Heading1 Heading2 Complaint Case No. CC/44/2016 1. Mst. Surekha Bag resident of Jhulpiapali, P.O. Tileimal, P.S. Barpali, Dist. Bargarh Bargarh Odisha ...........Complainant(s) Versus 1. The Branch Manager L.I.C. L.I.C. Of India, Bargarh Branch Bargarh, P.O./Dist. Bargarh Pin. 768028. Bargarh Odisha ............Opp.Party(s) BEFORE: HON'BLE MR. Sri. Krishna Prasad Mishra PRESIDENT HON'BLE MS. MISS AJANTA SUBHADARSINEE MEMBER HON'BLE MR. Sri Pradeep Kumar Dash Member For the Complainant: Sri. Susil Kumar Mahapatra with other Advocates, Advocate For the Opp. Party: Dated : 08 Jan 2018 Final Order / Judgement Date of filing:-01/11/2016. Date of Order:-08/01/2018. DISTRICT CONSUMER DISPUTE REDRESSAL FORUM (COURT) B A R G A R H. Consumer Complaint No. 44 of 2016. Mst. Surekha Bag, widow of Late Sripati Bag, R/o ? Jhulpiapali, Po:- Tileimal, Ps-Barpali, Dist-Bargarh. ..... ..... ..... ..... ..... Complainant . - V e r s u s - The Branch Manager, Life Insurance Corporation of India, Bargarh Branch, Po/Dist-Bargarh. ..... ..... ..... ..... ....Opposite Party. Counsel for the Parties:- For the Complainant :- Sri S. K. Mahapatra, Advocate with others Advocates. For the Opposite Party :- Sri D. Mishra, Advocate with others Advocates. -: P R E S E N T :- Sri Krishna Prasad Mishra ..... ..... ..... ..... ..... P r e s i d e n t. Sri Pradeep Kumar Dash ..... ..... ..... ..... ..... M e m b e r. Ajanta Subhadarsinee ..... ..... ..... ..... ..... M e m b e r (W). Dt.08/01/2018. -: J U D G E M E N T:- Presented by Sri Krishna Prasad Mishra, President:- Brief Facts of the Case;- The case is filed by the Complainant in accordance with the provision U/s 12 of the Consumer Protection Act 1986, pertaining to the deficiencies in rendering service on the part of the Opposite Party as here under. The Complainant is the wife and the legal heirs of her deceased husband namely Sripati Bag who had insured his life with the Opposite Party?s company under a Policy Janaraksha plan with profits (with Accidental Benefit) vide insurance policy No-593375265 for an amount of Rs.50,000/-(Rupees fifty thousand)only with an additional accidental benefit in case the death caused to him due to accident for another amount of Rs. 50,000/-(Rupees fifty thousand)only, by paying required amount of premium commencing the same from Dt. 29.05.2008. The further case of the Complainant is that during the subsistence of the Policy period the deceased husband of the Complainant died out of a railway accident and accordingly the Complainant claimed for the sum assured amount but the Opposite Party paid her the simple sum assured amount in lieu of the death of her husband but did not pay her the amount due against the accidental benefit yet for which she has repeatedly run after the Opposite Party but to no effect as such she has served a pleader notice through her advocate but still to no effect consequent upon which she preferred to file the case before the Forum claiming such activities of the Opposite Party as deficiencies in rendering her with due service against which she has claimed Rs.50,000/-(Rupees fifty thousand)only for the Accidental benefit with an additional amount of Rs.50,000/-(Rupees fifty thousand)only in lieu of her mental, physical and financial harassment, and in support of her case has filed the following documents (i) copy of the Policy, (ii) Copy of the Pleader Notice along with Regd. postal receipt as Annexure No.1(one), & No.2(two). On perusal of the Complaint, Annexures and on hearing her Advocate the case was admitted and notice to the Opposite Party was served, in response the Opposite Party appeared and filed it?s version disclosing some very material points such as the case is filed being barred by limitation, in it?s averments also has contended that the Complaint does not reveal anything materially required in as much as the exact date of the death, the cause of death, further to it?s averments has also pointed out that the sum assured amount of Rs. 40,000/-(Rupees forty thousand)only instead of Rs.50,000/-(Rupees fifty thousand)only as mentioned in the Complaint even in it?s claim for accidental benefit also. In it?s version the Opposite Party has claimed the date of the death of the deceased husband as on Dt.13.04.2012 and has also claimed to have given it?s best service to the Complainant by paying her sum assured amount of Rs. 40,000/-(Rupees forty thousand)only along with an amount of Rs.6,720/-(Rupees six thousand seven hundred twenty)only as bonus in total Rs.40,670/-(Rupees forty thousand six hundred seventy)only on Dt.31.01.2013 immediately after getting information of the death of the deceased insured to the Complainant through net banking in her account, And in furtherance to it?s averments has claimed that no documents to the effect of the cause of the death in relation to the accident has been filed before the Office of the Opposite Party and such claim has been made beyond the limitation of time from the date of the payments made to her as such is not maintainable in a belated stage hence is liable to be dismissed, moreover has denied to have received any pleader notice as such the case is not filed with any merit hence is liable to be dismissed. Having gone through the Complaint, version and the materials available in the record and on hearing the counsels of the respective Parties, some points as follows have come up before us to properly adjudicate the case, Whether the case is maintainable in view of the law of limitation as per the Act. Whether the Opposite Party is deficient in rendering service to the Complainant. Whether the Complainant is entitled to any relief as sought for by her . While dealing with the question of the points of maintainability of the case before the Forum in view of the period of limitation it came to our observation from the present materials available in the record and from the conduct of the Complainant that she is an illiterate and rustic villager lady even though has put her signature in the complaint and in some other documents, it is not sufficient to deducts from the points of natural justice that she well efficient to conduct anything at par with that of a real highly literate lady as it is seen from the information supplied to her counsel on the basis of which the Complaint is prepared and filed before the forum,Further more on the death of her husband she has claimed for the sum assured amount from the Opposite Party as per the term and condition of the Policy issued to her deceased husband at the time of the commencement of the Policy, along with the Documents available with us now as has mentioned in her complaint,but to the same though the Learned counsel for the Opposite Party has vehemently Opposed with a plea of not to have filed the same in due time , but in this critical juncture of the case if we would think of the circumstances in view of the spirit of the enactment of the Consumer Protection Act 1986, it is a benevolent provision of Law specially meant to give protection to such consumer with a lenient gesture. Furthermore it reveals from the materials available in the record that while the Claim was made by the Complainant immediately after the death of the deceased husband i.e on Dt.13.04.2012. But the amount of the sum assured has been disbursed to her on Dt.31.01.2013 after a lapse of seven months ,so in the mean time it was the mandatory duty of the Opposite Party to inquire in to and to ascertain the cause of the death of the deceased since the Policy it self is basically meant for both for natural and for accidental death benefit too ,More over it is being clearly established from the averments made by the version of the Opposite Party in it?s para no.5(sub para 3) that it was within the Knowledge of the Opposite party as has been admitted to have asked her for the required document in relation to the alleged accidental death ,so even if it is believed that those concerned documents were not filed by the time of the claim was made but it is seen from the Complaint that she has run to the office of the Opposite Party for several time for payments of the said accidental benefit and has claimed to have filed the documents in relation to the railway accident of her deceased husband insured and also has substantiated the same by filing those same documents before the Forum which can?t be brushed aside , As such in such circumstances we are of view it was also the duty of the Opposite Party as an Honest and largest Insurance business concern of the country, to ascertain the cause of the death and to award the benefit if any to it?s Consumer on it?s own as such the Plea of the Limitation raised by the Opposite Party is not acceptable ,So in our pragmatic view the opposite party can?t slip out of it?s responsibility merely on some technical fault if any of a helpless rustic village lady. Hence the question of the maintainability is in assertive in favor of the complainant. Secondly with regard to the points as to whether the Opposite Party is deficient in rendering service to the Complainant, It has been observed from the Conduct of the Opposite Party in dealing with the Complainant taking the advantage of her technical ignorance which is also the composite responsibility of the Parties as are bound by an agreement at the time of the commencement of the Policy , but has deviated from it?s responsibility to discharge in excavating the truth and to act accordingly and to pay her the due amount of the accidental benefit too, which tantamount to deficiencies of service ,hence it is answered accordingly in favor of the Complainant. Thirdly with regard to the entitlement of the Claim amount of the Complainant, as we have already discussed in detail of the case and have opined in favor of the Complainant and has already been awarded with a part payment of Rs.46720/-(Rupees forty six thousand seven hundred twenty)only against the death,it is obvious that she is entitle to the benefit against the accidental benefit too in accordance with the Policy and as per the Provision of the Act. Hence Order follows. O r d e r Hence the Opposite party is directed to Pay an amount of Rs. 40,000/-(Rupees forty thousand)only against the Sum assured of accidental benefit, with interest @ 6% P.A. from the date of filing of the case and also is directed to pay an amount of Rs. 5000/-(Rupees five thousand)only in lieu of her mental and physical harassment to the Complainant within thirty days of the receipt of the order, in default of which the total amount would carry an interest @ 9% P.A. till actual realization of the amount. Accordingly the order is pronounced in the Open Forum to-day i.e on Dt.08/01/2018. In the result the case is disposed off against the Opposite Party. Typed to my dictation and corrected by me. ( Sri Krishna Prasad Mishra) P r e s i d e n t. I agree, I agree, (Sri Pradeep Kumar Dash) ( Ajanta Subhadarsinee) M e m b e r. M e m b e r (W) [HON'BLE MR. Sri. Krishna Prasad Mishra] PRESIDENT [HON'BLE MS. MISS AJANTA SUBHADARSINEE] MEMBER [HON'BLE MR. Sri Pradeep Kumar Dash] Member