Sri Rama Chandra Das, President - This complaint has been filed by the complainant under section 12 of C.P Act with the prayer to direct the OPs to pay sum assured Rs.30000/- with interest from 15.12.2007 till date along with litigation cost of Rs.15000/- and for mental agony Rs.10000/-
The case of the complainant is that his deceased wife Saraswati Sahoo was appointed as Anganawadi helper in village Jagannath Prasad under Gania block of Nayagarh District by the CDPO., Gania. The Central Govt. implemented Anganwadi Karya karti Bima Yojana with the help of L.I.C for the benefit of Anganwdi worker /helper as security measure from 01.2.2004. His wife died on 15.12.2007 and after that he made request to OP No.2 for settlement of the claim but was in vain. On 28.7.2014 he intimated to OP No.2 with a copy to OP No.1 for settlements. In response to this letter the OP No.1 on 05..8.14 sent form and said to make an bond for the delay . The complainant sent all the documents to OP No.2 on 13.3.2015 with a copy to OP No.1 by registered post. But the OP No.2 remain silent. The OP No.1 on 1.4.2015 intimated the complainant after receiving the form that OP No.2 shall settle the claim. Since the OP No.2 remain silent and as per .R.D.A Rule the claim shall be settled within one month, no action was taken hence he file this complaint with the prayers above.
The OP No.2 appear and filed her written version stating that the complaint is not maintainable beyond period of limitation as the matter occurred on 15.12.2007 and further stated that the deceased wife of the complainant might be an Anganwadi helper but not was insured in Anganwadi Kartri Karti Bima Yojana and was not enrolled in the list of group insurance scheme under said Yojana in the register of Members of C.D.P.O ., Gania. The complainant not sent any letter to OP No.2 after the death of his wife on 15.12. 2007. He has never requested or approached OP No.2 regarding the insurance of his diceased wife. As the deceased wife of the complainant was not a member in group Insurance scheme under this yojana it was not possible on the part of OP No.2 to correspond the matter with any body else.
The OP No.2 on 29.4.2004 received letter No.19/2003-8422 dated 12.2.2004 from the department of Odisha Women and Child development and as per that the OP No.2 enrolled the names of Anganwadi Workers / Helpers in Group Insurance scheme in the register of member under the said Yojana on 22.7.2004. The deceased Sarawswati Sahoo was not a member in this scheme She could have enrolled herself as member in the month of April 2005 or 2006 or in 2007. The complainant falsely stated that his wife was member on 01.04.2004. After receiving the letter from the complainant the OP No.2 was astonished that the deceased Saraswsati Sahoo was not a member of group insurance scheme under Anganwadi Karya Kari Bima Yojana who died 8 years back and the complainant wanted details regarding insurance scheme to get the claim from OP No.1. The OP No.2 has never done deficiency in service in this matter. The complaint has no merit and may be dismissed with cost.
The OP No.1filed the written version and submitted that the OP No.2 is the Nodal Officer of LIC regarding this matter. In case of contingency the application in original with signature and recommendation of the Nodal Officer is required for the L.I.C to initiate any action from the side of L.I.C. In 30.7.2014 the LI.C received by Post the xerox copy of death information of the claim form only signed by the beneficiary not attested by OP No.2 with seal and signature as per the procedure. The Nodal agency (Op No.2) is to forward to the L.I.C original claim form duly certified and the death certificate duly attested by her. As the documents were incomplete the L.I.C sent letter to the beneficiary on 5.8.14 for necessary compliance with copy to OP No.2. On receipt of that letter the beneficiary sent again the said xerox copy only signed by him not attested by the Nodal agency. The Xerox copy of the affidavit was also not signed by the Nodal agency. The beneficiary submitted some documents (xerox copy only) on 13.3.2015 not certified by the Nodal agency. On receiving these xerox copies from the complainant the OP No.1 on 8.4.2015 wrote a letter to OP No.2 for necessary compliance with a copy to the complainant. Without the signature of the Nodal Officer on all documents the claim cannot be settled . The OP No.1 has no deficiency in service to-wards the complainant. The delay was due to negligence on the part of the complainant and OP No.2. The L.I.C is in favor of settlement of the claim, It is the complainant and the OP No.2 who should comply to the requirements of L.I.C. The complainant without any reason and basis filed this case against OP No.1 having no merit and the same may be dismissed with cost.
On the above pleadings of the parties the following issues emerges for the just decision of this complaint.
1. Whether Saraswati Sahoo the deceased wife of the complainant was enrolled as member in group insurance scheme under Anganwadi Karya Katri Bima Yojana and was entered in the register of the member by OP No.2 on 22.7.2004 as per the letter No.19/2003 - 8422 dated 12.4.2004 of Govt of disha Women and Child department ?
2. Whether there was any deficiency in service on the part of either OPs?
3. Whether the complainant is entitled to get the benefit of his deceased wife ?
In order to prove the case the complainant filed his evidence in shape of affidavit and relied on the xerox copies of documents filed along with the complaint and the xerox copies of the documents filed on 18.6.2015 and on 4.8.2015 as per the list. OP No.1 only filed his evidence on affidavit without any documents. The OP No.2 filed her evidence on affidavit and relied on the xerox copies of the documents filed on 18.8.2015 as per the list.
DECISSISON
Issue No.1 : At the time of filing of the complaint on 8..6.2015 the complainant only filed the xerox copies of brochure of Anganwadi Karya Katri Bima Yojana letter of the complainant dated 28.7.2014 and 13.3.2015 addressed to OP No.2, the death certificate of his wife and letters received from OP No.1 dated 5.8.2014 and 01.4.2015 and the appointment letter of deceased Saraswati Sahoo baring letter No.255 date not visible of C.D.P.O., Gania. During admission of the complaint, complainant was asked to file the enrollment certificate and deposit of the premium receipt AKBY and he filed the intimation letter No.268 dated 5.7.2014 to-wards his RTI application dated 22.5.2014 along with the xerox copies of the registered of members group insurance scheme under AKBY and a letter No.371 dated 23.7.04 of C.D.P.O., Gania addressed to OP No.1 regarding deposit of bank draft amounting Rs.4615. On going through the register of member at Sl. No.46 it was found Saraswati Sahoo , A.H of Jagannathprasad , Nayagarh aged 28 years wife of Bijay Kumar Sahoo aged about 35, the Forum believed that the deceased Sarasswati Sahoo was the member under group insurance scheme and accordingly the complaint was admitted. The complainant in his affidavit never mentioned that the xerox copy of the registered member filed by him on 18.6.2015 in that his name and the address of his wife has been mentioned at Sl No.46 of the enrollment list.
The OP No.2 in support of her evidence filed the xerox copies of the documents as per the list on 18.8. 2015. In letter No. ICDS-1-19/03-8422dated 12.4.2014 which was received in her office ;on 29.4.2004, in that it is mentioned the scheme will be effective from 01.02.2004 and shall be optional for the target group i.e. AWS and AWHS of the C.D.P.O who is the D.D.O of AWWS/AWHS and has been nominated as the nodal agency for the purpose of the scheme. The AWWS or helper who is not covered under any other Janashree Bima Yajana of L.I.C can be member of the AKBY. She has to fill up an application form and hand it over to the Nodal agency along with her share of the annual premium for coverage under the scheme . The nodal agencies i.e CDPO shall collect the application forms from the interested AWWS/AWHS and deduct the member share of the annual premium at @ Rs.80/- from the honorarium of the concerned AWW/AWH and deposit the amount along with the list of members and their application forms with the P & G.S unit of L.I.C. The claims of the member shall be processed though the nodal agency and settled by L.I.C promptly by ;sending account payee cheques directly to the beneficiary. The OP No.2 in her affidavit has clearly mentioned that the wife of the complainant is not a member in group insurance scheme AKBY for which it was not possible on her part to make corresponded in this matter with any body else. As per the above cited letter of the ICDS the enrolled AWWS & AWHS in the register in group insurance scheme under AKBY on 22.07.2004 was sent to the LIC P & G.S department vide letter No. 371 dated 23.07.2004 in favour of 58 number of applicants with bank draft amounting Rs 4,615/-. The members of the scheme deposited Rs 80/- per annum. The deceased Saraswati Sahoo was not a member in the scheme nor she applied to be a member in the year 2005, 2006 in April 2007. The OP No.2 has filed the xerox copies of register of members in 5 sheets from Sl No. 1 to 58. At Sl No. 46 one name of Saraswati Sahoo of Dankhari Sahi, Rasori, Nayagarh aged about 38 years wife of Sanatana Sahoo with nominee Promod Sahoo aged about 15 years (Son has been maintioned). Therefore it clearly reveals Saraswati Sahoo, the deceased wife of the complainant was not been enrolled as member group insurance scheme.
The complainant which he filed the xerox copy of the page shcarting from Sl No. 37 to 48, Sl No. 46 the name of the husband, the address of the member her age, the name of her husband and name of the nominee differs with the list of members furnished by OP No.2. Therefore it appears that the complainant after getting the certified copies of register of members under RTI act from OP No.2 has inserted the address, age, name of the complainant and name of the nominee. And thereafter taken the xerox copies of the same and filed in the Forum to believe that his deceased wife of the member of group insurance scheme and he (complainant) is a nominee of her. The complainant has misrepresented this Forum by manipulating the address, age and his name as husband and nominee in Sl. No.46 of register of members by taking advantage of the similar name of another member of the scheme. On the besis of manipulated document the complainant has filed this vexatious complaint before his forum for unlawful gain.
Issues No. 2 : In the previous issue we found the deceased wife of the complainant was not the member of group insurance scheme AKBY till she died on 15.12.2007. The OP No.1 is to settle the claim if the claim application, death certificate being attested sealed and signed by the nodal agency (OP No.2). The OP No.2 has to forward the claim of the beneficiary of the deceased insured certifying that she was the member of group insurance scheme. Since the wife of the complainant was not the member of group insurance scheme the OP No.2 did not send the claim of the complainant to OP No.1. The complainant file the letter No. ICDS-1-35/08-314 dated 11.9.2009 of WCD department in that Rs.80/- contribution of AWW/AWH per year earlier has since been waived . The complainant did not file any letter of the Govt. from which year this contribution as been waived as per the scheme any AWW and AWH are not made members of group insurance scheme compulsorily ,but it is an optional. The OP No.1 nor OP No.2 made any deficiency in their service towards the complainant rather the complainant has misrepresented this Forum by manipulating his name against the name of another person namely Saraswati Sahoo of Village Danakhaisahik.
Issue No.3 : We found the OP No.1 and 2 have no deficiency of service on their part but the complainant by manipulating the entry at Sl. No.46 of register of members has come to this Forum for wrongful gain from OP No.1 by dragging both the OPs with malafied intention. It is held in 2012(2) CPR 306 (NC) and 2012(2) CPR 526(NC) that “ Frivolous petition must be dismissed with punitive cost ” The complainant is not entitled for any relief but should be saddled with punitive cost which to be paid to the OPs under section 26 of the C.P Act . Hence we order;
ORDER
The complaint be and same is dismissed on contest with cost of Rs.6000/- for the vexatious complaint with manipulated documents filed by the complainant . The above cost shall be paid by the complainant at the rate of Rs.3000/- each to the OP N o.1 and 2 within one month from the date of this order failing which the OPs shall realise the same in due process of law.
Issue free copy to the parties.
The final order is prepared by us, corrected,
signed, sealed and pronounced in the open
Forum on this 31st August, 2015
