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by suppressing the material facts especially about his health condition and hence it

is liable to be dismissed in limine. The respondents has intimated that the husband

of the deceased died on 20-6-2006 at RIMS Hospital, Kadapa. The policy was

introduced w.e.f 28-2-2006 and the claim arose within a gap of 2 months 9 days from

the date of issue of the policy. Enquiries revealed that the husband of the

complainant was not keeping good health for the past 15 years, the case sheet of the

husband of the complainant revealed that he was suffering from Myopathy for the

past 15 years and Hereditary Neuropathy, hypertension a n d Ischemic Stroke

(Cerebal Thrombosis T old peripheral neuritis). The Household card also shows that

the husband of the complainant was standing with the support of two other persons

for the photo. Hence, he was unable to stand. Even on this facts about his health

condition were not disclosed at the time of taking policy hence, the complaint is liable

to be dismissed in limine. The repudiation of the claim by the respondent is in order

and there is no deficiency of service on the part of the respondents at any point of

time. The respondents request to dismiss this complaint with exemplary costs in the

interest of justice.

4. On the basis of the above pleadings the following points are settled for

determination.

i. Whether the complainant is entitled to the relief as prayed for?

ii. Where there is any deficiency of service on the part of the

respondents?

iii. To what relief?

5. On behalf of the complainant Ex. A1 to A5 were marked and on behalf of

the respondents Ex. B1 and B2 was marked. Oral arguments were heard from both

sides.

6. Point No. 1& 2 Ex. A1 is the Xerox copy of insurance policy bearing No.

654251734 in the name of V. Chennaiah, husband of the complainant. Ex. A2 is the

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Xerox copy of medical attendance certificate issued by Civil Assistant surgeon, RIMS

Hospital, Kadapa. Ex. A3 is the Xerox copy of death certificate of the deceased V.

Chennaiah. Ex. A4 is the Xerox copy of proposal for insurance dt. 28-2-2006 in the

name of V. Chennaiah, husband of the complainant. Ex. A5 is the original

repudiation letter dt. 10-1-2009 issued by Senior Divisional Manager, LIC of India in

favour of the complainant. Ex. B1 is the Xerox copy of Ex. A1. Ex. B2 is the Xerox

copy of case record in the name of V. Chennaiah, husband of the complainant.

7. As could be seen from the above documentary evidence it is a fact that

the husband of the complainant insured his life for a sum of Rs. 50,000/- by paying

Rs. 3,409/- annual premium and obtained Beema Gold Policy of Ex. A1 and B1. At

the time of issuance of this policy he was aged 42 years. He was nominated the

complainant as a nominee to this policy. The contention of the respondents that he

was suffering from Myopathy for the last 15 years and hereditary neuropathy,

Thrombosis will not stand on its legs before the truth for the reason that Ex. A2 dt.

28-2-2007 issued by Civil Asst. Surgeon, RIMS Hospital, Kadapa clearly indicates

that primary cause of death was cerebral Ischemic Stoke (Brain Hemorrhage) and

secondary cause was respiratory arrest and the patient was suffering with this illness

3 days prior to the admission. The patient was admitted on 11-6-2006 and expired

on 20-6-2006. Ex. A2 is the crystal clear that the husband of the complainant was

suffering from the said illness since 3 days prior to the date of admission. So it gives

the conclusive meaning that the husband of the complainant was not suffering with

the particular disease (Cerebral Ischemic Stroke) at the time of submission of

proposal forms for the issuance of Ex. A1 and B1 on 28-2-2006. According to the

complainant the medical officer of the respondent company thoroughly examined the

husband of the complainant and certified that the health condition of the husband of

the complainant was hale and healthy. Only on the recommendation of their own

doctor, respondents issued Ex. A1 and B1 in favour of the husband of the

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complainant. Even in Ex. B2 case record, there is a mention of patient was unable to

talk and altered sensorium since 3 days prior his admission on 11-6-2006. The

respondents took nearly 3 years time for the settlement of the claim after the death

of the husband of the complainant (20-6-2006). The complainant approaching the

respondents since August 2006 for the settlement of this claim and the respondents

issued Ex. A5, repudiation letter on 10-1-2009. It indicates clearly that there is a

deficiency of service on the part of the respondents company. The respondents failed

to convenience this forum in support of the repudiation Ex. A5 at any point of time.

For the facts and circumstances discussed supra and the documentary evidence on

record shows clearly that the complainant deserves consideration in her favour in the

settlement of the claim in question.

8. Point No. 3 In the result, the complaint is allowed, directing the

respondents to pay Rs. 50,000/- (Rupees Fifty thousand only) towards assured

amount of the policy along with interest @ 9% p.a. from the date of death of the

husband of the complainant i.e. on 20-6-2006 till the date of realization, to pay

Rs. 3,000/- (Rupees three thousand only) towards mental agony and Rs. 2,000/-

(Rupees two thousand only) towards deficiency of service and Rs. 1,000/- (Rupees

one thousand only) towards costs, totaling Rs. 56,000/- (Rupees fifty six thousand

only) payable within 45 days from the date of receipt of this order.

Dictated to the Stenographer, transcribed by him, corrected and pronounced

by us in the open forum, this the 16

MEMBER MEMBER PRESIDENT

APPENDIX OF EVIDENCE

Witnesses examined.

For Complainant : NIL For Respondent : NIL

Exhibits marked for Complainant : -

Ex. A1 X/c of insurance policy bearing No. 654251734 in the name of

V. Chennaiah, husband of the complainant.

Ex. A2 X/c of medical attendance certificate issued by Civil Assistant surgeon,

RIMS Hospital, Kadapa.

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Ex. A3 X/c of death certificate of the deceased V. Chennaiah.

Ex. A4 X/c of proposal for insurance dt. 28-2-2006 in the name of

V. Chennaiah, husband of the complainant.

Ex. A5 Original repudiation letter dt. 10-1-2009 issued by Senior Divisional

Manager, LIC of India in favour of the complainant.

Exhibits marked for Respondents: -

Ex. B1 X/c of insurance policy bearing No. 654251734 in the name of

V. Chennaiah, husband of the complainant.

Ex. B2 X/c of case record in the name of V. Chennaiah, husband of the

complainant.

MEMBER MEMBER PRESIDENT

Copy to :-

1) Sri V. Eswar Reddy, Advocate.

2) Sri T.V.S.S. Murthy, Advocate.

1) Copy was made ready on :

2) Copy was dispatched on :

3) Copy of delivered to parties :

B.V.P. - - -