Sri B.NARAYANAPPA,

      President

1. The complainant Smt. Venkatalakshmi, Mysuru  has filed this complaint against the opposite party No.1 Bajaj Allianz Life Insurance Company Ltd., Yerwada, Pune.  Opposite party No.2 Manager, Vijaya Bank, Mysuru.  Opposite party No.3 Bajaj Allianz Life Insurance Company Limited, Mysuru praying to direct the opposite party  Nos.1 or 3 to pay policy amount of Rs.15,00,000/- in respect of policy No.0337755202 either in favour of complainant or in favour of opposite party No.2 and also direct the opposite party No.2 to refund a monthly installment of Rs.48,000/- received from complainant on 31.10.2018 with interest at 18% p.a. and to return all the documents in favour of complainant and also to pay Rs.2,00,000/- towards compensation.

2. The brief facts are that:-

The husband of the complainant by name Chikkanna.C was the account holder in opposite party No.2 Bank and also policy holder of opposite party No.1 and its consumer.The complainant is a nominee of the policy obtained by her husband Chikkanna.C.On 01.09.2017 the said Chikkanna.C had borrowed a loan of Rs.17,00,000/- from opposite party No.2 on the security of his house bearing No.4239 situated at Devaraja Mohalla, Vijaya Nagar, 2^nd stage, Mysure on monthly installment of Rs.24,300/-.For the security of the said loan of Rs.17,00,000/- as per the direction of opposite party No.2 the opposite party Nos.1 and 3 had issued insurance policy for Rs.15,00,000/- in the name of Chikkanna.C bearing policy No.0337755202 by receiving premium of Rs.87,635/- which was valid for a period of 8 years and risk commenced on 18.09.2017.As per the terms of the policy, if the policy holder dies it is the duty of the insurance company to pay sum assured to the tune of Rs.15,00,000/- to the nominee.The said Chikkanna.C died on 17.06.2018 therefore it is the duty of the insurance company to pay full amount towards loan.It is further contended that the death of Chikkanna.C was natural in spite of it, the opposite party Nos.1 and 3 did not pay insurance amount.Even though the complainant had submitted death certificate of her husband and other documents, on 16.06.2018opposite party No.1 issued irrelevant notice for which the complainant replied through her counsel, but no response from the opposite party Nos.1 and 3 and not paid the sum assured either to the complainant or to opposite party No.2 and thereby committed deficiency in service.The opposite party No.2 by colluding with opposite party Nos.1 and 3 came near the house of complainant and threatened to auction her house and received a sum of Rs.48,000/- from the complainant and thereby cheated the complainant.Hence, this complaint.

3. After registration of this complaint, notices were ordered to be issued to opposite parties.  In response to notice the opposite party  Nos.1 and 3 appeared through  its counsels and have filed version and denied the material averments made in the complaint and contended that the complaint of the complainant is not maintainable.  Hence, the same is liable to be dismissed and further contended that the deceased Life Assured has not disclosed the treatment/diagnosis of TB with past history from 09.04.2017 in the enrolment form dated 16.09.2017.  The deceased life assured was under an obligation to mention the actual illness or disease in the proposal form at the time of applying for the insurance policy.  Had he disclosed the same the company would not have insured the life assured.  The insurance policy is based upon contract whereby the proposal along with the first insurance premium is received from the proposer.   After receipt of proposal form issued the policy as per the requirement of the proposer and further contended that the policy holder and the company are bound by the terms and conditions of the insurance policy.  The opposite party submit that upon receipt of the death claim made investigation and found that the life assured taken treatment for TB disease at Karnataka Government Hospital in PHC Gandhi Nagar from 09.04.2017 to 07.11.2017 and the policy was availed while the life assured was very much taking treatment for TB.  The said fact amounts to non-disclosure of material facts.  Hence, the present complaint is not maintainable and the complaint is not bonafide.  When the deceased had knowledge of his particular pre-existing disease he is obliged to disclose the same but the deceased had not disclosed his pre-existing disease to insurance company.  Therefore the insurance company repudiated the claim of the complainant.  Tthere is no deficiency in service on the part of opposite party Nos.1 and 3.  The complainant who is wife of deceased policy holder was also aware of her husband’s pre-existing disease but she also failed to disclose the same.  For all these reasons opposite party Nos.1 and 3 prays to dismiss the complaint.

4. Opposite party No.2 in its version has contended that the complaint is not maintainable either in law or on facts.  Hence, the same is liable to be dismissed.  The deceased Chikkanna.C the husband of complainant is a borrower i.e., secured debtor by depositing Title Deed of property bearing No.4239 situated at Vijayanagar, 2^nd stage, Mysuru.  The sanctioning of loan, repayment of the same, default of the borrower and treating the loan account as non-performing asset as provided under SARFAESI Act do not amounts to deficiency in service on the part of opposite party No.2.  The loan borrowed by deceased Chikkanna.C from opposite party No.2 is only in accordance with law and his son by name Shridhar, Driver-Cum Conductor, KSRTC is a joint loanee and they furnished guarantor by name Doreraju, Assistant Master, Government High School.  The said Chikkanna.C failed to pay two continuous installments to opposite party No.2 and not disclosed the reasons of his death.  Therefore the opposite party No.2 gone to the house of complainant to recover loan amount and confirmed the death of Chikkanna.C since his son Mr. Shridhar is the joint borrower, he had to pay the loan of his father, there is no deficiency in service on the part of opposite party No.2.  Hence, prays to dismiss the complaint.

5.  The complainant in order to prove of her case has filed her affidavit by way of examination in chief and the same was taken as P.W.1 and got marked Exhibit P.1 to P8.   On the other hand on behalf of  opposite party Nos.1 and 3 one Sri. Srinath N.V, the Authorized Representative of opposite party had filed his affidavit by way of examination in chief and the same was taken as RW.1 and got marked certain documents and the opposite party Nos.1 and 3 in support of their case also got filed affidavit of Dr. Sadashivappa. M by way of examination in chief and the same was taken as R.W.2.  The opposite party No.2 has also filed its affidavit and got marked Exhibit R.1 to 6.  The complainant/P.W.1 has also filed further evidence by way of additional affidavit.  

6. Heard the arguments of both sides.   The complainant as well as opposite party Nos.1 to 3 have also filed their written arguments.
7. The points that would arise for our consideration are as under:-  

1. Whether the complainant proves  the alleged deficiency in service on the part of opposite parties?
2.  What order?

8.       Our findings on the aforesaid points are as follows:

       Point No.1 :- In the negative;

      Point No.2 :- As per final order for the following

:: R E A S O N S ::

9.        Point No.1:- The learned counsel for the complainant has argued as per the contention taken in the complaint averments, affidavit of complainant and documents produced on behalf of complainant and as per notes of arguments.  On the other hand counsel for the opposite party Nos.1 to 3 have also argued as per the contention taken in the version of opposite parties, their affidavits and documents and notes of arguments.

10.      It is not in dispute that the deceased Chikkanna.C  was the husband of the complainant herein who borrowed a loan of Rs.17,00,000/- from opposite party No.2 on the security of his house bearing No.4239 situated at Devaraja Mohalla, Vijayanagar, 2^nd stage, Mysore, on monthly installment of Rs.24,300/- and as per the instructions of opposite party No.2 he obtained insurance policy/membership No.0337755302 from opposite party Nos.1 and 3 and the risk of policy commenced of 18.09.2017 and is valid for a period of 8 years.

11.    It is also not in dispute that the said Chikkanna.C had died on 17.06.2018.  According to the complainant the said Chikkanna.C died of natural death, but opposite party Nos.1 and 3 have totally denied the contention of complainant that the death deceased Chikkanna.C was natural death but they contended that the deceased Chikkanna.C was  died due to TB disease and he suffering from pre-existing disease called TB from 09.04.2017 which was not disclosed by deceased in the enrolment form dated 16.09.2017, if the deceased had disclosed the same to opposite party Nos.1 and 3  they would not have issued the insurance policy and clearly contended that the deceased Chikkanna.C had taken treatment at Karnataka Government Hospital in PHC Ghandhinagar from 09.04.2017 to 07.11.2017 and the policy was availed while he was taking treatment for TB.  In view of non-disclosure of material facts by the deceased opposite party Nos.1 and 3 repudiated the claim of the complainant.  Hence, contends that the complaint is not maintainable.

12.    Opposite party No.2 admits that it had advanced loan to the deceased and the said loan is a joint loan borrowed by deceased Chikkanna.C  and his son Shridhar by depositing of Title Deeds and executing Registered Mortgage Deed on the guarantor by name Doreraju and also contended that the said Chikkanna.C failed to pay the loan installment and not disclosed his death, when the opposite party No.2 visited the house of complainant the death of Chikkanna.C was confirmed and contends that there is no deficiency in service on the part of opposite party No.2.

13. Complainant/PW.1 in her affidavit has reiterated and reaffirmed the contents of complaint averments.  So also the RW.1 to 3  in their affidavits have reiterated and reaffirmed the contents of their versions.  The complainant has produced death certificate of Chikkanna.C and Bank pass book memorandum of deposit of Title Deeds and notice issued by opposite party No.1 to complainant and reply notice and particulars of cause of death of deceased etc.,.  As we have already stated above it is undisputed fact that deceased Chikkanna.C had availed loan of Rs.17,00,000/- from opposite party No.2 by executing memorandum of deposit of Title Deed with the opposite party No.2 Bank.

14. It is the specific contention of opposite party Nos.1 and 3 that the deceased life assured has not disclosed the treatment/diagnosed of TB with past history from 09.04.2017 in the enrolment form dated 16.09.2017.  The deceased life assured was under an obligation to mention the actual illness or disease in the proposal form at the time of applying for insurance policy.  If he had disclosed the same the company would  not  have insured  the life assured under the said policy.

15.      Admittedly the opposite party Nos.1 and 3 have issued insurance policy in the name of deceased Chikkanna.C and the date of commencement of risk is 18.09.2017 and it is further specific contention of opposite party Nos.1 and 3 that upon receipt of the death claim the opposite party made investigation and found that life assured taken treatment towards the said disease at Karnataka Government Hospital in PHC Gandhi Nagar from 09.04.2017 to 07.11.2017 and the said policy was availed while the life assured was  very much taking treatment for TB and produced the medical reports of deceased issued by Princess Krishnajammanni TB and Chest Disease Hospital, Mysore which shows that the deceased admitted to hospital as in-patient and took treatment from 14.06.2018 to 17.06.2018 and it is important to note that as per medical report dated 14.06.2018 wherein it is clearly mentioned that reports received old case of PTB, so from this report it is crystal clear that the deceased was an old case of TB patient and he did not disclosed the same at the time of obtaining insurance policy from opposite party Nos.1 and 3 and as per medical reports the deceased expired on 17.06.2018 as per the discharge summary issued by Princess Krishnajammanni TB and Chest Disease Hospital, Mysore.  So from the medical reports produced by opposite party Nos.1 and 3 it is crystal clear the deceased was having pre-existing disease called TB since long time and it was old disease suffered by the deceased since long time  even before issuance of insurance policy by opposite party Nos.1 and 3 in favour of deceased.

16.      RW.2 Dr. Sadashivappa in his affidavit evidence has clearly stated that he  is working at Princess Krishnajammanni TB and Chest Disease Hospital, Mysore the patient by name Chikkanna .C s/o late Chikkaiah was admitted to male emergency ward on 14.06.2018 and died on 17.06.2018 at 6.45 a.m. and he treated the deceased, the cause of death was Sputum Positive Pulmonary Koch’s.  In his cross-examination lead by learned counsel for the complainant he has stated that Chikkanna .C was admitted to hospital on 14.06.2018.  On 05.06.2018 the Chikkanna. C came to their hospital as out-patient he denied the suggestion that they given report that the Chikkanna. C death was natural.  In his re-examination he has stated that deceased was died due to suffering from disease.  The death of deceased was due to TB disease.  From the cross-examination and re-examination of RW.2 it is crystal clear that the death of decease was not natural and the same was due to TB disease suffered by the deceased.  So from the medical reports and evidence of RW.2 and his cross-examination it is crystal clear that the deceased was died due to TB disease.  Therefore it is crystal clear that the deceased was suffering from TB  disease since long  time and even prior to issuance of insurance policy in the name of deceased  and the deceased did not disclosed his pre-existing disease called TB to opposite party Nos.1 and 3 at the time of issuance of insurance policy.  Therefore it is crystal clear that it is nothing but suppression of facts by deceased while obtaining insurance policy from opposite party Nos.1 and 3.

17.      In view of non-disclosure of pre-existing disease called TB by the deceased to opposite party Nos.1 and 3 at the time of obtaining insurance policy, it is nothing but clear suppression of material facts by the deceased and as clearly contended by opposite party Nos.1 and 3 in their version, if at all the deceased had disclosed his pre-existing disease called TB to opposite party Nos.1 and 3 in the enrolment form dated 16.09.2017 they would not have issued insurance policy to the deceased.

18.      In view of the deceased had not disclosed his pre-existing disease called TB to opposite party Nos.1 and 3 at the time of issuance of insurance policy, it is clear case of suppression of material facts by the deceased.  Therefore the opposite party Nos.1 and 3 have repudiated the death claim of complainant.  The Act of opposite party Nos.1 and 3 in repudiating the death claim of deceased  claimed by the complainant appears to be correct and  there is no fault or deficiency in service on the part of opposite party Nos.1 and 3 in repudiating the death claim of deceased  claimed by the complainant.  Under such circumstances, in view of non-disclosure of material facts such as pre-existing disease of deceased called TB suffered by the deceased since long time at the time of issuance of insurance policy.  The complainant cannot claim the death claim of deceased from the opposite party Nos.1 and 3.  Therefore it is crystal clear that the opposite parties have rightly repudiated the death claim of deceased claimed by the complainant.  Therefore there is no deficiency in service on the part of opposite parties as alleged by the complainant.  Hence, the complainant has failed to prove the deficiency in service of opposite parties.  Therefore the complaint is liable to be dismissed.   Hence, we answer point No.1 in the negative.

19. Point No.2:- For the aforesaid reasons, we proceed to pass the following

:: ORDER ::

The complaint of the complainant is dismissed.

No order as to cost.

Furnish the copy of order to both the parties at free of cost.

(Dictated to the Stenographer transcribed, typed by her, corrected by us and then pronounced in open Commission on this the 20^th August, 2020)