Karnataka

Chitradurga

CC/137/2017

Smt. Manjula Mallikarjuna, - Complainant(s)

Versus

The Reliance Life Insurance Company Limited, - Opp.Party(s)

B.R. Sangameshwara.

12 Oct 2018

ORDER

COMPLAINT FILED ON:19.12.2017

DISPOSED  ON:12.10.2018

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, CHITRADURGA.

 

CC.NO:137/2017

 

DATED:  12^th OCTOBER 2018

PRESENT :-     SRI.T.N.SREENIVASAIAH :   PRESIDENT                             B.A., LL.B.,

                        SMT. JYOTHI RADHESH JEMBAGI

BSc.,MBA., DHA.,                LADY MEMBER

 

……COMPLAINANT	Smt. Manjula Mallikarjuna, W/o Late G.R. Mallikarjuna, Banasihalli, Doddagatta post, Hosadurga Taluk, Chitradurga District. Karnataka State-577 527.   (Rep by Sri.B.R. Sangameshwara, Advocate)
V/S
…..OPPOSITE PARTIES	1. The  Manager, Reliance Life Insurance Company Limited, C.S.C. Office, Customer Service Centre, BSC Avenue, 2nd Floor, Opposite Hotel Chethana, Akkamahadevi Road, Davanagere-577 002,   2. The Manager, Reliance Nippon Life Insurance Company Limited, 9th Floor, R-Tech Park, Nirion Compound, Goregoan(E), Mumbai-400063 CIN U-66010 MH 2001 PLC 167089.   (Rep by Sri. B.S. Shivamurthy,Advocate)

ORDER

SRI. T.N. SREENIVASAIAH:   PRESIDENT

The above complaint has been filed by the complainant u/Sec.12 of the C.P Act, 1986 for the relief to direct the OPs to pay Rs.11,39,152/- along with interest @ 12% p.a, Rs.5,000/- towards costs and such other reliefs.

2.     The brief facts of the case of the above complainant is that, the husband of the complainant by name Sri. G.R. Mallikarjuna had insured his life for Rs.15,00,000/- under policy No.50429909 client No.08486193 and he has paid yearly premium amount of Rs.1,00,000/-.  The first premium commenced on 25.10.2012 for a term of 15 years.  Accordingly, the husband of the complainant paid four premium of Rs.4,00,000/- to the OPs.  On 22.05.2015, the husband of the complainant had met with an accident near Doddaghatta and sustained grievous injuries.  The Hosadurga Police have registered a case against the offending driver of motor cycle in Crime No.160/2015 and the same has been registered as C.C.No.207/2015.  The husband of the complainant has taken continuous treatment for the above said injuries.  After the accident, he has spent lot of money for his treatment.  Due to several complications of injuries he was admitted in Sakra World Hospital, Bangalore and he died on 12.06.2017 due to the injuries sustained in an accident.  After his death, his wife i.e., the complainant has filed an application along with documents before the OPs claiming death benefit of her husband, but the OPs have settled the claim for Rs.3,60,848-84 by deducting commission.  According to the complainant, it is a life assured policy, the OPs have to pay the entire sum of Rs.15,00,000/-.  But, the OPs have failed to do so.  The complainant got issued legal notice to the OPs on 25.10.2017, the same has been served to the OPs.  After receipt of the notice, the OPs have not settled the claim of the complainant, it is a deficiency of service on the part of OPs.  The cause of action arose for this complaint on 31.08.2017 when the complainant had received the letter from the OPs and on 25.10.2017 the date of issue of legal notice which is within the jurisdiction of this Forum and hence, prayed for allow the complaint.

3.     After service of notice to the OPs, one Sri.B.S. Shivamurthy, Advocate appeared on behalf of OPs and filed version.  According to the OPs, the complaint filed by the complainant is not maintainable either in law or on facts and the same is liable to be dismissed in limine. The complainant has filed this complaint by suppressing the real facts by stating false affidavit that, due to the injuries sustained in the accident, her husband was died and it is to be proved by the complainant herself.  The averments made in para t1 to 6 of the complaint are denied as false and the complainant is put to strict proof of the same.  No doubt, the husband of the complainant by name G.R. Mallikarjuna has obtained insurance policy on his life and accordingly, the OPs have given policy No.50429909 under RLIC Classic Plan-RG, the nominee under the policy is Manjula Mallikarjuna i.e., the complainant for Rs.15,00,000/- for a term of 15 years.  The policy is yearly policy.  The policy commenced on 25.10.2012 and he has paid yearly premium amount of Rs.1,00,000/- up to 2015, but he failed to pay the 5^th premium due in the year 2016 even in grace period because of which the policy entered into discontinued mode as per clause 9.1 of terms and conditions.  In view of the aforesaid reasons, the OPs have paid fund value of Rs.360,848-84 vide cheque No.113052 dated 23.08.2017 dispatched via speed post POD EM755751286IN on 28.08.2017.  The OPs after issue of policy has duly assumed and undertaken the risk on life of policy holder and in case of any eventuality OPs would have been statutory liable to honor claim of policy holder, thus the OPs have already undertaken risk on life insured and life assured failed to pay the due premium under subject policy rendering the same in discontinued mode, thus complainant cannot demand sum assured under the policy.  The complainant has created false story based on her conjecture and surmises.  The complainant has failed to produce single piece of evidence to substantiate her false story.  It is stated that, the OPs in receipt of claim intimation from the complainant regarding death of the life assured on 12.06.201.  However, since the life assured failed to pay the 5^th premium due in the year 2016 and hence, the policy was discontinued.  The contents of the prayer column are vehemently denied.  The complainant has filed this complaint only to give harassment to the OPs and intend to collect money from the OPs and hence, prayed for dismissal of the complaint.

   4.  Complainant has examined as PW-1 by filing affidavit evidence and the documents Ex.A-1 to A-16 got marked and closer her side.  OPs have examined one Sri.G.G. Padmakar Tripathi, the Manager Legal as DW-1 and no documents have been produced to disprove the case of the complainant.

5.     Arguments heard.

6.     Now the points that arise for our consideration for decision of above complaint are that;

(1)  Whether the complainant proves that the OPs have failed to settle the death benefit claim of the life assured by name G.R. Mallikarjuna and entitled for the reliefs as prayed for in the above complaint?

              (2) What order?

        7.     Our findings on the above points are as follows:-

                Point No.1:- Partly in Affirmative.

                Point No.2:- As per final order.

REASONS

8.     It is not in dispute that, the husband of the complainant by name Sri. G.R. Mallikarjuna has obtained above said life insurance policy from the OPs i.e., yearly paid policy.  Every year he was paying premium amount of Rs.1,00,000/- to the OPs and the same is for a term of 15 years.  The said G.R. Mallikarjuna has paid four premiums regularly, but he has not paid the 5^th premium because he met with an accident on 22.05.2015 and he has taken treatment continuously and while taking treatment, he died on 12.06.2017 due to the injuries sustained at the time of accident.  After the death of her husband, the complainant has filed a claim petition along with documents before the OPs for settlement of the insurance amount.  But the OPs failed to settle the claim.  Lastly, the complainant has issued notice through her counsel and accordingly, the same has been served.  After service of notice to the OPs, they never come forward to settle the claim.  Therefore, the complainant has filed this complaint claiming compensation before this Forum.  The OPs appeared before this Forum and filed version.  The main contention taken by the OPs is that, the husband of the complainant has paid four premium amounts i.e.., Rs.1,00,000/- to the OPs.  The first premium has been commenced in the year 2012 and accordingly, the husband of the complainant has paid 4 premiums up to 2015.  Due to the accident, the husband of the complainant was suffered grievous injuries because of that, he was admitted to the Hospital and he was unable to pay the 5^th premium to the OPs.  As per the version filed by the OPs, it clearly shows that, life assured has to pay nearly 5 installments or on death of the life assured whichever is earlier.  In this case the husband of the complainant was died within 5 years after obtaining the policy.  According to the version, the OPs themselves stated that, if the insured was died within 5 years, the nominee was entitled for the benefit of the life assured.  As per the documents produced by the complainant, which clearly shows that, the complainant is the nominee, but the OPs have also not disputed that the complainant is the nominee to the life assured.  But they have taken a contention that, the 5^th premium was not paid.  The policy obtained by the husband of the complainant is a life assured policy.  If the policy holder dies after completion of the three premiums, it is their duty to settle the claim.  In this case, the husband of the complainant has paid 4 premiums to the OPs.

9.     We have gone through the entire documents filed by the complainant ie.., Ex.A-1 to Ex.A-16.  According to the documents, which clearly shows that, the Ex.A-1 is the Doctor Certificate issued by the Sakra World Hospital, Bangalore and Ex.A-2 is the death certificate, Ex.A-4 is the FIR, Ex.A-5 is the statement of Sri. Narasimhamurti, Ex.A-6 is the spot mahazar, Ex.A-7 is the sketch, Ex.A-8  MLC report, Ex.A-9 is the motor vehicles accident report, Ex.A-10 is the Wound certificate, Ex.A-11 is the letter dated 27.11.2017 by Vinit Mishra and Associates to the Advocate for complainant, Ex.A-12 is the letter dated 31.07.2017 by OP to complainant, Ex.A-13 is the legal notice dated 25.10.2017, Ex.A-14 is the 2 postal receipts and postal acknowledgement, Ex.A-15 is the Charge sheet, and Ex.A-16 is the Broacher.  As per the certificate issued by the Doctor, it clearly shows that, the deceased G.R. Mallikarjuna was died due to accident met near Doddaghatta village on 22.05.2015.  But the Ops have stated in their version that, they have send the amount to the complainant on 31.08.2017 for Rs.3,60,848-84 drawn on State Bank of India.  It clearly shows that, the OPs have send the Ex.A-12 after the requisition submitted by the complainant.  According to the OPs, the husband of the complainant has not paid the 5^th premium amount but, they have not issued any notice to the deceased G.R. Mallikarjuna and the OPs have not issued any letter to the husband of the complainant towards cancellation of policy.  After filing the requisition by the OPs, the OPs have send the letter, it clearly shows there is a deficiency in service and the OPs have tried to escape from the clutches of law.  The Ex.A-12 to 16 clearly shows that, the OPs have not made any efforts to settle the claim within August 31^st 2017.  After filing of the requisition by the complainant, send the letter, which is not correct and it is a deficiency of service and negligence on the part of OPs.      Hence, the complainant is entitled for compensation from OPs.    Accordingly, this Point No.1 is held as partly affirmative to the complainant.

          10. Point No.2:- As discussed on the above point and for the reasons stated therein we pass the following:-

ORDER

The complaint filed by the complainant U/s 12 of CP Act 1986 is partly allowed.

It is further ordered that the OPs are hereby directed to pay a sum of Rs.11,39,152/- to the complainant along with interest at the rate of 9% p.a from 31.08.2017 till realization.

It is further ordered that, the OPs are hereby directed to pay Rs.10,000/- towards mental agony and Rs.5,000/- towards costs of this proceedings to the complainant. 

It is further ordered that, the OPs are hereby directed to comply the above order within 30 days from the date of this order.

            (This order is made with the consent of Member after the correction of the draft on 12/10/2018 and it is pronounced in the open Court after our signatures)         

           

MEMBER                                                   PRESIDENT

-:ANNEXURES:-

Witnesses examined on behalf of Complainant:

PW-1:  Complainant by way of affidavit evidence.

Witnesses examined on behalf of OPs:

DW-1:  Sri.G.G. Padmakar Tripathi, the Manager Legal by way of affidavit evidence.

Documents marked on behalf of Complainant:

01	Ex-A-1:-	Doctor Certificate issued by the Sakra World Hospital, Bangalore
02	Ex-A-2 & 3:-	Death certificates
03	Ex-A-4:-	FIR
04	Ex.A-5:-	Statement of Sri. Narasimhamurti
05	Ex.A-6:-	Spot Mahazar
06	Ex-A-7:-	Spot sketch
07	Ex.A-8:-	MLC report
08	Ex-A-9:-	Motor vehicles accident report
09	Ex-A-10:-	Wound certificate
10	Ex-A-11:-	Letter dated 27.11.2017 by Vinit Mishra and Associates to the Advocate for complainant
11	Ex-A-12:-	Letter dated 31.07.2017 by OP to complainant
12	Ex-A-13:-	Legal notice dated 25.10.2017
13	Ex-A-14:-	2 postal receipts and postal acknowledgement
14	Ex-A-15:-	Charge sheet
15	Ex-A-16:-	Broacher

 

Documents marked on behalf of OPs:

-Nil-

 

MEMBER                                                   PRESIDENT

Rhr**