Present (1) Nisha Nath Ojha,
District & Sessions Judge (Retd.) President
(2) Smt. Karishma Mandal,
Member
Date of Order : 31.07.2017
Nisha Nath Ojha
- In the instant case the Complainant has sought for following reliefs against the Opposite party:-
- To direct the opposite party no. 1 and 2 to pay the sum insured amount of Rs. 5,00,000/- along with 18% interest.
- To direct the opposite parties to pay Rs. 1,00,000/- ( Rs. One Lack only ) as Compensation.
- To direct the opposite parties to pay Rs. 21,000/- ( Rs. Twenty One Thousand only ) as Litigation costs.
- The facts of this case lies in a narrow compass which is as follows:-
It has been asserted by the complainant that she is nominee of her husband who had purchased Life Insurance Policy from opposite party no. 2 for sum of Rs. 5 Lack under policy of Anmol Jeevan (without profit) as will appear from annexure – 1 which is policy bond. The second premium was paid by life assured as will appear from annexure – 2. Her husband died on 16.12.2004 as will appear from annexure – 3. Thereafter the complainant informed the opposite party no. 1 through agent Shri Shambhu Kumar Sharma on 12.01.2005 as will appear from annexure – 4.
It has been asserted that in annexure – 4 due to mistake instead of 12.01.2005 the date 12.01.2004 has been mentioned. The opposite party no. 1 thereafter issued a claim form on 22.07.2005 as will appear from annexure – 5 whereby and where under the opposite party no. 1 has sought some papers on and information. Thereafter the complainant filed all necessary documents with affidavit as will appear from annexure – 6.
It has been further asserted that statement of the nominee was correct and she has not withheld any information as will appear from annexure – 7.
It has been also stated that agent of life insurance has also filed a confidential report after receiving the death information on 12.01.2005, the aforesaid report has been annexed as annexure – 8. After 2 years of receipt of the aforesaid information the opposite party issued a letter to the claimant and demanded some information which was supplied by the complainant who is also a nominee.
The grievance of the complainant is that despite receiving all the information the claim of the complainant has not been settled.
On behalf of opposite party no. 1 and 2 a written statement has been filed stating therein that the complainant is wholly misconceived. It has been stated that after death of her husband the complainant lodged a claim before opposite party no. 1 and 2 and after lodging the complaint of the complainant, the opposite party no. 1 and 2 sought some information from the complainant regarding treatment details of life assured who was treated at Popular Nursing Home, Chauhatta, Ashok Raj Path but the aforesaid information was not furnished by complainant for which several letters were issued to the complainant by opposite parties as will appear from annexure – A series.
In Para – 5 of the written statement following facts have been asserted by the opposite parties, “that it is submitted that due to non co – operation on the part of complainant in respect of furnishing required information to the corporation the claim of the complainant could not be settled till date.”
On behalf of opposite party no. 1 and 2 additional written statement has been filed stating therein that matter was investigated by S.K. Mishra branch manager, Bihar Sharif who vide his report dated 20.12.2005 has stated that prior to taking the policy in question the life assured met with an accident while he was going to Patna by a Jeep near Bhakhtiyaarpur and suffered spinal injury and was admitted to Popular Nursing Home, at Patna. Thereafter he got paralytic attack as such the aforesaid report of Sri S.K. Mishra has been annexed as annexure – B.
On behalf of complainant no rejoinder has been filed.
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The complainant has asserted that the insured died on 16.12.2004 as will appear from annexure – 3 which is death certificate. The opposite parties have asserted that prior to taking insurance the insured met accident as such the entire claim is nothing but fake. This fact is also established from annexure – B which is a report of S.K. Mishra branch manager dated 20.12.2005.
On behalf of complainant this fact has not been denied by complainant by filing rejoinder and as such the entire fact appears to be disputed.
It goes without saying that this forum has no jurisdiction for deciding disputed fact and as such this complaint stands dismissed but without cost.
Member President
