DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KANDHAMAL, PHULBANI
C.C.NO. 84 OF 2022
Date of Filing: 30.11.2022
Date of Order: 08.05.2023
Sri Jagannath Behera,
S/o Uma Charan Behera,
At-SudaSahi, Majhipadar
POPS- Bisipada, Phulbani
District-Kandhamal …………………….. Complainant.
Versus.
- The Manager (CRM),
LIC of India,
At- Berhampur Divisional Office,
Jeevan Prakash, Khodasingi
PO- Berhampur-760010
DIST-Ganjam
- The Branch Manager,
LIC Phulbani Branch
At/PO- Phulbani
District-Kandhamal …………………….. Opp. Parties.
Present: Sri Purna Chandra Mishra - President.
Sri Sudhakar Senapothi - Member.
For the Complainant : Mr.Purna Chandra Tripathy Adv.
For O.P. No.1 & 2 : Mr.B.K.Mohanty & Associates Adv.
JUDGEMENT
Mr. Purna Chandra Mishra, President.
Complainant Jagannath Behera has filed this case u/s 35 of CP Act-2019 alleging deficiency of service on the part of the Opposition Parties for not paying his insurance claim praying therein for direction to the Opposition Parties to pay a sum of Rs. 5 Lakhs towards accident benefit with interest @ 12% from the date of filing of complaint and pay cost of compensation of Rs. 25,000/- and Rs. 1, 00,000/- respectively.
- Brief fact leading to the case is that the complainant obtained one Insurance Policy bearing No. 574469129 for a period of 21 years from 14.11.2018 to 14.11.2039 for a sum assured for Rs. 5,00000/-(five lakhs), the quarterly premium was Rs. 5,881/-. During the force of the policy, he made with an accident on 09.01.2020 while he was catching fish and he became completely disabled and he submitted all relevant documents to the agent who had offered the plan to him. In spite of repeated approaches, nothing was done for which he approached this Commission for relief as discussed above.
- After receipt of notice, the OPs appeared through their advocates and filed their written version. In their written version, the OPs stated that they have not received single information or documents regarding the incident and the complainant have not made any claim before them. As the complainant has not mentioned the name of the agent nor impleaded him as a party of this case, it is not possible on their part to ascertain. Therefore, they pray for dismissal of the case against them.
- It is seen from the documents on record that there is no evidence to show that the complainant has lodged the claim before the OPs. Since the agent has not been made as a party to the case, it is not possible on our part to know whether he has deposited his documents with the OPs or not.
- As the policy was in force on the date of accident and the agent is said to have received the documents and the OPs’ denial of the incident creates a peculiar situation. So, we feel that the complainant’s claim be considered by the OPs. The OPs are to provide a claim form to the complainant and the complainant is to submit the completed filled in form for consideration of the OPs as per law and hence the order.
O R D E R
The complaint petition is disposed of with a direction to the OPs to provide a claim form to the complainant and the complainant is directed to file the claim form with all the relevant documents within a period of 15 days from the date of receipt of the claim form from the OPs and the OPs shall dispose of the claim application of the complainant in accordance with the law within a period of 30 days from the date of receipt of the application form and communicate the result to the complainant by Registered Post. Under the facts and circumstances of the case, parties to bear their own cost.
Computerized & corrected by me.
I Agree
MEMBER PRESIDENT
Pronounced in the open Commission today on this 8th May of2023 in the presence of the parties.
MEMBER PRESIDENT
