1.                     The brief facts of the case of the complainants are that late Lal Mohan Pattnaik, S/o. late Dandapani Pattnaik during his life time had obtained Policy Nos. 1.571632076, 2.570213275, 3.590407961 & 4.570205007 from the OP.2 in which the Complainant No.1 being the wife of the DLA as nominee under Policy No.1 to 3 and the complainant No.2 being the daughter of the DLA was nominee under Policy No.4 above respectively.  It is submitted that the policy holder died on 14.7.2014 but the claim was stopped by Ops due to vigilance case and the complainants submitted claim form with necessary documents before the Ops for settlement of claims in their favour as nominees soon after getting clearance from vigilance but no response from the Ops.  It is further submitted that the complainants sent notice to Ops through their Advocate and the Ops replied to that notice denying any payment.  Thus alleging deficiency in service on the part of the Ops, the complainants have filed this case praying the Forum to direct the Ops to settle the claim at Rs.2, 75,000/- in their favour and to pay Rs.1.00 lac towards compensation and costs to the complainants.

2.                     The Ops filed counter denying the allegations of the complainant but admitted about the policies taken by Lal Mohan Pattnaik during his life time who died on 14.07.2014 and in 3 policies, his wife Geeta Rani Sahu and in one policy, his daughter S.P.D. Pattnaik was nominee.  It is contended that the complainants submitted relevant documents for settlement of claims under Policy No. 571632076, 2.570213275 &570205007 and as the claims under above policies were early in nature and due to pending of vigilance case, the claims could not be settled.  It is further submitted that after getting clearance from the vigilance, they sent the matter to OP.1 for admission and the same were also admitted in favour of nominees but due to pending of C.C. No.320/2014 before DCDRF, Rayagada filed by Smt. Kuntala Pattnaik, M/o. late Lal Mohan Pattnaik regarding the same matter, the Ops have awaited the result of that case.  Further the Ops submitted that under Policy No.590407961, the policy holder died after the date of maturity of the policy and the claim is payable on production of succession certificate from a competent court.  Thus denying any deficiency in service on their part, the Ops prayed to dismiss the case of the complainant.

3.                     Both the parties have filed certain documents in support of their cases.  The complainants have filed affidavit.  Heard from the parties through their respective A/Rs and perused the materials available on record.

4.                     In this case it is an admitted fact that 4 Nos. of LIC policies were taken by Lal Mohan Pattnaik during his life time the details of which are given below:

            Policy No.        Sum Assured               DOC                 Nominee                    

            571632076      100000/-                     28.07.2005      Gitarani Sahu(Wife).

            570213275        50000/-                     28.02.2000      Gitarani Sahu(Wife).

            590407961        25000/-                     28.12.1991      Gitarani Sahu(Wife).

            570205007      100000/-                     28.03.1998      S.P.D.Pattnaik(Daughter-minor).

The LA died on 14.07.2014 and it is an admitted fact that the complainants have submitted all relevant documents for settlement of claims under Policy No. 571632076, 2.570213275 & 570205007.  The case of the complainants is that the Ops in spite of repeated requests have not settled the claims in their favour as nominees.

5.                     The Ops submitted that the claims could not be settled as the same were early claims and also due to pending of vigilance case.  It is further their contention that after clearance of vigilance case, they have admitted the claims in favour of the nominees but due to pending of Consumer case at DCDRF, Rayagada, they have not settled the claims.

6.                     It is seen that under all the policies, the complainants are the nominees and u/s.39 of Insurance Act, the nominee should take out representation to the moneys payable under the policies from any court.  Accordingly the complainants being nominees have rightly approached this Forum for settlement of death benefits of the DLA and as such the sum assured is payable to the nominees u/s.39 of Insurance Act, 1938.  By not effecting payments in favour of the complainants-nominees, the Ops in our opinion, have committed deficiency in service for which the complainants suffered.

7.                     In this case, the Ops have admitted that the complainants have submitted relevant documents for settlement of claims under Policy Nos.571632076, 570213275 & 570205007.  In case of Policy No.590407961, the Ops say that the policyholder died after the date of maturity of the policy on 28.12.2011 and hence title under the policy remains open.  As per rule, whatever claim is payable under the policy shall be paid only on production of succession certificate from a competent court of law.  We are not inclined to say anything regarding Policy No.590407961 since the Ops are ready to settle the claim as per law.

8.                     From the above facts and circumstances, we come to the conclusion that the Complainant No.1 is entitled to get the claims of Rs.1, 50,000/- under Policy No.571632076 & 570213275 and the Complainant No.2 is entitled to get claims of Rs.1, 00,000/- under Policy No.570205007.  Regarding compensation as prayed for, it is concluded that by not getting the maturity claims after vigilance clearance, the complainants must have suffered some mental agony and also have come up with this case incurring some expenditure.  Considering the sufferings of the complainants we feel a sum of Rs.5000/- each towards compensation and costs in favour of the complainants will be just and proper.

9.                     Hence ordered that the complaint petition is allowed in part and the Ops being jointly and severally liable are directed to pay Rs.1, 50,000/- towards maturity benefit along with other benefits if any to the Complainant No.1 under Policy No. 571632076 & 570213275 and to pay Rs.1, 00,000/- towards maturity benefit along with other benefits if any to the Complainant No.2 under Policy No.570205007 with interest @ 6% p.a. on both the awards from the date of filing of this case i.e. 17.01.2017 and to pay Rs.5000/- each towards compensation and costs to the complainants within 30 days from the date of communication of this order.

(to dict.)