Jharkhand

Bokaro

CC/16/105

Mantu Napit - Complainant(s)

Versus

The LIC of India Division Office, Hazaribag, Jharkhand - Opp.Party(s)

Dadan Singh

31 Jul 2018

ORDER

Complainant Mantu Napit filed this complaint for a claim of Rs. 1,00,000/- (One Lac) of death claim under L.I.C. Policy with 12% Interest for delay and compensation of Rs. 10,000/- of mental and physical harassment and litigation cost.

2.         Brief fact of the complaint is that earlier complainant  filed C.C. No. 101/2014 before Consumer Forum Dhanbad which was disposed vide order dt. 12.08.2016 on territorial jurisdiction.  

            The fact of the claim of the complainant is that the wife of the complainant Anita Devi is a policy holder of L.I.C., Bokaro branch II. The Policy No. is 544054080 which commenced from 05.07.06 for a sum of Rs.50,000/-. Complainant is the nominee in the policy.

            Anita Devi died on 11-08-2006 during treatment of burn injury of 60% in B.G.H., Bokaro. The death was due to cardio respiratory failure.

            Complainant being nominee and beneficiary filed a death claim under the policy of his wife on 18.10.2006, 01.05.07 and 08.05.2013 along with order of U.D. Case No. 50/06 dt. 08.04.2013.

            L.I.C. did not clear the claim inspite of long period which is deficiency in service.

            A Legal Notice dt. 23.08.2013 was sent to O.P. but there was no response.

3          Complainant filed the following documents in support of claim-

            Anx-1- Copy of order of C.C. 101/2014 of Consumer Forum, Dhanbad.

            Anx-2 to 2/2- Copy of L.I.C. Policy, payment receipt and current status.

            Anx-3 to 3/1- Copies of U.D. F.I.R and fardbeyan.

            Anx-4 To 4/1- Copies of death Certificate of B.G.H. and Govt.

            Anx-5 to 5/1- Copies of Receiving of documents

            Anx-6 to 6/1- Copies of U.D.F.I.R and acceptance order.

            Anx-7- Copy of the claim application of the complainant.

4          O.Ps L.I.C. appeared and filed W.S. The Policy is admitted and liability is admitted as per clause 4B to the extent of payment of first premium without interest and without extra premium to the female of III category of age between 18 years to 30 years.

            It is submitted that the accident accrued in home, other the public, so Late Anita Devi is female of category IIIrd as per terms and Condition.

            It is also submitted that since the death accrued only 8 days from the date of issue of this policy which creates a deep suspicion. It is violation of clause 4B and claim is fit to be dismissed and claimant is not entitled to death claim and company has exclusive right to repudiate the claim.

            Anx-A- Copy of terms and condition is filed by this O.P. in support:-

 

F I N D I N G S

5.         We perused the complaint and the documents filed. We hold that complainant, being nominee and beneficiary under the L.I.C. Policy and premium has been paid, is a Consumer and the claim is a Consumer dispute.

6.         The policy is admitted by O.P. L.I.C. and it is also admitted the death of policy holder wife Late Anita Devi. But it is submitted that Late Anita Devi was a house wife without any earning, so she falls under clause 4B, Category III as per terms and condition and affect of the claim settlement if death of female life assured occurred as a result of an accident, in the instant case, burn injury in house other than public place, the death claim liability will be limited to the sum equal to the total amount of premiums paid under the policy equal without any interest within 3 year of life risk commenced.

            In the instant case, first premium of Rs. 1113/- was paid on 05-07-2006 and the death of the late Anita Devi occurred on 11-08-2006.

            The Claim was filed on 18.10.2006 but still the claim is not cleared. It is submitted that death is suspicious but the question arises what the O.P. has been doing since 18.10.2006 when the claim was filed even after acceptance of U.D. Case by the competent court. Therefore, the submission of suspicion is not accepted.

7          Annexure-A is the terms and condition filed b the L.I.C. but no document is filed before us by O.P. to show that the terms and condition was well explained to the policy holder in case of any risk of death. The claim by O.P. is denied only on the ground of terms and condition and there in no proof to show the terms and condition was explained else why one should take policy of life risk for only limited to the sum of premiums paid. The O.P. in taking highly technical ground for repudiation which in our view goes against the principle  of natural justice and cannot be accepted.

8          Thus we hold O.P. L.I.C. is liable to pay the claim of death to the claimant and liable for deficiency in service of delaying the claim for such a long period.

9          Thus, we allow the claim of sum assured of Rs. 50,000/- with interest of 6% p.a. for delay in payment since the date of claim i.e. 18-10-2006 till the payment.

            Accordingly, O.P.  L.I.C. is directed to pay Rs. 50,000/- (Rs. Fifty thousand) only with interest of 6% (Six percent) p.a. since 18.10.2006 till the realization along with compensation of Rs. 10,000/- (Rs. Ten thousand) only and litigation cost of Rs. 5000/- (Rs. Five thousand).

            All the payment be paid within 60 (Sixty) days failing which, rate of interest on claim amount shall be enhanced to 12% (Rs. Twelve percent) till realization.