IN THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, JAJPUR.
Present: 1.Shri Biraja Prasad Kar, President,
2.Sri Pitabas Mohanty, Member,
3.Miss Smita Ray, Lady Member.
Dated the 17th day of November,2014.
C. C. Case No.244 of 2012
1. Abhimanyu Samal, S/O Late Banchhu Samal
2. Smt.Saraswati Samal,W/O Abhimanyu Samal
Both of are Vill- Taranjia, PO-Aruha,
P.S.Dharmasala,Dist.-Jajpur. ……………..Complainants .
(Versus)
1. The Branch Manager, At.Branch L.I.C of India,Cuttack-753002
P.O.Chandini chowk, P.S.Lalbag, Dist. Cuttack.
2. Branch Manager,L.I.C Of India,
At/P.O/ Dist. Jajpur.
…………………………Opp.Parties.
For the Complainant: Sri P.K.Ray ,Sri S .Mohapatra, M.R. Biswal, Advocates.
For the Opp. Parties: Sri M.S.Mahunta , Sri R.K.Jena, Advocates
Date of order : 17. 11.2014.
SHRI BIRAJA PRASAD KAR, PRESIDENT.
Deficiency in Insurance service is the grievance of the complainant.
Briefly stated, the facts of complainants’ case are that the complainants’ deceased son Kailash Chandra Samal had done one L.I.C policy bearing policy No.5855704459 under the O.Ps. . Kailash Chandra Samal died on 15.11.2005 during the operation of policy. After the death of Kailash ch.Samal the present complainants being the legal heirs of deceased Kailash ch. Samal laid claim before the O.Ps in the year 2009 and submitted all the required documents before the O.Ps. on 29.05.09 but the O.Ps. did not settle the claim. Hence, the complainants gave advocate notice to the O.Ps. on 15.02.10 . But it was in vain. Finding no other way the complainants filed this dispute against the O.Ps. alleging deficiency in service on the part of the O.Ps. and prayed to direct the O.Ps. to pay the matured amount of Rs.50,000/- to the complainants and to pay the interest @12% per annum with P.I and F.I thereon . The complainants also prayed to direct the O.Ps. to pay Rs.27,000/- to the complainants towards mental agony and harassment.
On being noticed the O.Ps. appeared through their advocate and filed their written version denying the allegations made in the complaint petition. The O.Ps. have pleaded in their written version that Kailash ch. Samal availed a policy bearing No.585520459. Kailash ch. Samal, the life assured died on 15.11.2005 as alleged by the petitioners, but the petitioners intimated the matter to the O.Ps. in the year 2009. The O.Ps. have not received the death certificate from the claimant so far. The petitioners have not submitted all the required documents. The O.Ps. have not received the original policy Bond, Certified Copy of F.I.R and P.M Report etc. about the cause of death. The petitioners should submit the above mentioned documents in original. The life assured has paid his premium for two years and three months only, then life assured will be covering the risk. The proof of evidence has not been submitted in time and properly with the clarification regarding the delay in submitting the claim after more than 3 years of cause of action i.e date of death to ascertain the bonafide of such claim.
As per policy condition, maturity value is payable in case of in force policy and if the assured is surviving till the date of maturity. In the instant case the policy holder died as alleged within 3 years. So the O.P is quite unable to pay the death value without ascertaining the genuineness of the claim through inquiry as the complainants have not intimated in time enabling the O.Ps. to conduct the enquiry. Hence, the case is liable to be dismissed.
On the date of hearing we heard arguments from both the sides. Perused the pleadings and documents available on record.
The learned advocate for the complainants argued that there is no dispute that the deceased Kailash ch.Samal had done one L.I.C policy under the O.Ps. and the said kailash ch.Samal died on 15.11.2005. After the death of Kailash ch.Samal the legal heir, the present complainants lodged claim before the O.Ps. and submitted all the relevant documents to the O.Ps. on 29.05.09 which was duly acknowledged by the O.Ps. and the O.Ps. had issued receipt . The O.Ps. did not settle the claim for which the complainants issued lawyer’s notice to the O.Ps. on 15.12.10. But the O.Ps. did not gave any reply to the advocate notice which amounts to deficiency in service. The complainants have been forced to file this dispute. During the pendency of the dispute the O.Ps. have settled the claim on 27.03.14 and paid Rs.54,089.00 . Hence, there is extreme delay in settlement of the claim which amounts to deficiency in service and the complainants are entitled to interest and compensation towards harassment . The advocate for the O.Ps. submitted that due to non supply of material documents there is delay in settling the claim.
We have gone through the documents available on record and found that the O.Ps. have received the stamp paper zerox 100/-, Death Certificate Zerox, Death Claim of Kailash Ch. Samal, Legal heir certificate zerox and renewal premium zerox on 29.05.09. After receiving the aforesaid documents from the complainants , the O.Ps. remained silent and the complainants gave advocate notice. The O.Ps. also remained silent to the advocate notice. The O.Ps. have settled the claim on 27.03.14. There is delay of 5 years in settling the claim of the complainants by the O.Ps. In our opinion delay in settling the claim amounts to deficiency in service . The O.Ps. have not filed any documents to show that there is delay on the part of the complainants for submitting the relevant documents before the O.Ps. . Hence, the complainants have suffered a lot for which they are to be compensated .
Under the above mentioned circumstances we hold that there is deficiency in service on the part of the O.Ps..
O R D E R
In the result the C.C.Case is allowed on contest against the O.Ps. . The O.Ps are directed to pay interest @ 9% per annum on Rs.50,000/- from 26.07.12 i.e the date of filing the C.C.Case to 26.03.14. The O.Ps. are also directed to pay Rs.5,000/-(five thousand) towards cost of the litigation. The above order is to be carried out within two months from the date of the order.
This order is pronounced in the open Forum on this the 17th day of November ,2014. under my hand and seal of the Forum.
(Shri Pitabas Mohanty) (Shri Biraja Prasad Kar)
Member. President.
Typed to my dictation & corrected by me
(Miss Smita Ray) ( Shri Biraja Prasad Kar )
Member. President.
