Tripura

West Tripura

CC/6/2017

Smt. Mampi Dhar (Ghosh) & Sri Bipradip Ghosh. - Complainant(s)

Versus

The Divisional Manager, Life Insurance Corporation of India & others. - Opp.Party(s)

Mr.S.Roy, Mr.S.Debbarma.

20 Apr 2017

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM
WEST TRIPURA :  AGARTALA

CASE   NO:   CC- 06 of 2017

1. Smt. Mampi Dhar(Ghosh),
W/o- Lt. Bipul Kanti Ghosh,
C/O- Sri Rabindra Dhar,
Ramkrishna Ashram,
Gangail Road, P.S. West Agartala,
West Tripura.

2. Sri Bipradip Ghosh,
S/O- Lt. Bipul Kanti Ghosh,
(Petitioner No.2 to be represented 
by the petitioner No.1 
i.e., his natural guardian)        ..…..…...Complainants.

             -VERSUS-

1. The Divisional Manager,
Life Insurance Corporation of India,
Silchar Division, Silchar, Kachar,
Assam- 788001.

          2. The Branch Manager,
Life Insurance Corporation of India,
Branch No.II, Krishnanagar, T.R.T.C.
Agartala, P.S. West Agartala,
West Tripura.            ..….....Opposite Parties.
 
     2. Smt. Anjali Ghosh,
     W/O- Lt. Bhajan Chandra Ghosh,
     Jangalia, P.S. Bishalgarh,
     District- Sepahijala, Tripura. .........Proforma Opposite Party.

 

                 __________PRESENT__________

 SRI A. PAL,
PRESIDENT,
  DISTRICT CONSUMER  
DISPUTES REDRESSAL FORUM,
      WEST TRIPURA, AGARTALA. 

SMT. Dr. G. DEBNATH
MEMBER,
  DISTRICT CONSUMER 
DISPUTES REDRESSAL FORUM, 
  WEST TRIPURA,  AGARTALA.

SRI U. DAS
MEMBER,
  DISTRICT CONSUMER 
DISPUTES REDRESSAL FORUM, 
  WEST TRIPURA,  AGARTALA.

 

C O U N S E L

    For the Complainant    : Sri Sukendu Debbarma,
                      Sri Subrata Roy,
                      Advocates.
                     
    For the O.P. No.1 & 2    : Sri P.K. Debnath,
                      Advocate.

For the O.P. No.3        : None Appeared.
                 

        JUDGMENT  DELIVERED  ON:   20.04.2017

J U D G M E N T
        This case arises on the application filed by Mampi Dhar (Ghosh) and Bipradip Ghosh U/S 12 of the Consumer Protection Act. Petitioner's case in short is that her husband, Bipul Kanti Ghosh purchased policy from the LICI on 04.05.10 and  31.03.10 from the O.P. LICI. 2 policies from LICI and one policy from Tata AIF. On the death of her husband she claimed the sum assured from the LICI. LICI claimed succession certificate from the competent court of law. Succession certificate was granted in her favour. But inspite of production of succession certificate the amount was not paid by the LICI. Therefore, she filed this case for getting redress.

2.        O.P. LICI appeared, filed written statement denying the claim. It is stated by the LICI that the claim is to be settled with the nominee, Anjali Ghosh, mother of the life assured. Anjali Ghosh could not produce the treatment particulars and discharge summary etc. which were required for releasing the benefits of the policy. LICI was also refrained from processing of the procedure due to order of the Civil Court. LICI  is to settle the claim as per Insurance Act after receipt of the particulars from the claimant including the duly attested photocopy of succession certificate. There was no deficiency of service by the LICI.

3.        On the basis of contention raised by the both the parties following points cropped up for determination.
        (I)Whether the petitioner was entitled to get the sum assured and other benefits of the policy of her deceased husband?
        (II)Whether there was deficiency of service by the LICI?

4.        Petitioner side produced the succession certificate, birth certificate, written statement of LICI in the succession certificate, death certificate of Bipul Kanti Ghosh, survival certificate of Bipul Kanti Ghosh.
        Petitioner also produced statement on affidavit of Mampi Dhar (Ghosh), Petitioner of the case.  

5.        O.P. on the other hand produced the reply letter, reminder letter and speed post letter and also statement on affidavit of Nabarun Ghosh.

Anjali Ghosh the nominee and proforma O.P. produced no written statement in this case.

7.        We have gone through all the documents as produced by the parties and on the basis of all these documents we shall decide the above points.
Findings:
8.        We have gone through the policy certificate issued by the LICI. Date of proposal was 08.05.10. Name of the nominee  U/S 39 of the Insurance Act was Anjali Ghosh, the mother of the deceased. For another policy the date was 31.03.12. Anjali Ghosh has been shown as the nominee. First policy was for the amount of 2 lacs and single premium Rs.40,000/-. 2nd policy was also for Rs.2 lacs and single premium was Rs.40,000/-. O.P. LICI did not contend that policy was lapsed and not eligible for other benefits. We have gone through the death certificate issued by the Register Birth & Death and found that Bipul Kanti Ghosh died on 29th December 2011. So on such death O.P. LICI was to take proper step for disbursement of the sum assured Rs.2 lacs  + Rs.2 lacs total Rs.4 lacs to be paid to the nominee, Anjali Ghosh, mother of the deceased for arranging the payment to all legal heirs of Bipul Kanti Ghosh. We have gone through the survival certificate and found that Bipul Kanti Ghosh left survivors i.e., his wife, son and mother. Petitioner Mampi Dhar and her one year son Bipradip Ghosh were supposed to get 2/3rd of the sum assured of Rs.4 lacs in 2 policies. As the benefits and sum assured was not released in time so both the petitioner and son and wife did not get the benefits of the policy. The contention of the O.P. is that requirement were not fulfilled by the nominee. Nominee had made communication with the LICI. We have gone through the letter given by Anjali Ghosh to the Manager, Claim LICI. In that letter it was written that previously she had fulfilled all requirements and submitted the claim  form to the O.P. and also submitted necessary treatment particulars and death certificate of life assured and also certificate of medical officer of TMC. In the Claim format nothing mentioned about the treatment particulars and discharge summary. Why this discharge summary and treatment particulars is necessary for releasing the claim not clarified by the LICI.
9.        In the cross examination Nabarun Ghosh stated that  enquiry was conducted in the case. But what enquiry was done and the enquiry report was not produced. Naburan Ghosh in his statement on affidavit stated that after receiving form from the nominee Anjali Ghosh mother of the deceased wrote letters on various occasions dated 27.07.16, 11.01.17 for submitting treatment particulars and discharge summary for deciding the claim. But O.P. did not receive the treatment particulars from the claimant. Representative of O.P. also stated that photograph of the succession certificate has no legal status. He also stated that claim can not be decided without receipt of the fundamental bonafide requirements. LICI had enquiring Cell. So it could collect the information from the hospital if any doubt arise about the cause on the death of life assured. It was not done and unnecessarily claim was not settled after 5 years of the death of Bipul Kanti Ghosh life assured. This is deficiency of service by LICI. As the claim was not settled so the petitioners being the legal heirs and successors of Bipul Kanti Ghosh suffered a lot. They are entitled to get the policy benefits. It is true that time was taken for collection of succession certificate. But as per Insurance Act the amount or sum assured could have been disbursed to the nominee within the 5 years without succession certificate. Nominee is duty bound to disburse the amount to actual legal heirs. This is the principles laid down by our Apex Court. Even after production of succession certificate the benefits of the policy sum assured was not released till today. This is again deficiency of service of the LICI. Petitioner being legal heir with the minor son are under distress condition due to this deficiency of service. The petitioner are found entitled to get 2/3rd of the sum assured and 1/3rd will go in favour of proforma O.P. Anjali Ghosh. The amount was not disbursed to the petitioner & as a result petitioner suffered. We find prolong delay in settlement of the claim. 
10.        We therefore direct the O.P. LICI to settle the claim, disburse the amount to the nominee, Anjali Ghosh directing her to pay 2/3rd of the amount to the petitioner, Mampi Dhar(Ghosh) and Bipradip Ghosh, minor son of the petitioner. LICI is to assure that both of them should get 2/3rd benefits of the policy. We also direct to pay compensation amounting to Rs.20,000/- to the petitioners No.1 and 2 for their deficiency of service. The direction is to be  followed within one month. If the amount is not paid it will carry interest @ 9% P.A. 
                 
                       Announced.

SRI A. PAL
PRESIDENT,
DISTRICT CONSUMER  DISPUTES 
REDRESSAL FORUM,
WEST TRIPURA,  AGARTALA.

 

SMT. DR. G. DEBNATH,
MEMBER,
 DISTRICT CONSUMER DISPUTES 
REDRESSAL FORUM, 
WEST TRIPURA, AGARTALA    SRI U. DAS
MEMBER,
  DISTRICT CONSUMER 
DISPUTES REDRESSAL FORUM, 
  WEST TRIPURA,  AGARTALA.