BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM :: KADAPA Y.S.R DISTRICT
PRESENT SMT. K. SIREESHA, B.L., PRESIDENT FAC
SRI M.V.R. SHARMA, MEMBER.
Friday, 28th March 2014
CONSUMER COMPLAINT No. 60/ 2013
1. S. Shahzadi Begum, W/o Late Mahammed Ghouse Peer,
Muslim, aged 71 years, House wife.
2. Md. Hafeezur Rehaman, S/o Late Mahammed Ghouse Peer,
Muslim, aged 52 years,
Both are residing at D.No. 10/636, Bellam Mundy Street,
Kadapa. ….. Complainant.
Vs.
1. The Divisional Manager, LIC of India,
Yerramukkaplli, Kadapa.
2. The Branch Manager, LIC of India,
Nagarajuet Branch, Kadapa. ….. Respondents.
This complaint coming on this day for final hearing on 24-3-2014 in the presence of Sri Y. Srinivasulu, Advocate for complainant and Sri T.V.S.S. Murthy, Advocate for respondents and upon perusing the material papers on record, the Forum made the following:-
O R D E R
(Per Smt. K. Sireesha, President FAC),
1. Complaint filed under section 12 of the C.P. Act 1986.
2. The brief facts of the complaint are as follows:- The complainant submitted that the complainant No. 1 is wife and complainant No. 2 is the son of one Md. Ghouse Peer, S/o Muqthoom Sahib. The said Md. Ghouse Peer during his life time had taken two LIC policies Nos. 651969185 & 652263946 forum the respondent for a value of Rs. 50,000/- and Rs. 40,000/- on 15-9-1998 and 28-3-1999 respectively. The date of maturity of the said two policies are on 15-9-2013 and 28-3-2014. The said Md. Ghouse Peer, had regularly paying the premium amount of Rs. 3,614/- and Rs. 4,363/- per year. The term of the said two policies in 15 years. As per the said policy in case the insured died before the date of maturity the respondents have to pay the assured sum amount + vested bonus. The said Ghouse Peer died on 18-12-2000 due to heart attack. The complainants are the nominees of the said Ghouse Peer. The said Ghouse peer, was worked as Sub-Treasury Officer, Kadapa.
3. It is submitted that the complainants being the nominees, they have complied with all the requirements to the respondents for death claim of the said Ghouse Peer and submitted original LIC policy bonds to the respondents. On 24-9-2009 the respondent No. 2 has sent a letter to the complainants to expedite the death claim of Ghouse Peer and requested to send the Household card of the said Ghouse Peer. Accordingly, on 25-9-2009 the complainants submitted all the requirements of the respondents, letter dt. 24-9-2009. Since then the complainants are going around the respondent’s office for the settlement of death claim of the said Ghouse Peer. Though the complainants fulfilled all the requirements as asked by the respondents, they have not settled the death claim for the reasons best known to them. Since the said Ghouse Peer died before the maturity of the policies, the nominees i.e. complainants are entitled to the sum assured amount with vested bonus.
4. It is submitted that the complainant No. 1 is aged about 70 years and she is bed ridden and the complainant No. 2 had underwent cataract operation and spent Rs. 3,00,000/- towards medical expenses.
5. Further submitted that the complainants have addressed a legal notice dt. 26-6-2013 calling upon the respondent No. 2 to settle the death claim of the said Ghouse Peer and pay the claim amount to the complainants, within a period of 7 days of receipt of the legal notice. The said legal notice was duly served on 28-6-2013 to the respondent No. 2. Having received the legal notice the respondent No. 2 did not settle the death claim for the reasons best known to him. Being Insurance company a duty is cast upon the respondents to settle the just claim of the complainant. Thus the act of the respondents clearly amounts to deficiency of service on their part and also made the complainants to suffer mental agony. Hence, this complaint.
6. It is submitted that the complainants approached the respondents on several times to settle the death claim of Md. Ghouse Peer. But they are postponing the same on some pretext or other without reason. The complainants are obliged to file this complaint before the Hon’ble forum, having no other alternative.
7. Cause of action of action arose on 15-9-1998 and 28-3-1999, when said Md. Ghouse Peer had taken two LIC policies from the respondent No. 2 and paid premium installment amounts and the said policies expired on 15-9-2013 and 28-3-2014 and when on 18-12-200, the said Ghoue Peer died due to Heart attack and when the complainants submitted all the requirements before the respondents and when on 24-9-2009 the respondent No. 2 issued a letter to the complainants to send the Household card and when on 25-9-2009 the complainants send reply dt. 26-6-2013 and in spite of several requests the respondents are postponing to settle the death claim of the said Ghouse Peer and when the complainant issued legal notice to the respondent No. 2 and when having acknowledged the legal notice the respondent No. 2 failed to sent reply or settle the claim and when the respondents company is situated in Kadapa city, within the jurisdiction of this Hon’ble Forum. An Indian Postal order worth of Rs. 200/- is enclosed herewith.
8. It is therefore, prayed that this Hon’ble forum may be pleased to pass an order in favour of the complainants against the respondents (i) direct the respondent No. 2 to pay policy amount of Rs. 50,000/- + Rs. 40,000/- = Rs. 90,000/- plus vested bonus i.e. Rs. 40,000/- along with interest to the complainants, (ii) pay a sum of Rs. 30,000/- towards mental agony, (iii) pay Rs. 5,000/- towards costs of this complaint and (iv) to grant such other reliefs as the Hon’ble forum deems fit and proper in the interest of justice.
9. Counter field by the respondents. The complaint filed by the complaint is not maintainable either in law or on the facts of the case.
10. The complainant is put to very strict proof of each and every allegation which are not admitted by this respondents.
11. It is true that the deceased life assured late Ghouse Peer had taken two LIC policies 651969185 & 652263946, with date of commencement 15-9-1998 & 28-3-1999 with plan and term 14-15, 14-15 with premium of Rs. 4,363/- and Rs. 3,614/- with mode yearly, respectively. Shanzadi Begum Wife and Habeezur Rahiman Son are the nominees under the above policies.
12. It is further submitted that the policy holder died on 18-12-2000. The complainant intimated the death of deceased vide letter dt. 16-3-2009 and submitted claim forms and original policy bonds on 8-6-2009. The complainant applied for claim after 9 years elapsed from the date of death. After the examination of the claim the respondents informed the complainant vide their letter dt. 2-7-2009 “that we have no liability to settle the claim under the said policies as the claims are time barred”. It is further submitted that as per claim forms B, B1 submitted by the complainant that the deceased life assured was suffering from chronic heart problem and had taken treatment for it in the RIMS General Hospital, Kadapa. Had complainant intimated the death of deceased life assured immediately after the death of respondents we would have caused enquiries and would have produced evidences. As the duration elapsed from date of death to date of preferring claim is 9 years, the evidences to prove the suppression of materiality of the health facts could not be established as there is no chance of preserving records for 9 years in any hospital. It clearly attracts the provisions of limitation act.
13. In the light of above submissions it is clear that the present complaint is bared by limitation and that prays to dismiss the same in the interest of justice. Otherwise the respondents will be put to suffer irreparable loss and injury.
14. On behalf of the complainant Ex. A1 and A8 were marked and on behalf of the respondents Ex. B1 to B5 were marked.
15. On the basis of the above pleadings the following points are settled for determination.
i. Whether the complainant is entitled to the relief as prayed by them or not?
ii. Whether there is negligence or deficiency of service on the part of the Respondents?
iii. To what relief?
16. Point Nos. 1 & 2. It is very clear that the deceased late Md. Ghouse Peer, who is the husband of 1st complainant and father of 2nd complainant had obtained two LIC policies bearing Nos. 651969185 & 652263946 for a value of Rs. 50,000/- and Rs. 40,000/- dt. 15-9-1998 and 28-3-1999 from respondent company under Ex. A1 and Ex. A2. Ex. B4 is original policy bond. The deceased late Md. Ghouse peer died on 18-12-2000 as per Ex. A8 and Ex. B2. The term of the above said two policies is 15 years. The maturity date of the above two policies 15-9-1998 & 28-3-1999 respectively. The claim form was submitted by the complainant under Ex. A3. As per Ex. A4 the respondents required some documents to settle the claim. Ex. A7 also clearly shows that the respondents need some documents to settle the claim. Ex. A7 dt. 12-3-2014 clearly shows that the respondents required some documents to settle the claim. It is an admitted fact that the deceased Md. Ghouse Peer, who is the husband of the 1st complainant and father of the 2nd complainant had obtained two policies from the respondent company. The maturity date of the two policies were 15-9-2013 & 28-3-2014. As seen from the above averments it is very clear that the policies are inforce at the time of death of the deceased Md. Ghouse Peer. As per the Ex. A7 it is very clear that the respondents are ready to settle the claim. But it is not understandable what prevented them to settlement of the death claim of the deceased Md. Ghouse Peer. Ex. B5 is the claim form submitted by the complainants to the respondents. From the above all documentary evidence it is very clear that the policies were in force at the time of death of the deceased Md. Ghouse Peer. The complainants 1 & 2 are eligible compensation as prayed by them. There is gross negligence and deficiency on the part of respondents.
17. Point No. 3 In the result, the complaint is allowed, directing the respondents 1 & 2 jointly and severally liable to pay Rs. 50,000/- policy amount (Fifty Thousands) bearing policy No. 651969185 along with vested bonus upto the date of maturity of policy bond i.e. 15-9-2013, pay Rs. 40,000/- (forty Thousand) policy amount bearing policy No. 652263946 along with vested bonus upto the date of maturity of policy bond i.e. 28-3-2014, pay Rs. 10,000/- (Ten Thousands) towards mental agony and pay Rs. 5,000/- (Five thousands) towards cost of the complaint to the complainant, within 45 days of date of receipt of orders.
Dictated to the Stenographer, transcribed by him, corrected and pronounced by us in the open Forum, this the 28th March 2014
MEMBER PRESIDENT FAC
APPENDIX OF EVIDENCE
Witnesses examined.
For Complainant NIL For Respondents : NIL
Exhibits marked for Complainant : -
Ex. A1 P/c of insurance policy bond dt. 15-9-1998 issued by the respondent
company.
Ex. A2 P/c of insurance policy bond dt. 28-3-1999 issued by the respondent
company.
Ex. A3 P/c of claim form submitted by the complainants to the respondent.
Ex. A4 Letter issued by the respondent to the complainant dt. 24-9-2009.
Ex. A5 Reply letter issued by the complainant to the respondent
dt. 25-9-2009.
Ex. A6 Office copy of legal notice dt. 26-6-2013 along with postal receipt.
Ex. A7 Letter issued by the respondent to the M Ghouse peer who is
husband of the petitioner No. 1 and father of the petitioner No.2.
Ex. A8 P/c of the proceedings of the Asst. Treasury officer, Kadapa,
dt. 3-4-2001.
Exhibits marked for Respondents: -
Ex. B1 Letter dt. 2-7-2009 addressed to Smt. Shahzadi Begum & Md. H. Rahiman.
Ex. B2 Death Intimation letter dt. 16-3-2009. (Original)
Ex. B3 Claimant statement in claim form A (original)
Ex. B4 Original policy bond bearing Nos. 651969185 & 652263946
Ex. B5 Claim form B, B1 (Original).
MEMBER PRESIDENT FAC
Copy to :-
1) Sri Y. Srinivasulu, Advocate for complainant.
2) Sri T.V.S.S. Murthy, Advocate for respondents.
B.V.P.
