ORDER                                    Dated:  06.12.2016

Mohd. Anwar Alam, President

1. Complainant filed this complaint on 21.04.2015 and alleged that an  insurance policy no. DL 104145CS  Type EA, was issued by OP  in favour             her husband late Sh. Laxmi Narayan Yadav for an sum assured of Rs. 10,00,000/-. After the death of her husband she requested OP for release of the  assured  amount but vide letter  dated 13-06-2014 OP rejected her claim.  Complainant sent legal notice dated 09.10.2014  to OP. She further alleged that OP the entire requirements of the policy were fulfilled  and  OP  was fully satisfied and accepted  her claim  but with malafide intentions or purpose to deprive her claim OP rejected the claim. Hence there is deficiency in service on the part of OP in not settling her claim accordingly. She prayed  that OP be directed to pay Rs. 20,00,000/- as double of policy amount , Rs. 1,00,000/- as compensation for harassment  and  Rs. 20, 000/-as litigation cost. 
2. In reply, OP objected that the relief as sought is not maintainable. OP admitted that complainant is the nominee of the insured in respect of the  policy no. DL 104145CS for a sum assured of Rs. 10,00,000/- with a monthly premium of Rs 5750/-   and OP has received the premium from June 2009 to May 2012 in respect to the aforesaid policy. OP also admitted that the death certificate of the insured proves the death of the insured on 26.05.2012  at Mata Chanan Devi Hospital, New Delhi and complainant had preferred the death claim which was duly considered and examined in detail by OP and the claim was not found admissible by the competent authority in view of the fact that the  insured concealed  his diseases while taking the policy as per information given in column no. 16 (b) of the proposal form and furnished false information about his health in column 16 (a)  and (c) of the proposal form and the same was communicated to the complainant vide letter dated 13.06.2014.  OPs further admitted that the death summary issued by Mata Chanan Devi Hospital  was examined by the Panel Doctor to PLI and it clarifies that the insured had past history of Diabetes, Hypertension, Old Cardiovascular disease due Ischemia, Urinary Tract infection with nephropathy.    OPs denied rest of the allegations made in the complaint and prayed that the complaint be dismissed with costs.
3. The complainant   has filed rejoinder to the reply and explained that the objections filed by OPs are baseless. In support of his complaint, complainant filed affidavit his own affidavit along with documents i.e. copy of insurance policy    (Ex. CW1/1 ) (colly) , copy of  receipts of premium (Ex. CW1/2) (colly) , copy of  death certificate (Ex. CW1/3) , copy of letter of rejection of claim dated 13.06.2014   (Ex. CW1/4),  copy of reply dated 16.10.2014 and 19.11.2014  (Ex. CW1/5 to Ex. CW1/6), copy of driving license of husband of the complainant (Ex. CW1/7) and copy of ration card (Ex. CW1/8) , copy of legal notice (Ex. CW1/9) , copy of postal receipt  (Ex. CW1/10)  , copy of courier receipt  (Ex. CW1/11 ).
4.  In support of reply, OPs filed affidavits of  P. Bharatha Lakshmi and Mr. Ashok Kumar    (Assistant  Directors, Admn. )  along with documents i.e. copy of proposal form  (Ex.DW-1/1) , copy of  letter of acceptance dated 24.06.2009 (Ex. DW-1/2) , copy of certificate of insurance (Ex.DW-1/3), copy of death claim (Ex. DW1/4), copy of death summary (Ex. DW1/5), copy of opinion of Dr. Harbans Singh (Ex. DW1/6), copy of letter dated 13.06.2014 (Ex. DW1/7) and copy of legal notice of the complainant (Ex. DW1/8)
5. Both the parties filed their written arguments.
6. We have heard the arguments and considered the evidence led by the parties and their written and oral arguments.  In this case points to be considered are as under:-

   (a) Whether complainant is a consumer?

   (b) Whether there is any deficiency in service on the part of the OP?

   (c) Relief?

7.  In reply OP admitted the insurance policy of deceased and complainant was her nominee therefore complainant is a consumer.

8. Jurisdiction of the forum is to be decided on the basis of relief claimed by the complainant. As complainant herself prayed that OP be directed to pay Rs. 20,00,000/- as double of policy amount and Rs. 1,00,000/- as compensation for harassment as well as Rs. 20,000/- as cost of litigation to the complainant totaling to Rs. 21,20,000/-. This amount is not covered within the pecuniary jurisdiction of this District Forum hence in our considered opinion this complaint is not maintainable in this forum.

9. In these facts and circumstances, we are of the opinion that this complaint is not maintainable in this forum. Hence complaint is dismissed accordingly and complainant is  also directed to file her complaint before the Hon’ble State Commission within 30 days from the date of receipt of this order.

10. Both the parties will bear their own cost.

11. Copy of the order made available to the parties free of cost as per law.

      File  be consigned to record room.

Announced on………