Karnataka

Chitradurga

CC/106/2017

Shusheelavva - Complainant(s)

Versus

1. 1. The Manager, Reliance Life Insurance Company - Opp.Party(s)

KBC

04 Jun 2018

ORDER

COMPLAINT FILED ON:25/10/2017

DISPOSED      ON:04/06/2018

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, CHITRADURGA.

 

CC.NO: 106/2017

 

DATED:  4^th JUNE 2018

PRESENT: - SRI. T.N. SREENIVASAIAH  : PRESIDENT                                   B.A., LL.B.,

                   SRI.N. THIPPESWAMY        : MEMBER

                          B.A., LL.B., PGD.CLP  

 

……COMPLAINANT/S	Susheelavva Guddappa Mylarada, W/o Guddada Ningappa Mylarada, Age: 40 Years, Agriculturist and Business, Sunagara Oni, Ranibennur City, Haveri-581115.   (Rep by Sri. K.B. Chandrappa, Advocate)
V/S
…..OPPOSITE PARTIES	1. The Manager, Reliance Life Insurance Co. Ltd., C/S/C Office, Bangalore Road, Challakere, Chitradurga.   2. The Manager, Reliance Life Insurance Co. Ltd., No.44, BSC Avenue, 2nd Floor, Akkamahadevi Road, P.J. Extension, Opp: Chetan Hotel, Davanagere Town.   (Rep by Sri. B.S.Shivamurthy, Advocate)

ORDER

SRI. T.N. SREENIVASAIAH:   PRESIDENT

The above complaint has been filed by the complainant u/Sec.12 of the C. P Act, 1986 for the relief to direct the OPs to pay    Rs.7,37,432/-, the policy amount and other benefits with cost  and such others reliefs.

2.      The brief facts of the case of the above complainant are that, the husband of the complainant by name Guddappa Ningappa Mylarada has obtained endowment policy bearing No.52384820 from the OPs on 29.09.2015 in the name and style of reliance lifelong saving plan with half yearly premium of Rs.20,000/- for term of 29 years.  The sum assured under the policy was Rs.7,34,432/- covering the natural death and accidental death.  It is further submitted that, the above said Guddappa was died on 06.10.2015 due to severe heart attack in his house at Ranebennur City, Haveri District.  After the death of her husband, the complainant intimated the same to the OPs on 06.07.2016 and claimed the benefit under the policy along with necessary documents. After perusal of the records submitted by the complainant, the OPs have repudiated the claim stating that, the deceased Guddappa Ningappa Mylarada was not properly furnished his age, occupation and income.  After receiving the repudiation letter, the complainant has issued legal notice to the OPs through her counsel.  The repudiation made by the OPs itself is illegal and unfair trade practice on the part of OPs and it is purely a deficiency of service.  The premium amount has been sent by the husband of the complainant through Challakere Branch office and hence, this Forum has got jurisdiction to entertain this complaint.  The cause of action arose to file this complaint is when the OPs made repudiation and issued legal notice to the OPs which is within the jurisdiction of this Forum and hence, prayed for allow the complaint.

3.      After issuance of notice to the OPs, OPs appeared through Sri. B.S. Shivamurthy, Advocate and filed version.  The main contention of the OPs is that, the complaint can be filed within the territorial jurisdiction Forum where the OP resides or work for gain.  However, in the present case, the complaint is filed according to the place of the complainant which is against to the provisions of the Act.  As the cause of action arose at Davanagere Branch of OP and hence, the complaint to be presented before the Davanagere District Consumer Forum.  It is further submitted that, after careful valuation of the records obtained by the investigation agency during death claim investigation, it was revealed that, the life assured had provided false and incorrect information on various facts and deliberately misrepresented material facts relating to his income and hence, the policy obtained by the life assured in breach of basic doctrine of utmost good faith and hence, the same cannot be termed as deficiency in service rendered by the OPs.  It is further submitted that, the present complaint is filed by the nominee of deceased policy holder i.e., the complainant but, neither declared nor made other legal heirs of the deceased life assured as a parties to the present proceedings as much as no objection affidavit from other legal heirs is not filed in the present complaint and hence, the complaint is liable to be dismissed on this ground alone as the complainant has filed this complaint without obtaining the succession certificate from competent court of jurisdiction.  Further it is submitted that, the complainant with a malafide and dishonest intention not only concealed the material facts from this Forum but also twisted and distorted the same to suit her own convenience and to mislead the Forum and further it is submitted that, the complaint is devoid of any material particulars and has been filed merely to harass and gain undue advantage and unjustified money from the OPs.  Further it is noteworthy that, OPs have already refunded the premium paid by the DLA after necessary deductions through HDFC online transfer NEFT reference No.N254170365289097 dated 08.09.2017 for an amount of Rs.19,324/-.  Further submitted that, the company received the claim intimation from complainant informing that the life assured died on 06.10.2015 that as the death of the life assured was within two months of issuance of subject policy, this was squarely covered as early claim under Section 45 of Insurance Act 1938.  As the claim is within two years of the issuance of policy, the OPs had conducted an investigation for claim processing.  On careful evaluation of the records obtained by the company during claim processing it was revealed that, the deceased life assured had suppressed the material information and had grossely misrepresented while answering the material questions specifically asked in the proposal form.  It is further submitted that, during investigation it was found that the deceased life assured was a coolie and used to do seasonal business like selling of utensils as per proposal form.  As per proposal form, the DLA’s occupation was a business of commission agent and his annual income was of Rs.2,50,000/- but, during enquiry it was found that, the DLA was a coolie and used to do seasonal business like selling of utensils and was not involved in the work as mentioned in the proposal form that he was having annual income below Rs.1,00,000/-.  It is further submitted that, the discrepancy was also observed in the age of DLA and as per proposal form the DLA was born on 17.05.1974, thus his age was 41 years at the time of proposal for subject policy i.e., on 28.09.2015.  As per voter ID card obtained during investigation bearing No.KYN1853548 his age was 32 years in 2002, thereby 45 years at the time of proposal.  Further as per ration card his age was 44 years in 2014, thereby 45 years at the time of proposal.  As per the Adhar Card, his date of birth was 1970 making his age to be 45 years at the time of proposal form.  Hence there was a discrepancy of 4 years in the age of DLA.  Further it is submitted that, the reason given by the DLA to the questions pertaining to his past medical history he was hale and healthy at the time of issuance of subject policy.  However, it was found that, DLA was suffering from Cancer and was in treatment.  Anganawadi teacher confirmed the said fact and provided photographs of the registered maintained by the Anganawadi.   Further it is submitted that, the LA deliberately mislead the OPs by concealing material information and furnishing false information while filling up the proposal form.  The OPs relied on and believed that the information given by the life assured in proposal form was true and correct in all aspects.  It is submitted that, the life assured had not disclosed the full, complete and correct facts regarding his income and occupation as well as other facts.  It is further submitted that, the allegations made in paragraph 2 to 10 are all false and complainant is put to strict proof of the same.  The complaint filed by the complainant is not maintainable either in law or on facts and the same is liable to be dismissed in limine.            

4.      Complainant herself examined as PW-1 by filing affidavit evidence and the documents Ex.A-1 to A-4 were got marked and closed her side. On behalf of OPs, one Sri. Chinna Rangaswamy, the Manager of OP No.2 has examined as DW-1 by filing the affidavit evidence      Ex.B-1 to B-8 documents have been got marked and closed their side.  

5.      Arguments of both sides heard.

6.      Now the points that arise for our consideration for decision of above complaints are that;

 

1. Whether the complainant proves that, the OPs have committed deficiency in service for non-settling her claim and entitled for the reliefs as prayed for in the complaint?

              (2) What order?

          7.      Our findings on the above points are as follows:-

                    Point No.1:- Partly in affirmative.

                   Point No.2:- As per final order.

 

REASONS

8.      Point No.1:- It is the case of the complainant that, her husband by name Guddappa Ningappa Mylarada has obtained the endowment half yearly policy from the OPs for a term of 29 years.  The premium amount has been paid by the complainant for a sum of Rs.20,000/- i.e., half yearly premium under the name and style as reliance lifelong saving plan for a sum assured amount of  Rs.7,34,432/-.  The husband of the complainant was died on 06.10.2015 due to severe heart attack in his house situated at Ranebennur City.  After the death of her husband, the complainant has approached the OPs for settle the claim of her husband but, the OPs have repudiated the same on the ground that the deceased was not furnished the correct age and occupation at the time of filling the proposal and the complainant is not entitled for any relief.  The complainant Advocate argued that, the husband of the complainant has send an amount of Rs.20,000/- to the OPs towards the premium amount through Challakere Branch Office.  After receiving the amount, the OPs have issued the policy bearing No.52384820 to the husband of the complainant. 

9.      Advocate for the OPs argued that, this Forum has no jurisdiction to entertain this complaint because the husband of the complainant was died at Ranebennur, Haveri District and the policy was issued by the OPs through Davanagere Branch.  Hence, the Davanagere District Forum has got jurisdiction to try this case.  Further the OPs have taken a main contention that, the husband of the complainant has not furnished the documents with regard to the income and occupation at the time of filling the proposal form.  But, here is the case on hand that, the documents produced by the complainant and OPs shows that the husband of the complainant has obtained the policy from the OPs and an amount of Rs.20,000/- has been paid through Challakere Branch which is within the jurisdiction of this Forum.  The main allegation made by the OPs that, at the time of obtaining the policy, the age of the husband of the complainant was 41 years and as per the documents produced by the OPs shoed that, the age of the husband of the complainant is 44 years at the time of death.  But, here the age of the husband of the complainant is within 50 years at the time of his death.  As per the policy terms, the death benefit, if the person died within 50 years, the benefit will be 10 times of the annualized premium so, the husband of the complainant has paid Rs.20,000/- half yearly premium and as per the calculation, one year premium is of Rs.40,000/-.  As per the policy term 10 times of the annualized premium is of    Rs.4,00,000/-.  Therefore, the complainant is entitled for a sum of Rs.4,00,000/-. 

10.    We have gone through the entire documents filed by the complainant and OPs.  Accordingly, the husband of the complainant has obtained endowment half yearly premium policy for an amount of Rs.20,000/- for 29 years.  The husband of the complainant has paid the premium amount of Rs.20,000/- through Challakere Branch and the assured amount under the policy is of Rs.7,34,432/-.  The deceased Guddappa Ningappa Mylarada was died on 06.10.2015 due to severe heart attack in his house at Ranebennur city.  After the death of her husband, the complainant informed the same and claimed benefit under the policy along with necessary documents.  After investigation made by the OPs, they have repudiated to pay the claim on the ground that, at the time of obtaining the policy, the husband of the complainant was not furnished the age and occupation properly.  But the documents produced by both sides shows that, the age of the deceased policy holder at the time of obtaining the policy is 41 years.  As per the documents it is seen that, the age of the husband of the complainant is 45 years.  The documents produced by the OPs clearly shows that the deceased age was 45 years.  As per the terms of the policy, within 50 years if the policy holder died, the benefit will be calculated at 10 times of the annualized premium and as per calculation, the complainant is entitled for Rs.4,00,000/-.  Therefore, we come to the conclusion that, the OPs have committed deficiency in service in settling the claim made by the complainant under the policy bearing No.52384820 obtained by her husband and hence, this Point No.1 is held as partly affirmative to the complainant.          

            11.     Point No.3:- As discussed on the above points and for the reasons stated therein we pass the following:-

ORDER

            The complaint filed by the complainant U/s 12 of CP Act 1986 is partly allowed.

            It is ordered that the OPs are hereby directed to pay a sum of Rs.4,00,000/- to the complainant along with interest @ 9% p.a from the date of complaint till realization.

            It is further ordered that, the OPs are hereby directed to pay Rs.10,000/- towards mental agony and Rs.5,000/- towards cost of the proceedings to the complainant. 

            It is further ordered that, the OPs are hereby directed to comply the above order within 30 days from the date of this order.

             (This order is made with the consent of Member after the correction of the draft on 04/03/2018 and it is pronounced in the open Court after our signatures)

           

                                     

 MEMBER                                                   PRESIDENT

-:ANNEXURES:-

Witnesses examined on behalf of Complainant:

PW-1:  Complainant by way of affidavit evidence.

Witnesses examined on behalf of OP:

DW-1:  Sri. Chinna Rangaswamy, the Manager of OPs by way of affidavit evidence. 

Documents marked on behalf of Complainant:

01	Ex-A-1:-	Repudiation letter dated 28.08.2017 by the OP
02	Ex-A-2:-	Death Certificate
03	Ex-A-3 & 4:-	Insurance Policy
04	Ex-A-5:-	ID Card

 

Documents marked on behalf of OPs:

01	Ex-B-1:-	Adhar Card
02	Ex-B-2:-	Voter ID
03	Ex-B-3:-	Ration Card
04	Ex-B-4:-	Investigation report
05	Ex-B-5:-	Repudiation Letter
06	Ex.B-6:-	Proposal Form
07	Ex.B-7:-	Transfer Certificate
08	Ex.B-8:-	Policy with Schedule

 

 

 

MEMBER                                                            PRESIDENT

Rhr**