In a legal battle fought by a mother for the last seven years to recover an
amount due on insurance policy of her son after his accidental death, the Life
Insurance Corporation paid an amount of Rs 37 lakh following an order passed by
South Goa district consumer disputes redressal forum under execution petitions.
In this case of landmark recovery of decreetal amount, the forum recently
directed the LIC to pay a sum of Rs 37,18,081 to the complainant mother, one
Malkumi Puno Ladekar, a resident of Navelim, Salcete. She was a nominee of her
deceased son, who had drawn two life insurance policies, wherein each basic sum
assured was Rs 5 lakh with double accident benefit.
Her son died due to drowning on May 12, 2002, at Galgibaga. Thereafter, the
mother filed a complaint before the forum in 2003 in respect of the claim of
these policies as LIC failed to pay her the insurance amount. The complainant
stated she had put forward her claim before the LIC for payments as per the
terms of both the policies. However, LIC, Vasco branch, from where the policies
were drawn failed to respond.
Subsequently, the complainant lodged a claim before the senior divisional
manager, (LIC) Panaji, who through a letter informed the complainant that her
claim is withheld due to personal and family history of the deceased.
The complainant pointed out in support of her claim, that magisterial enquiries
were duly conducted declaring that the cause of the death was purely
accidental.
The complainant further alleged that the LIC was avoiding to make the payments
and hence served a legal notice in 2003 on LIC and demanded that they clear the
dues under the said two policies within a time stipulated under the said
notice. Instead of complying with the requirement of the said notice, the LIC
intimated the complainant that the said policies are referred to the LIC zonal
manager, Mumbai, for review. The company failed even to reply to the various
representations made by the complainant from time to time without any valid
reason whatsoever only with a view to harass the complainant and delay the
payment under one pretext or the other, the complainant alleged.
The complainant therefore asked the consumer court to order the LIC to pay her
Rs 5 lakh being the normal assured amount due under one of the policies,
immediately. She also prayed that the LIC be ordered to pay accidental death
benefit of Rs 5 lakhto her as due under the second policy along with other
benefits available under the policy like bonus etc. She also said that they be
ordered to pay damages at the rate of Rs 100 per day from the date of demand
made by the complainant from March 19, 2003, till the date of payment, besides
the costs to be paid to the complainant.
Upon receiving notices from the forum, the LIC denied the claim and disputed
the cause of death of the deceased as reflected in the order of the SDO, Quepem
and the validity of the final police report. LIC further alleged that the case
looked to be of a suicidal death. However, the forum, after verifying various
facts of the case, opined that the complainant had succeeded in proving her
case with convincing documentary evidence as regards her entitlement for the
amount to be received by her under the two policies. The forum also held that
there was no justification on the part of the insurance company to repudiate
the claim of the complainant and that the acts of omission and commission on
the part of LIC clearly amount to the deficiency in service as defined under
the Consumer Protection Act, 1986. The forum also agreed with the contention of
the complainant that under the relevant policy, double the amount of the policy
becomes due and payable by the LIC as the same is of d
ouble benefit in case of accidental death.
The forum in year 2007 ordered LIC to pay an amount of around Rs 35 lakh to the
complainant.
Forum president advocate Jagdish Prabhudessai told TOI recently that the
forum's order in this case was upheld by the state commission, national
commission and the Supreme Court "with slight modifications as to the rate of
interest granted by the forum," while dismissing the appeals of LIC.
"In this case, two execution applications were filed. The forum issued the
notice for non-compliance of the order under Section 27 of the Consumer
Protection Act, 1986 and it directed LIC to make full payment due under the
decree since the Supreme Court had dismissed their appeals," Prabhudesaid
informed .
The LIC sought time to comply with the order and subsequently paid the entire
decreetal amount of Rs 37,18,081 by demand draft which included the cost of Rs
3,000 awarded by the state commission and interest on the principal amount
payable under the two policies at the rate of 12% per annum from March 19, 2003
till June 1, 2010, Prabhudessai informed.
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