IN THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM:SUNDARGARH-I
CONSUMER COMPLAINT CASE NO.73/2009.
Roheda Bibi @ Robwda (32 Yrs.),
R/o: Brahmabarda, Ps: Dharamsala,
Dist: Jajpur at present Netaji Chowk,Rajgangpur,
Dist: Sundargarh,Orissa. ………………………………………………Complainant.
Versus
1. The Branch manager,
Life Insurance Corporation of India,
Uditnagar Branch, Po: Uditnagar,
Rourkela-12,Dist: Sundargarh, Orissa…………………………..Opp.Party
Counsel for the parties:-
For the Complainant Sri Y.Nabi, Adv.& Ors.
For the Opp .Parties. Sri A.K.Dash,Adv. & Ors..
O R D E R Dated : 03.12.09
Md. Inclab Ummar, President:-
Deficiency in service is the complaint of the complainant.
In brief the case of the complainant is that the husband of the complainant late Abdul Halim khan made policy with the O.P bearing policyNo.593303215 on dt. 18.11.06 for a assured sum of Rs.10,00,000/- (Rupees ten lakh)only and paid premium of Rs.2160/- as half yearly mode. The late husband of the complainant was staying in Qr No. B/18 in sector-4 Rourkela when the policy was made. At that time the complainant was staying at her native village on dt.25.01.07 and the policy holder, husband of the complainant expired due to Heart Attack.
The complainant is the legal married wife of the deceased Abdul hakim khan as well as nominee in the said policy and the policy was in force at the time of death of the policy holder. The complainant submitted the claim statement on dt.07.07.08 along with all relevant document available with her to the O.P and claimed the insured amount. After running to the O.P several times the complainant could not get any
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satisfactory reply rather the O.P remain silent in the matter of payment of the claim amount for which the complainant has filed this dispute case with a prayer for a direction to the O.P to pay Rs.10,00,000/- (Rupees ten lakh)only insured amount along with 18% interest per annum along with Rs.1,00,000/- (Rupees one lakh) only for harassment and Rs.50,000/- as litigation cost.
2. The O.P appeared through its learned Advocate and filed the written version wherein it has been submitted that the LIC of India has more than 2500 branches all over India where proposal are accepted from prospective client proposer through the agent apply for issue of life Insurance policies. The deceased Abdul hakim has taken policy on dt 18.11.06 for a assured sum of Rs.10,00,000/- vide policy No.593303215. The life assured died on dt.25.01.07 in his native village Brahmabarda and the death of the complainant was informed to the O.P on dt.23.05.08.
On receipt of the death intimation the O.P promptly acted on it and issued necessary claim forms for compliance of the same by the complainant with original policy bond, attersted copy of death certificate, documentary age proof of the deceased late A.H.Khan. The complainant only submitted medical attendant certificate and some has been witnessed by Brahmabarda GP. There is no endorsement by any qualified doctor or from a hospital. Moreover it being a case of early death claim (duration of policy bond just 2months 7 days) as per manual provision. The claim settlement procedure of LIC of India, claim investigation is to be entrusted to class I officer of the O.P company of examine authority of the claim. During course of inquiry of the officer had reasonable doubt on over insurance because the DLA’s income was only Rs.2500/- per month which was not consistent with the policy amount Rs.10,00,000/-. The DLA late A.H.Khan shown his annual income to be Rs.60,000/- per annum. The school certificate to prove the age do not tells about the school from which the DLA has passed. So the claim manager vide his letter dt.03.10.08 has called for the original school certififcate of the DLA and past 3 years statement particulars from the complainant. But the claimant has not submitted such documents for which O.P company is not able to take any decision and the claim has not been repudiated yet. The O.P is not able to take any decision about the claim of the complainant only due to non co operation of the complainant and prayed for the dismissal of the cased as there is no deficiency in service on the part of the O.P.
3. Heard the leaned advocate appearing for both the parties and perused the documents as filed by the parties in their support and we have gone through the case in detail. It is an admitted fact that deceased A.H.Khan had made a policy with O.P bearing No.593303215 dt.18.11.06 for a assured sum of Rs.10,00,000/- and paid a premium of Rs.2160/-. All documents were also submitted by the deceased and after verification of the documents and after the satisfaction of the O.Ps the policy was issued to the deceased A.H Khan after receipt of the premium. But unfortunately the policy holder died and after his death the O.P is asking for the documents to his wife who is complainant as well as legal heir and nominee in the policy. All available documents were submitted by her to the O.P.
In the written version it has been submitted by the O.P that the claimant submitted only the medical attendant certificate signed by Dr. A.S Khan DMS and the same has been witnessed by Brahmabarda GP. The cause of death is for Heart Attack. There is no endorsement of such death by any qualified doctor or from a Hospital.
In our opinion it is not necessary for the death of the policy holder any endorsement of such death by a qualified doctor. No body can say that when he will die. It is the duty of the O.P to verify all documents which are necessary before issue of policy and after death of the policy holder asking for the documents which are not available with the complainant is nothing but harassing the complainant and it amounts to deficiency in service .
4. Thus under the circumstances we allow the case of the complainant and direct the O.P to pay the insured amount Rs.10,00,000/- (Rupees ten lakh) only to the complainant within 30 days from the date of receipt of this order,failing which the O.P would be liable to pay 12%(twelve) percent interest per annum on the awarded amount from the date of receipt of this order till the actual date of payment to the complainant.
The case is disposed off accordingly.
Complaint is allowed.
Md. Inclab Ummar
President.
1. S. Patel, lady Member, I Agree.
2. S.K.Choudhury,Member,I Agree.