Parimala w/o Late.Gururaj rao - Complainant(s)


The Manager,LIC Koppal - Opp.Party(s)

Sri.M.V.Mudgal Adv

04 Apr 2015


Complaint Case No. CC/14/34
1. Parimala w/o Late.Gururaj rao
Parimala w/o Late.Gururaj rao,age:34,occ:household,K.J.Kulkarni Hospital behind,padaki colony koppal
1. The Manager,LIC Koppal
The Manager,LIC Koppal,near bus stand koppal
For the Complainant:
For the Opp. Party:

Deceased Guguraj Rao Kulakarni, the complainant’s husband was a State Government employee working as Village Accountant under the Tahasildar Yelburga insured his life on 28-03-2010 for a sum of Rs.1 Lakh opting for Salary Saving Scheme, under which Rs.989/- is required to be deducted as premium in every calendar month.  The policy holder died on 26-07-2011.  The complainant made a claim for the sum assured under the policy.


            2.  On 24-09-2011,  LIC wrote a letter to the Tahasildar Yelaburga as per Ex.B.2, which reads thus;


“We are enclosing herewith a Claim Form-E (Revised) with a request to submit the same duly completed and signed.  The Life Assured expired on 26.07.2011 and was working as Village Accountant.  Leave availed on sick ground from 28.03.2007 to 26.07.2011 along with certified copies of leave applications and leave sanctioned are required.


Please confirm the Monthly installment premiums due for 06/2011 and 07/2011 are recovered from salary and sent to our office.  Please submit the information at the earliest.”


            3.  The Tahasildar, Yelaburga issued the Certificate by Employer, as per Ex.B.1 on 29-08-2011, which is as follows;




4.  On 27-09-2014, LIC issued a letter as per Ex.B.3 to Tahasildar, Yelaburga stating as follows;


“For consideration of payment of death claim under the above policy we require “CERTIFICATE OF EMPLOYER” duly signed and sealed together with copies of leave applications availed on medical ground. 


As per your certificate dated 29.08.2012 (Xerox copy enclosed) the above employee has availed medical leave from 28.03.2007 to 26.07.2011 please clarify for how many days he is no leave, as per your statement, he is on leave from 28.03.2007 to 26.07.2011


We therefore quest you to send us the attested copies leave applications and medical certificates produced by the said employee for availing the above medical leaves from 28.03.2007 to 26.07.2011.

We are enclosing the fresh FORM NO.3.”


            5.  Since the amount has not been paid for a long time, the complainant approached this Forum seeking for a direction for payment of sum assured under the policy and also compensation under different heads.


            6.  In the written version, the LIC contended as follows;

“It is clearly shows from letter given by Tahasildar Yelburga office, dated 29-08-2012 that the deceased life assured was on sick during the said period.  The employer certificate Form E issued by Tahasildar Yelaburga is attached herewith in Original along with this written version.


The complainant’s husband, i.e. Guguraj, before making this policy he was under illness or sick as per the Employer Certificate (Form-E).  As per the Employer Certificate, the Deceased Life Assured had availed the leave on medical grounds but the copies of leave applications and the medical certificates for the dates of leave availed on Medical/sick grounds have not been provided by the employer for our requests vide our letters dated. 24-09-2011 and 27-09-2014 are enclosed herewith along with this written version.


In the Certificate by Employer (Claim Form “E”) in Sl.No.3 the absence of the Deceased Life Assured period of leave is mentioned as 28.03.2007 to 26.07.2011.  The days column is left Blank, means the employee was continuously on leave for the said period on medical grounds.  This respondent Corporation is prepared to process the claim once we receive the reply and requirements to our letter dated. 24.09.2011 and 27.09.2014 from the employer of the Deceased Life Assured, Certificate of Employer (Fresh Form E) Duly signed and sealed together with the copies of leave application submitted by the Deceased Life Assured on medical grounds during 28.03.2007 to 26.07.2011 and will be payable only if the claim is admitted.”


            7.  The case was posted for final order 19-12-2014.  On that day this Forum observed that it was necessary to call-for the Service Register of the deceased policyholder.  Accordingly, a direction was issued to the office of the Tahasildar, Yelaburga to produce Service Register of the deceased Gururaj Rao Kulkarni and the case was posted on 02.01.2015. On that day, an official from Office of the Tahasildar, Yelaburga has furnished the original Service Register of the deceased Gururaj rao.  The entries in the Service Register do not disclose that the official was on leave w.e.f. 28.03.2007 as mentioned in Ex.B.1, Certificate issued by the Tahasildar, Yelaburga on 29.08.2012.  The entries discloses that the official was on Commuted leave on medical ground from 05-05-2011 to 21-07-2011 not earlier.  Therefore, Attendance Register has been called pertaining to the deceased Gururaj Rao since 28.03.2007 to 28.03.2010 because the policy was taken on 28.03.2010 and the Certificate Ex.B.1 discloses that he was on leave from 28.03.2007.  There was no response from the office of the Tahasildar, Yelaburga in this regard inspite of service of notice on 08-01-2015.  As such, on next date of hearing on
06-02-2015, leave applications of the deceased Gururaj Rao on medical ground for the period from 28.03.2007 to 26.07.2011, which shown in Ex.B.2 has been called-for from the office of the Tahasildar, Yelburga.  The notice was served on 11-02-2015.  Nevetheless, there was no response from the office of the Tahasildar, Yelburga.  Since the entries in Service Register are to be accepted as correct, this Forum finds it fit to proceed with the case treating the document, Ex.B.1 as false document issued by the Tahasildar, Yelburga.  In the circumstances mentioned above, this Forum is of the opinion that the LIC is liable to make payment of the sum assured to the complainant, who is the wife and nominee of the deceased policyholder. 


            8.  In paragraph – 6 of the written arguments, it is contended that the notice to opponent sent by the complainant on 24-7-2012 and so the complaint filed on 08-8-2014 is barred by time.  The notice, Ex.A.3 discloses that the complainant has informed LIC Branch at Koppal about the death of her husband soon after the death.  But, this is a peculiar case, wherein the LIC has not repudiated the claim.  And even in the written version the LIC says that the requests dated: 24-09-2011 and
27-09-2014 have not been replied by furnishing the copy of the leave applications and medical certificates for the dates leave availed by the employer.  The copy of the letter, Ex.B.3 also indicates that the correspondence is still in progress.  The Tahasildar, Yelaburga, under whom the deceased was working has not positively responded to the summons issued by this Forum for furnishing the leave applications and we are constrained to conclude that the certificate, Ex.B.1 by the particular Tahasildar is false document and unfortunately the LIC could not decided the representation of the complainant for want of leave applications on medical ground from the employer.  We do not find any fault with the LIC in delaying the process and therefore we are not awarding any compensation for deficiency in service alleged.  We are also not awarding the litigation expenses.  What we are doing is directing the LIC to pay the sum assured to the nominee of the policy because it cannot reject the claim on the basis of the document, Ex.B.1 which is patently a false document and infact there is no rejection.


            9.  For the reasons stated above, this Forum directs the LIC to make payment of Rs.1,00,000/- (Rupees one lakh only) to the complainant within three months, in default of which the payment has to be done with interest at 10% p.a. from the date of expiry of the time granted till payment.


            Office to send back the Service Register of the deceased policyholder to the Office of the Tahasildar Yelaburga, wherefrom the records have been received after three months.


List of Documents Exhibited for the Complainant.


Copy of Policy bond



Death Certificate



Letter from complainant to OP



Copy of postal acknowledgments


List of documents exhibited for the opposite party


Certificate by Employer



Copy of letter from OP to Tahasildar Yelaburga



Letter from OP to Tahasildar Yelburga



Witnesses examined for the Complainant / Respondent.


Smt. Parimala W/o. Late Gururaj Rao,
R/o: Koppal


Sri. K.Parashurama S/o. K.Baramappa,
R/o. Raichur


[HONORABLE K.V.Krishnamurthy.]

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