Telangana

Mahbubnagar

CC/11/37

B. Ravi @ Ravinder S/o Laccha - Complainant(s)

Versus

The President, Dist. Mahila Samakya and 2 Others - Opp.Party(s)

Sri P. Bal Reddy

24 Nov 2011

ORDER

BEFORE THE DISTRICT CONSUMER FORUM AT MAHABUBNAGAR

Thursday, the 24^th day of November, 2011 

                                                   Present:- Sri P. Sridhara Rao, B.Sc., LL.B., President

       Sri A. Veerupakshi, B.A., LL.B., Member           

C.C.NO. 37 Of   2011

Between:-

B. Ravi @ Ravinder S/o Laccha, age: 25 years, Occ: Labour, R/o Zainallipur village, Mahabubnagar mandal and district.   

                                                                                                                                          … Complainant

 

And

1. The President, Dist. Mahila Samakya, Ambedkar Building, Collectorate compound, Mahabubnagar.
2. The Manager, LIC (P&GS) unit, Jeevan Prakash, 5-9-21, Secretariat Road, Hyderabad-500 063.
3. The Regional Manager, United India Insurance Corporation, UIIC building, Basheerbagh, Hyderabad.   … Opposite Parties

 

 This C.C. coming on before us for final hearing on 17-11-2011 in the presence of Sri K. Anil Kumar, Advocate, Mahabubnagar on behalf of the complainant and Sri P. Bal Reddy, G.P., Mahabubnagar for OP-1,  Sri Lakshmi Kantha Rao, Advocate, Mahabubnagar for OP-2, and   Sri A. Rajender Reddy, Advocate, Mahabubnagar for OP-3 and the matter having stood over for consideration till this day, this Forum made the following:   

                                                                                                        O R D E R

 (Sri P. Sridhara Rao, President)

1.  This is a complaint filed by the complainant under section 12 of Consumer Protection Act, 1986 seeking a direction to the opposite parties to pay to the complainant the policy amount of Rs.30,000/- together with interest @ 24% p.a. from the date of death of the policy holder   B. Shankeramma i.e., 30-11-2008 till payment, and Rs.30,000/- towards compensation for causing mental and physical suffering to the complainant  besides costs of the complaint.  

2. The averments of the complaint in brief are that:- The complainant is the son of late B. Shankeramma, who during her life time insured her life under Indira Life Insurance Scheme (Group Insurance) valid for a period of one year from 1-8-2008 upto 31-7-2009 nominating the complainant as her nominee. As per the policy, the nominee will get death benefit of Rs.30,000/- in case of natural death and Rs.80,000/- in case of accidental death.  In the meanwhile, while the policy was in force, the policy holder  B. Shankeramma died naturally on 30-11-2008 and the same is recorded in the records of deaths and births at the Tahsil Office, Mahabubnagar.  So the complainant is entitled for policy amount of Rs.30,000/- towards the death benefits of his mother/policy holder. Immediately after the death of his mother, the complainant informed about the death of his mother and made several representations to the OP-1 for payment of the policy amount by placing the claim before OPs.2 and 3.  But every time the opposite parties postponed the payment on the ground that the matter is pending before the OPs.2 and 3.  Then at last the complainant got issued legal notice to all the opposite parties on 4-1-2011 claiming the policy amount.  All the opposite parties received the said notices, but OP-2 alone issued reply stating that they have not received any claim from OP-1, and it is the OP-1 to submit the claim requirements to OP-2 through proper channel; while OPs.1 and 3 remained silent without issuing any reply.  The complainant suffered a lot physically and mentally for the negligence of the opposite parties besides losing the love and affection of his mother, as such he is also entitled for compensation towards mental and physical agony. Therefore the complainant, having no other option, filed the present complaint for the aforesaid relief. 

3. The opposite party No.1 having entered into appearance, and availing sufficient opportunity, failed to file any counter challenging the case of the complainant.

4. The opposite party No.2 filed counter stating that as per the scheme the OP-1 being Nodal Agency has to send the claim of the complainant, and since the claim is not received from the Nodal Agency, the claim is not settled, as such there is no delay or defective service on the part of this opposite party, and that through letter dated 8-1-2011 they accordingly replied the complainant to the legal notice got issued by him; and under such circumstances the present case is not maintainable against this opposite party and thus the complaint against this opposite party is liable to be dismissed. 

5. The opposite party No.3 filed counter stating that the mother of the complainant is a policy holder, but as per the terms and conditions of the policy, in case of accidental death of policy holder, this opposite party is liable to pay the sum assured to the nominee of the deceased policy holder; and that in the present case, even according to the complainant admittedly the death of the policy holder is a natural death, as such the complaint is not at all maintainable against this opposite party and is liable to be dismissed with costs on this score alone.            

6. Thereupon the complainant in support of his claim filed his affidavit evidence and got marked Exs.A-1 to A-5.  On the other hand, the OP-1 not only failed to file counter but also did not choose to file any affidavit evidence.  But however the OPs.2 and 3 in support of their contentions filed their affidavit evidence separately and OP-2 got marked Ex.B-1 which is no other than the copy of Ex.A-1 policy.     

7.  The points for determination now are: 

1. Whether there is any deficiency on the part of the opposite parties in  rendering service to the complainant as alleged?
2. Whether the complainant is entitled for the relief sought for by him? 
3. To what effect? 

8. The admitted facts of the case are that the complainant is the son of late B. Shankeramma who during her life time insured her life under Indira Life Insurance scheme (Group Insurance) for a period of one year valid from   1-8-2008 upto 31-7-2009 nominating the complainant as her nominee.As per the terms and conditions of the policy the nominee will get death benefit of Rs.30,000/- in case of natural death of the policy holder and OP-2 is liable to pay the said sum, and Rs.80,000/- in case of accidental death of the policy holder and OP-3 is liable to pay the said sum to the nominee/complainant. It is also an admitted fact that the policy holder  B. Shankeramma died naturally on 30-11-2008. Even as per the complainant and the OPs.2 and 3, the complainant, being the nominee of the policy holder, is entitled for assured sum of Rs.30,000/- and it is not yet paid to him.  

9. In view of the above said admitted facts, since the policy holder B. Shankeramma died naturally during the policy period, we find that OP-3 is not at all liable to pay the assured sum to the complainant since the assured sum is liable to be paid by OP-2 and therefore the complaint to the extent of OP-3 can safely be dismissed. 

10. Point Nos.1 and 2:- As stated above, it is an admitted fact that the policy holder B. Shankeramma died naturally on 30-11-2008 while the policy is in force the OP-2 is liable to pay the said assured sum of Rs.30,000/- to the complainant/nominee. It is the case of the complainant that to the legal notice got issued by him OP-2 only responded by way of giving reply to him stating that “no claim for the above death is received by it to settle the claim since the claim made by him is not received from the OP-1”.  It is also the contention of the OP-2 that since they have not received the claim made by the complainant from OP-1 they have not settled the claim of the complainant.  As the complainant himself is admitting the contention of the OP-2 that they have not received the claim from the 1^st opposite party we find that OP-2 cannot be made liable for payment of the assured sum of Rs.30,000/- to the complainant. Under the said circumstances, the complaint to the extent of OP-2 is also liable to be dismissed.

11. As far as the case against OP-1 is concerned it is the case of the complainant that immediately after the death of his mother/policy holder, he being the nominee made several representations to OP-1 for the payment of the policy amount by placing the claim before OPs.2 and 3, and that every time the OP-1 postponed the same on the ground that the matter is pending before the OPs.2 and 3. But the OP-1, being the concerned authority to forward the claim to OPs.2 and 3, having entered into his appearance ultimately failed to file any counter challenging the case of the complainant and to establish the fact that the matter is pending before OPs.2 and 3. As per the terms and conditions of the policy printed on the back side of the policy Ex.A-1 first it is the duty of the complainant to report the death of his mother/policy holder to the OP-1 furnishing the detailed particulars of the deceased, thereupon it is the duty of the OP-1 to get the matter enquired preliminarily through the insurance area committee, that basing on the committee report the OP-1 has to send the claim form to the OP-2 for settlement.  In the case on hand, the OP-1 having such responsibility on entering appearance in the case and availing sufficient opportunity did not even choose to file any counter to show that on receipt of the death intimation from the complainant about the death of the policy holder he got the matter preliminarily enquired through the insurance area committee and basing on the committee report the claim form was forwarded to OP-2 for settlement. In the case on hand, it is an admitted fact that even after making representations for several times by the complainant for the payment of the assured sum of Rs.30,000/- the said amount is not paid to him. Therefore, we are of the view that the right of the complainant in claiming the amount cannot be denied due to the latches on the part of the OP-1 in following the procedure.  Hence to meet out the interest of justice in the matter we thought it better to give suitable directions to the OPs.1 and 2 for settlement of the claim made by the complainant. Under the above said circumstances the complainant is directed to reapproach the OP-1 in writing and the OP-1 is directed to receive the same from the complainant and after following the due procedure mentioned in the terms and conditions of the policy Ex.A-1/B-1 forward the claim to the OP-2, if it is in order, for settlement. At the same time the OP-2 is directed that upon receipt of the claim made by the complainant from the OP-1 the claim shall be settled within reasonable time as per its rules. Hence under the present circumstances and for the reasons stated above, we hold that the complaint can accordingly be disposed off with the above said directions to OPs.1 and 2.  Both the points are answered accordingly.    

12. Point No.3:- In the result, the complaint is allowed in part against OP-1 directing the complainant to reapproach the OP-1 in writing within one month from the date of the present order and so also directed OP-1 to receive the same from the complainant on his approach in writing and after following the due procedure mentioned in the terms and conditions of the policy Ex.A-1/B-1 forward the claim to the OP-2, if it is in order, for settlement. The OP-2 is directed that upon receipt of the claim made by the complainant from the OP-1 the claim shall be settled within reasonable time as per its rules and intimate the same to the complainant and OP-1. The complaint to the extent of OPs.2 and 3 is dismissed.  No order as to the costs.      

        Typed to dictation, corrected and pronounced by us in the open Forum on this the 24^th day of November, 2011.    

 

    I agree                                                                                                    

MEMBER                                                                             PRESIDENT                

  Appendix of evidence

      List of Witness examined

On behalf of Complainant:                          On behalf of Opposite Parties:   

- Nil -                                                                      - Nil -                                       

List of documents marked:-

On behalf of Complainant:-    

Ex.A-1: Original Policy, dt.1.8.2008.

Ex.A-2: Photostat copy of Death Certificate, dt.7.10.2009.

Ex.A-3: Copy of Legal Notice, dt.4.1.2011.

Ex.A-4: Original Postal Acknowledgements.

Ex.A-5: Copy of Repudiation Letter, dt.8.1.2011.

On behalf of OPs.:                          

 Ex.B-1: Photostat copy of Policy and its conditions.                                                                                                                                   

                                                                                                   

 

                                                                        PRESIDENT                                                                                                  

Copy to:-

1. Sri K. Anil Kumar, Advocate, Mahabubnagar on behalf of the complainant.

2. Sri P. Bal Reddy, G.P., Mahabubnagar for OP-1.

3. Sri Lakshmi Kantha Rao, Advocate, Mahabubnagar for OP-2.

4. Sri A. Rajender Reddy, Advocate, Mahabubnagar for OP-3.