STATE CONSUMER DISPUTE REDRESSAL COMMISSION
BIHAR, PATNA
Appeal No. 265 of 2017
Indrajeet Kumar, S/o- Sri Bharat Prasad Mahto, Resident of Village- Belhi, Tola- Betonah, PO- Jainagar, PS- Jainagar, District- Madhubani
… Appellant
Versus
1. Branch Manager, Bajaj Allianz Life Insurance Company Ltd. Jaynagar, Madhubani.
2. Manager, Claim Review Committee, Bajaj Allianz Life Insurance Company Ltd. Viman Nagar, Pune, Maharastra
…. Opposite Parties/Respondent
Counsel for the appellant: Adv. Sanjeev Kumar
Counsel for the respondent: Adv. Manish Kumar Singh
Before,
Hon’ble Mr. Justice Sanjay Kumar, President
Mr. Ram Prawesh Das, Member
Dated 31.03.2023
As per Sanjay Kumar, President.
O r d e r
Present appeal has been filed by the complainant-appellant for setting aside the order dated 20.07.2017 passed by the Ld. District Consumer Disputes Redressal Forum, Madhubani in Consumer Complaint Case no. 17 of 2015 whereby and whereunder the Ld. Forum has dismissed the Consumer Complaint Case on the ground of, there being no cause of action for filing the complaint case.
Complainant had filed a Consumer Complaint case for payment of sum assured amount of Rs. 12,00,000/- (twelve lacs) being nominee of the deceased policy holder who had purchased life insurance policy of Rs. 12 lacs for the period of 20 years and had also paid half yearly premium of Rs. 27,539.46/- .
The District Consumer Forum dismissed the complaint case as the complainant failed to establish any cause of action for filing the complaint as he could not produce any legal notice served upon the Bajaj Allianz Life Insurance Co. Ltd. or any death claim filed before the insurance company for settlement of his claim.
Aggrieved by dismissal of his complaint complainant filed present appeal in which notices were issued to the Bajaj Allianz Life Insurance Co. Ltd. and they appeared and filed their written argument in which they have admitted that deceased had taken a life insurance policy which was valid from 13.10.2012 and the maturity date was 12.10.2032. It was further stated that insured died on 31.12.2012 at his residential place in the district of Madhubani at the age of 31 years.
After death of policy holder complainant-appellant filed a death claim against the policy for payment of sum assured amount which was rejected by the insurance company and against which complainant filed for review of the repudiation order and claims review committee reviewed the previous order and again rejected the claim by order dated 19.08.2013 on the ground that at the time of taking insurance policy the deceased was suffering from hepatosplenomegaly with ascitis and as such he had concealed about his ailment while filling proposal form which amounts to concealment of material fact as such the claim was repudiated.
In said view of the matter as the insurance company has admitted that insurance policy was purchased by deceased policy holder in which complainant was nominee and death claim was repudiated as such there was a valid cause of action for the complainant to file the complaint case.
Accordingly, the order passed by District Consumer Disputes Redressal Forum, Madhubani is set aside and the case is remanded back to Consumer Forum, Madhubani where Bajaj Allianz Life Insurance Co. Ltd. shall appear and file its written statement and the District Consumer Forum to decide the complaint case on its own merit within 90 days from the date of receipt /production of a copy of order passed by this Commission.
(Ram Prawesh Das) (Sanjay Kumar,J)
Member President
Md. Fariduzzama
