SupremeToday Landscape Ad
Back
Next
Judicial Analysis Court Copy Headnote Facts Arguments Court observation
Listen Audio Icon Pause Audio Icon
judgment-img

NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION,
NEW DELHI
V.B. Gupta, Presiding Member and Vinay Kumar, Member
Sri Faizan M A Zaheer —Appellant
versus
Branch Manager, LIC & Ors. —Respondents
First Appeal No. 521 of 2011
(Against the order dated 21.11.2011in CCSR No.5666 of 2011 of the State Commission, Andhra Pradesh)
Decided on 17.7.2012

Advocates:
Counsel for the Parties:
For the Appellants :Mr.Rayeece M.A. Khadir, Advocate.

IMPORTANT POINT
State Commission cannot entertain claim beyond its pecuniary jurisdiction.

Headnote:Consumer Protection Act, 1986—Sections 17, 19 and 21—Insurance—Money Plus policy—Non-settlement of death claim—Complaint returned by State Commission for presentation before appropriate forum—State Commission has fully considered nature of insurance policy and case of complainant—It is a case of death of assured just after three years of commencement of policy—In such a case, payable amount is sum assured or NAV of units allocated to policy holder, whichever is higher—Based on this, State Commission concluded that matter will fall within pecuniary jurisdiction of District Forum—Conclusion of State Commission is unassailable—Complaint has arisen from fact that OP had kept claim under policy pending and had not decided it—Question of acceptability or otherwise of decision of OP/LIC of India, on claim does not arise, as decision had not been taken by respondent/OP, till consumer complaint was filed before State Commission—It was not necessary for State Commission to hear OP/LIC of India—Appeal dismissed. (Paras 6 to 9)

       

ORDER

Vinay Kumar, Member—This appeal has been filed against the order of AP State Consumer Disputes Redressal Commission, in CCSR No.5666 of 2011. The Complainant had made the following prayer before the State Commission:-

“The Hon’ble Court may be pleased to direct the Opp Party No’s (1) to (3) to pay the following amount towards settlement of death claim of the deceased assured per Mr. Fazal Mohammed Omer Qayyum (since dead) to the Complainant/nominee.

i) admitted HLV of the deceased with multiplayer twenty two (22) times the annual income at rate of Rs.4,00,000 PA is equal to 22 × 4,00,000

= Rs. 88,00,000/-

Compensation towards causing mental agony and torture Rs. 5,00,000/-

Towards deficiency of service by not calling the Complainant for negotiation contrary to the Public notice of the officials of Opp party Rs.5,00,000/-

Total Rs.98,00,000/-”

2. The complaint arises out of Money Plus policy taken by the brother of the Complainant from OP/LIC of India with effect from 29.3.2007. The insured died on 13.1.2010. As the nominee of the insured, the Complainant informed the OP on 27.1.2010. After certain amount of correspondence, the OP/LIC of India issued a proposal form on 28.5.2011. Allegedly the claim under the policy was filed on 28.8.2010 but the claim continued to remain with the OP without being settled till 29.10.2011, when the consumer complaint was made. As it appears from the complaint petition, legal notice was also issued to the OP/LIC on 19.4.2011 with no result till the filing of the complaint before the State Commission.

3. It is seen from the record submitted before the State Commission that under the terms of the policy the following amounts were payable:-

“Sum assured under the Basic Plan

Accident Benefit Sum Assured Rs.1 lakh

Critical illness Rider Sum Assured : Rs.1 lakh

Amount payable on death:

In the event of the death of the life assured prior to the date of maturity, when the cover is in full force, an amount equal to the higher of sum assured under the basic plan or the Fund value units held in the Policy holder’s Fund value shall become payable notwithstanding which is mentioned above.”

4. The State Commission has noted that the assured had paid premium for three years commencing 29.3.2007, before he died on 13.1.2010. Considering the same, the State Commission has observed as follows:-

“At the end of three years if the person is aged 33 years fund value was mentioned at Rs.41,758/- and the death benefit of Rs.1 lakh. We reiterate that the nominee would be entitled to receive the sum assured under the basic plan or the fund value as on the death of life assured whichever is more i.e., where the sum assured is Rs.1 lakh and the premium of Rs.10,000/- is paid for three years, the nominee would be entitled for Rs.1 lakh only assuming the fund value for the three years contributed by the life assured would be less than the sum assured. Therefore it could not have been Rs.88 lakhs on payment of yearly premium of Rs.10,000/- under the scheme. Since his death was after three years of taking of the policy by no stretch of imagination it can be said that an amount of Rs.88 lakhs would be accrued by covering all these tables that were prepared by the LIC agents enclosed by the complainant while filing the complaint. We are not satisfied with the claim mentioned as it is not supported by any rules. Therefore we are of the opinion that this is a fit case where the complainant can be returned for presentation before appropriate Dist. Forum having jurisdiction in the matter.”

The State Commission therefore, decided to return the complaint with an observation that the same could be filed before an appropriate District Forum.

5. We have perused the records and heard Mr. RMA Khadir, counsel for the appellant. The order of the State Commission has been challenged on the ground that the State Commission has arrived at its conclusion without hearing the other side and without appreciating the record.

6. A





Click Here to Read the rest of this document

1
2
3
4
5
6
7
8
9
10
11
SupremeToday Portrait Ad
supreme today icon
logo-black

An indispensable Tool for Legal Professionals, Endorsed by Various High Court and Judicial Officers

Please visit our Training & Support
Center or Contact Us for assistance

qr

Scan Me!

India’s Legal research and Law Firm App, Download now!

For Daily Legal Updates, Join us on :

whatsapp-icon Back to top