IN THE DIST.CONSUMER DISPUTES REDRESSAL FORUM BELAGAVI.
Dated this 6 September 2017
Complaint No. 502/2016
Present: 1) Shri. B.V.Gudli, President
2) Smt.Sunita Member
-***-
Complainant/s:
Smt. Anandi W/o Vaman Kadolkar,
R/o:H.No.253, Kalmeshwar Galli,
Yallur, Tal: & Dist: Belgaum.
(By Sri.G.A. Hiremath, Advocate).
V/s.
Opponent/s:
1. The Manager,
LIC of India, City Branch III,
Congress Road, Belagavi.
2. The Divisional Manager,
LIC of India, Divisional Office,
Basaveshwar Circle, Goaves,
Belagavi.
(By Shri R.A. Prabhu, Adocate)
(Order dictated by Shri. B.V.Gudli. President)
ORDER
U/s.12 of the C.P. Act, complainant has filed the complaint against the O.Ps. alleging deficiency in service in not paying insurance policy claim amount.
2) Upon service of notice O.Ps.1 & 2 appeared through their counsel and filed their objections and produced some documents.
3) In support of the claim in the complaint, complainant has filed her affidavit, written arguments and produced some documents.
4) We have heard the argument and perused the records.
5) Now the point for our consideration is that whether the complainant has proved deficiency in service on the part of the O.Ps. is entitled to the reliefs sought?
6) Our finding on the point is negative, for the following reasons.
:: R E A S O N S ::
7) On perusal contents of the complaint and affidavit filed by the complainant, one Bharamany / Milthan Vaman Kadolkar had taken a Life insurance policy of his life on 11/02/2010 under Jeevan Anand (with profit) with accident benefit for a sum of Rs.1,00,000/- with yearly premium of Rs.5,156/- under policy No.635447855 from the opponent No.1 and the opponent No.2 is the divisional office of Opponent No1. The complainant is the mother and nominee to the policy obtained by Bharamani. The said policy was commenced from 11/02/2010 for a period of 21 years, maturing on 11/02/2030. The insured of the policy has regularly paid the yearly premium of Rs.5,196/- with delayed arrears on 18/03/2013 and next premium was due on February 2014. The insured expired on 15/12/2014 in accident and thereafter, the complainant submitted a claim for policy amount with accident benefits, but the opponent even though admitted the claim, have paid only Rs.1,23,000/- instead of double claim amount. The opponents failed to pay the insured amount. Hence, the complainant got issued legal notice through her counsel on 01/09/2016, the opponents did not reply to the said notice and also failed to comply the notice. Hence, the complainant has constrained to file this complaint against the OPs.
8) On perusal of contents of objection and affidavit of Manager (L & HPF) LIC of India admitted that Bharmani @ Mithun Vaman Kadolkar was holding life insurance policy of Rs.1,00,000/- bearing policy No. 635447855 dated: 11/02/2010 issued under Jeevan Anand (with profits) scheme with accident benefits. It is also admitted that, the insured paid yearly premium of Rs.5,156/- and admitted that, the complainant is the mother of insured and admitted that the life assured expired on 15/12/2014. It is admitted fact that, the insured expired on 15/12/2014 and opponents contend that they have paid a sum of Rs.1,23,500/- and the policy was settled, however, failed to pay the accident benefits, the opponents asked the complainant to produce driving licence of the deceased insured. The complainant did not produce the driving licence of the deceased – insured. The insured was not holding the driving licence at the time of accident. As per the Item No.10 (b) (iv) of the conditions and privileges of the policy. On perusal of contents of the complaint and objections and affidavit of the opponent, it is admitted fact that, the opponents paid a sum of Rs.1,23,500/- towards the insurance policy. However, the complainant has claimed accident benefits a sum of Rs.1,00,000/- The opponents contend that, as per insurance policy, if the insured violates the policy condition No. 10 (b)(iv), the insured is not entitled accident benefits. On perusal of insurance policy that, Item No.10 clause (b) clause (iv), the deceased - insured has violated the terms and conditions of the policy and not holding the driving licence at the time of accident, the complainant is not entitled for accident benefits. Already, the opponents have settled the matter and paid Rs.1,23,500/-, the complainant is not entitled for accident benefits. Hence, there is no deficiency of service on the part of the opponents.
9) Taking into consideration of the facts, evidence on record and the discussion made here before the complainant has failed to prove deficiency in service on the part of the O.Ps.
10) Accordingly the following
ORDER
The complaint filed by the complainant is dismissed. No order as to costs.
(Order dictated, corrected and then pronounced in the open Forum on: 6th day of Sep 2017)
