This C.C. is coming on before us for final hearing in the presence of Sri.Sri. Tellakula Ramesh Babu, Advocate for Complainant and opposite parties No.1 & 2 served, called absent; upon perusing the material papers on record; upon hearing and having stood over for consideration, this Forum passed the following order;

O  R  D  E  R

(Per Sri R. Kiran Kumar, FAC President)

          This Complaint is filed u/s.12-A of Consumer Protection Act, 1986. 

2.       The averments made in the complaint are that the mother-in-law of the complainant by name Bhukya had insured her life with opposite parties under Reliance Endowment Plan, obtaining policy from opposite party No.1 vide policy bearing No.51015992 for a sum of Rs.1,10,000/- payable in yearly premium and the policy term is 10 years.  The complainant submitted that her  mother-in-law paid Rs.13,200/- on 31-05-2013 and the opposite party had issued initial premium deposit receipt in her name.  The complainant further submitted that after conducting medical examination and after satisfaction the opposite parties accepted the proposal and issued policy bond in favour of the life assured, in which the name of the complainant was shown as nominee.  The complainant submitted that the policy holder, all of a sudden had fell sick on 27-12-2013 due to asthma, she was hospitalized and later she died on 30-12-2013 while undergoing treatment though effective medical care was taken.  That after the death of policy holder, the complainant as a nominee, had submitted the original bond to the opposite party No.1 along with claim form on 10-02-2014 which were filled the agent of opposite parties by name Badavath Rajesh and requested the claim amount payable under the policy.  The complainant further submitted that on 29-04-2014 she had received a letter from opposite parties, in which it was alleged that the age of life assured at the time of submission of proposal has been grossly understated and the life assured aged 73 years, thereby life assured had mislead the insurer to life insurance cover even though the permissible age at entry for the plan of insurance opted was up to 63 years and stated forfeiting the claim benefit of the complainant. The complainant further submitted that her mother-in-law had furnished correct particulars and she never misrepresented any information pertaining to the policy and even she has not withheld any information with regard to her health at the time of proposal, the opposite parties conducted several tests and obtained necessary documents including the household card and other relevant documents and the opposite parties did not made any allegation during the life time of the life assured, after her demise without any proof of record, to avoid the insurance amount to the complainant, the opposite parties  repudiated the claim of the complainant without any valid reason, the opposite parties are liable for damages for the mental agony, inconvenience caused to the complainant and for deficiency of service, for that the complainant filed the present complaint.  

3.       To prove her case, the complainant filed the following documents and the same have been marked as Exs.A-1 to A-5.

Ex.A.1 –Initial payment deposit receipt, dt. 31-05-2013.

Ex.A.2 –Photocopy of Death Certificate dt.11-01-2014.

Ex.A.3 –Photocopy of letter issued by Opposite party No.1 to the complainant dt. 29-04-2014.

Ex.A.4 –Office copy of the Legal Notice, dt.29-01-2015 along with postal receipts (2) and Acknowledgement (1).

Ex.A.5 –Policy Schedule.

4.       On receipt of Notice none appeared on behalf of opposite parties 1 & 2.

5.       Written Arguments of Complainant filed.

6.       Upon perusing the material papers on record, now the points that arose for consideration are,  

i)  Whether the complainant is entitled for the claim?

ii) To what relief?

Point:-

i)       The case of the complainant is that the mother-in-law of the complainant had insured her life with opposite parties company,  on submission of proposal form the opposite party No.1 had issued insurance policy bearing No.51015992 for a sum of Rs.1,10,000/- payable in yearly premium commenced from 14-06-2013 and the life assured had paid Rs.13,200/- on 31-05-2013.  According to the complainant after conducting medical examination, after satisfaction the opposite parties accepted the proposal and issued insurance policy in favour of her mother-in-law, in which the name of the complainant is shown as nominee.  According to the complainant the life assured felt sick on 27-12-2013 due to asthma and she died on 30-12-2013 while undergoing treatment, after the death of her mother-in-law the complainant submitted original bond along with all necessary documents to the opposite parties through their agent Badavath Rajesh.  According to the complainant, she received a letter from the opposite parties in which it is alleged that the age of life assured at the time of submitting proposal she had understated her age, thereby life assured had mislead the insurer to offer life insurance cover and stated forfeiting the claim benefit of the complainant.  According to the complainant as the opposite parties failed to settle the claim amount she approached the Forum for redressal.

          From the documents and material available on record there is no dispute about the life Insurance policy obtained by the mother-in-law of the complainant from opposite parties.  Also there is no dispute about the death of Bhukya Bhadri.  From the record we observed that the complainant submitted claim form along with all necessary documents to the opposite parties for settlement of claim.  As per exhibit A3 the opposite parties repudiated the claim of the complainant stating that at the time of submitting proposal the life assured had been grossly understated her age and the life assured was aged 73 years, thereby life assured has misled insurer to offer life insurance cover even though the permissible age at entry for the plan of insurance opted was up to 65 years, but the opposite parties failed to produce any evidence, even failed to appear before this Forum to prove their contention.  And also we observed that at the time of accepting the proposal the opposite parties obtained several documents including the household card which is marked as Exhibit A5 in which her age is about 58 years as on 11-01-2007.  From the above we cannot accept the objection taken by the opposite parties in Exhibit A3 letter dt. 29-04-2014. In view of the above circumstances, this point is answered according in favour of the complainant.

ii)      In the result, the complaint is allowed in part directing the opposite parties to pay the claim amount of Rs.1,10,000/- (Rupees One Lakh Ten Thousand) with interest @9% P.A. from the date of repudiation i.e. 29-04-2014 till actual payment. 

         Typed to dictation, corrected and pronounced by us in the open forum, on this the 11^th day of September, 2015.

    Member                  FAC President             

District Consumer Forum, Khammam.

APPENDIX OF EVIDENCE

WITNESSES EXAMINED

For Complainant                                                       For Opposite party   

       -None-                                                                           -None-

DOCUMENTS MARKED

For Complainant                                                       For Opposite party

                Member              FAC President             

District Consumer Forum, Khammam.