NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
Not Stated, Not Stated
Original Complainant – Appellant
Versus
Life Insurance Corporation of India – Respondent
Revision Petition | Appeal No. 36/2009 | Complaint Case No. 251/2007
| Table of Content |
|---|
| 1. insurance claim processes require full disclosure. (Para 1 , 2 , 3) |
| 2. delay in claims processing triggers liability for deficiency in service. (Para 4 , 5 , 6) |
| 3. fraudulent suppression of information voids insurance claims. (Para 7 , 8 , 9) |
| 4. court upheld the ruling not to provide the sum assured. (Para 10 , 11 , 12) |
1. The present Revision Petition has been filed by the Original Complainant under S.21 of the Consumer Protection Act, 1986 against the Order dated 5.11.2009, passed by the Chhattisgarh State Consumer Disputes Redressal Commission, Pandri, Raipur, (hereinafter referred to as the State Commission) in Appeal No. 36/2009, preferred by Life Insurance Corporation of India, the Opposite Party / Respondent herein (hereinafter referred to as the Respondent / Insurance Company). By the Impugned Order, the State Commission while reversing the Order dated 23.12.2008, passed by the District Consumer Disputes Redressal Commission, Durg (hereinafter referred to as the District Commission) in Complaint Case No. 251/2007, filed by the Complainant / Petitioner, has disposed of the Appeal filed by the Respondent / Insurance Company, with a direction to the Respondent / Insurance Company to pay a sum of Rs. 25,000 to the Complainant / Petitioner herein as compensation for the deficiency in service committed by it in not deciding the claim in time and thereby compelling the Complainant / Petitioner to re - approach the District Commission as also Rs.500 as costs. By its Order dated 23.12.2008, the District Commission had allowed the Complaint filed by the Complainant / Petitioner and directed the Respondent / Insurance Company to pay to the Complainant / Petitioner the amount of 13 policies in question along with interest @ 6% p.a. from the date of filing of the Complaint and also pay litigation costs of Rs. 2,000.
2. The facts, in brief, as culled out from the Complaint are that one Sukhdev, the husband of the Complainant / Petitioner (hereinafter referred to as the Insured), while working in Bhilai Steel Plant, had taken 13 insurance policies in the total sum of Rs.13,40,000. The details of the said policies have been given in Para - 2 of the Complaint. The premium of the said policies was being deducted from the monthly salary of the Insured and paid to the concerned Branch of the Respondent / Insurance Company. The Insured died on 15.11.2002 in the Jawaharlal Nehru Hospital, Bhilai Steel Plant, Bhilai, where - after the Complainant / Petitioner preferred claim under the policies in question. When no amount was paid to her by the Respondent / Insurance Company, she sent a notice, dated 14.11.2004, to the Respondent / Insurance Company but neither there was any reply to the notice nor was any amount paid by the Respondent / Insurance Company. Accordingly, the afore - noted Complaint came to be filed before the District Commission, praying for a direction to the Respondent / Insurance Company to pay the assured sum of Rs.13,40,000 along with bonus as per Rules as also interest @ 12% from the date of the Complaint etc.
3. Upon notice, the Respondent / Insurance Company filed its Reply before the District Commission. While admitting about issuance of all the 13 policies in question, it was stated on behalf of the Respondent / Insurance Company that the Insured had taken the policies from different Branches. The premium was being deducted from the salary of the Insured. However, subsequently, the Insured requested his Employer not to deduct the premium, on account of which the Employer stopped sending the premium amount and, therefore, the policies were lapsed. The Employer Bhilai Steel Plant had not been made a party in the Complaint otherwise things would have been cleared. As directed by the State Commission in the first round of litigation, the Complainant / Petitioner had not filed the claim forms properly and, therefore, the matter was not considered. Further, it was stated by the Respondent / Insurance Company
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