure-4, 5 & 6, but the Ops without considering the same in its proper perspective, repudiated the claim on flimsy grounds. Hence, the complainant was constrained to file the present case. From the above, it is clear that the complainant is covered under the definition of a consumer as defined under the provisions of the Consumer Protection Act, 1986. Consequently, the complainant has cause of action to file the case and the case is maintainable.
6. Let us see as to whether the Ops are deficient in providing service towards the complainant and whether the complainant is entitled for the reliefs, as prayed for. From the documents filed on behalf of the complainant, it is found that the deceased life assured was the father of the complainant, who had purchased two policies from the Ops vide policy No.NP141400016865 & NP141400020542 and the complainant was the nominee. Policies were covered for a sum assured amount of Rs.1,50,000/- each. The deceased father life assured had deposited annual premiums to the Ops @ Rs.13,949/- in respect of both the policies. After the death of life assured on 6.7.2014, the complainant claimed benefits and for that the office of the Ops issued relevant documents claim Form A, B, C in favour of the complainant and he submitted all the relevant documents along with death certificate and policy bond before the Ops. At that time, Ops assured him to pay the claim amount very soon, but the Ops intentionally and deliberately did not pay the death benefit to him till date even after several approaches and reminders made by the complainant. So, the complainant and his family members are facing both financial loss and mental agony.
7. Further, on perusal of the policy bonds in question, it is found that the life assured had submitted all required information viz. name, address, date of birth, occupation, annual income, family history, personal medical history, health condition along with declaration which was recommended by the agent Mamata Dey which was acknowledged by the Branch Manager Manas Ranjan Dash. On proper verification & scrutiny of the information supplied by the life assured, the Ops have issued the Policy Bonds in favour of the life assured Purna Das. Thus, there is no doubt that the life assured had obtained the policy bonds by misrepresentation or by concealing the material facts. Therefore, the Ops have committed gross error in repudiating the claim in question, which should have been accepted in accordance with the proposal form. Therefore, withholding of death claim in favour of the complainant is illegal & arbitrary and thereby deficiency in service is clearly attributes against the Ops. On the other hand, in this case, the Ops did not choose to appear nor filed version to defend their case. Hence, the statement of the complainant remained unchallenged and thus, it can be used against the Ops. Accordingly, both the Ops are jointly and severally liable for the compensation, as claimed by the complainant. Hence, it is ordered -
O R D E R
The case of the complainant be and the same is allowed on ex-parte against the Ops. Both the Ops are hereby directed to pay the sum assured amount of Rs.1,50,000/- each in respect of policy No.NP141400016865 & NP141400020542 to the complainant with interest @ 9% per annum from 06.07.2014 till its actual realization along with compensation of Rs.50,000/- towards harassment, mental agony meted out by the complainant and litigation cost, within 45 days of from receipt of this order, failing which the complainant is at liberty to realize the same through the process of law.
Pronounced in the open court of this Commission, this the 8th day of October, 2024 under my signature & seal of the commission.
