Complaint filed on: 02-12-2016 Disposed on: 16-11-2017
BEFORE THE DISTRICT CONSUMER DISPUTES
REDRESSAL FORUM
OLD DC OFFICE COMPOUND, TUMAKURU-572 101
CC.No.150/2016
DATED THIS THE 16th DAY OF NOVEMBER 2017
PRESENT
SMT.PRATHIBHA. R.K. BAL, LLM, PRESIDENT
SMT.GIRIJA, B.A., LADY MEMBER
Complainant: -
Smt.Noorjan
W/o. Late Mahaboobsab,
MAR Layout,
Pavagada Taluk
(By Advocate Sri.Muralikrishna)
V/s
Opposite parties:-
1.The Manager,
LIC of India, Branch-I, Tumakuru
2.The Manager,
LIC of India, Pavagada Branch, Tumakuru District
3.The General Manager,
LIC of India, United India, 1st and 3rd floor, Next to Canara Bank, JC Road, Bengaluru.
4.The General Manager, Corporate office, LIC of India, Yogakshema, Jeevan Bima Marg, PB No.19953, Mumbai-21
(OP No.1 and 2 by Advocate Sri.G.S.Narayan)
(OP No.3 and 4- Exparte)
ORDER
SMT.PRATHIBHA. R.K. PRESIDENT
This complaint is filed by the complainant against the OP Nos.1 to 4, under Section 12 of the Consumer Protection Act. The complainant prays to direct the OPs to pay the benefits as per the terms and conditions of the policies by the 1st OP and to pay damages of Rs.2,25,000=00 for deficient service and grant such other relief as prayed in the complaint, in the interest of justice and equity.
2. The brief facts of the complaint is as under.
The husband of the complainant was working as Assistant in Kavery Grameena Bank, Pavagada branch, Tumakuru district and he had obtained LIC policies under the Double Accident Benefit Scheme from the 1st OP. The policies bearing No.611589981 for Rs.152=00, No.610598921 for Rs.135=00, Rs.612725228 for Rs.588=00, No.612274644 for Rs.287=00, No.610599271 for Rs.222=00, Rs.612724574 for Rs.215=00, No.612929564 for Rs.374=00, No.612931635 for Rs.1076=00, No.612930952 for Rs.640=00, No.61275855 for Rs.215=00 and No.611394453 for Rs.118=00. The husband of the complainant made the complainant and his son and daughter as nominees in the above said policies.
The complainant further submitted that, the husband of the complainant died on 6-10-2014 due to injuries sustained by him in a road traffic accident. Accordingly, the complainant approached the OP and gave representation to the OP No.1 and 2 claiming the insurance amount as per the terms and conditions of the policies. But the OPs have refused to give benefits under the above said policies stating that, the complainant has to produce Driving Licence of the husband of the complainant. It is further respectfully submitted that, the OP have not looked into the documents produced by the complainant. The husband of the complainant died in the road traffic accident due to rash and negligent act of the offending vehicle and not the fault of the husband of the complainant. The case was registered against the offending vehicle in Cr.No.152/2014 dated 6-10-2015 before the Pavagada Police. Hence, the question of producing the driving licence of the deceased does not arise at all. The complainant got issued a legal notice to the OPs calling upon them to give benefits as per the terms and conditions of the policies, but the OPs have given evasive reply to the said legal notice. Hence, the present complaint is filed.
3. In response to the forum notice, the OP No.1 and 2 have appeared through their counsel and filed common version. The OP No.3 and 4 did not appear before the forum and they were called out absent and they have been placed exparte.
4. In the version, the OP No.1 and 2 have contended that, the complaint is not maintainable and sustainable either in law or on facts. The complainant has not come to the forum with clean hands and suppressed the facts. There is no cause of action to file the complaint and there is no deficiency in service from the end of the OP in any way. The complainant has not made out any ground to bring the complaint within the ambit of the provisions invoked. Hence, viewing from the any angel, the complaint is not maintainable and it is to be dismissed in limine.
Without prejudice, the OPs submitted that, one Sri.Mehaboob Sab, employee of Kavery Grameena Bank, Pavagada branch, Tumakauru district. During his life time, he had obtained insurance policies from the LIC of India and died in an accident while riding his motor cycle. As per the law of land, any one driving the vehicle should have the valid driving license issued by the concerned government authorities. In case, the person who is not in possession of valid driving license is involved in a road traffic accident and killed, it will be deemed to be an act in violation of the law of the land. In view of the death of the policyholder Sri.Mahaboob Sab due to road traffic accident while riding the two wheelers. While submitting the mandatory requirements for settlement of basic insurance claim and the accident benefit, shall have to submit copy of the driving license or extract of particulars of driving license from the jurisdictional issuing authority i.e. RTO. The point of issue is, it is not who and how the accident was caused, but the person who was driving the vehicle and the offering vehicle of the person also must and shall possess the driving license. Hence, it is absolutely necessary that, the deceased life assured Sri.Mehaboob Sab should have possessed the valid Driving License while driving his motor cycle, lest he was involved in an act in contravention of the law of the land. As per the procedure, the OPs Corporation settled the claim and called for copy of the driving license for consideration of settlement of the accident benefit. Instead of submitting the driving license, the complainant has approached the Hon’ble Forum with the false and concocted statements that claim under the policies are not at all settled.
The OPs further submitted that, Policy No.612929567 is JEEVAN SAATHI POLICY – Joint life insurance plan where under the risk for Rs.50,000=00 was covered for the DLA Sri.Mahaboob Sab and immediately on his death, the basic sum of Rs.50,000=00 was paid to the second life i.e. nominee, the complainant. Waiving the future premiums under the policy till maturity, risk is covered for Rs.50,000=00 till the date of maturity i.e. 6-7-2027 and on the nominee surviving the maturity date, full sum assured Rs.50,000=00 + full bonus for 16 years will be settled. In case of death of the nominee before the maturity, death claim for sum assured Rs.50,000=00 + accrued bonus till the date of death of the nominee will be paid to the alternative nominee Suniya Banu, Daughter. This makes very clear that, there is no truth in the complaint that, the claim under the policies are not settled and the complainant has lodged this consumer complaint with ulterior motives of damaging the repudiation of the OPs Corporation.
The OPs further submitted that, there is no specific averments that, the accident benefit under the policies are not settled, although the policy holder Sri.Mahaboob Sab died in road traffic accident. As per the policy conditions “IF ANY INJURY is sustained to the body resulting solely and directly from the accident caused by outward violent and visible means and such injuries solely lead to the death of the person within 180 days from the date of such accident, independent of all other reasons, in such cases, accident benefit is payable”. “And, accident benefit under the said insurance policy is not payable if the death is caused while involving in any act in contravention to the law of the land”.
The OPs further submitted that, as per the Indian Motor Vehicle Act, if a person is riding or driving the vehicle without valid driving license, it tantamount to breach of law. In the instant case, the DLA Sri.Mahaboob Sab was not holding valid driving license and died while driving the two wheelers, as such the accident benefit was not settled. However, the OPs Corporation is ready to settle the accident benefit if valid license or extract of the driving license from the concerned regional transport authority is submitted. The OPs have requested the complainant to produce the driving license or its extract. Instead of submitting the said requirement, the complainant has approached the Hon’ble Forum with the false and concocted complaint that death claim under the policies are not settled and refused by the OPs Corporation, false alleging deficiency of service which is totally illegal and against the basic ethics of contract of insurance. Therefore, there is no substance or truth in the contention put-forth by the complainant in her complaint and hence the complaint is devoid of merits. All other contentions which are not controverted or denied and which are contrary to the facts and law are hereby specifically denied as false, frivolous, fabricated and concocted for the purpose of the complaint. Hence, it is prayed to dismiss the complaint with costs, in the interest of justice and equity.
8. In the course of enquiry in to the complaint, the complainant and OP No.1 and 2 have filed their affidavit evidence reproducing what they have stated in their respective complaint and version. The complainant has produced documents which were marked as Ex-P1 to P31. The OP No.1 and 2 have produced document along with a memo dated 1-9-2017 which were marked as Ex.R1 to R4. We have heard the arguments of both parties and perused the documents and then posted the cases for orders.
5. Based on the above materials, the following points will arise for our consideration.
1. Whether there was deficiency in service on the part of the OPs as alleged by the complainant?
2. What Order?
6. Our findings on the above points are;
Point no.1: In the negative
Point no.2: As per the final order below.
REASONS
7. On perusal of the pleadings of the complaint, objections of the OPs and affidavit evidence of both parties, it is an admitted fact that, the husband of the complainant deceased Sri.Mehaboob Sab had obtained LIC policies under the Double Accident Benefit Scheme from the 1st OP and he made the complainant and his son and daughter as nominees in the said policies. On 6-10-2014 the complainant’s husband Sri.Mehaboob Sab died in a road traffic accident. Thereafter, the complainant had approached the OP No.1 and 2 and also gave representation claiming the insurance amount as per the terms and conditions of the policies. But the OPs have refused to give benefits under the said policies stating that, the complainant has to produce Driving Licence of the deceased Sri.Mehaboob Sab. As per the contention of the complainant is that, the husband of the complainant was died in the road traffic accident due to rash and negligent act of the offending vehicle not on the fault of the husband of the complainant and the case was registered against the offending vehicle in Cr.No.152/2014 dated 6-10-2015 before the Pavagada Police. Hence, the question of produce the driving licence of the deceased does not arise at all.
8. On the other hand, the OPs have vigorously contended that, it is not who and how the accident was caused. As per the law, any one driving the vehicle should have the valid driving license issued by the concerned government authorities. In case, the person who is not in possession of valid driving license is involved in a road traffic accident and killed, it will be deemed to be an act in violation of the law. In view of the death of the policyholder Sri.Mahaboob Sab died due to road traffic accident while riding the two wheelers. While submitting the claim form mandatory requirements for settlement of basic insurance claim of the accident benefit, shall have to submit copy of the driving license or extract of particulars of driving license from the jurisdictional issuing authority i.e. RTO. But the complainant has not submitted Driving licence. The OP counsel further submitted that, “accident benefit under the said insurance policy is not payable if the death is caused while involving in any act in contravention to the law of the land”. As per the Indian Motor Vehicle Act, if a person is riding or driving the vehicle without valid driving license, it tantamount to breach of law.
9. As could be seen from the reply to the legal notice given by the OPs dated 27-10-2016/Ex-P9, wherein it is stated that, the OPs have already settled the claim for basic sum assured and vested bonus of the said policies. The cause of death of the deceased life assured is due to road traffic accident i.e. as per FIR, DLA was riding the vehicle and met with an accident. It is the basic requirement for settlement of the accident benefit, the driving licence is must. Hence, the OPs informed the complainant to submit the driving licence of the Deceased life assured”.
10. Admittedly, Sri.Mehaboob Sab died in a road accident on 6-10-2014, and as per the Rule 3 of the Central Motor Vehicle 1989, the driving licence is mandatory for driving the vehicle. Therefore, the contention of the complainant that, the question of producing the driving licence of the deceased Sri.Mehaboob Sab does not arise, cannot be accepted as the driving licence is must. Hence, in view of the discussion made hitherto, the complainant’s husband Sri.Mehaboob Sab died in a road accident and DL is mandatory for claiming the accidental death benefits. Further, the OPs submitted that, they are ready to settle the accidental death benefits, if the complainant submitted the driving licence of the deceased Sri.Mehaboob Sab. The DLA did not possess any DL and hence he is not entitled to claim the benefits of insurance. Hence, for the above reasons, we come to conclusion that, there is no deficiency in service on the part of the OPs. Accordingly we answer this point in the negative. In the result, for the foregoing reasons, we proceed to pass the following order.
ORDER
The complaint filed by the complainant hereby dismissed. No costs.
Supply free copy of this order to both parties.
(Dictated to the Stenographer, transcribed and typed by him, corrected and then pronounced by me in the Open Forum on this, the 16th day of November 2017)
LADY MEMBER PRESIDENT
