IN THE DISTRICT CONSUMERS’ DISPUTES REDRESSAL FORUM AT MYSORE<br /> <br /> PRESENT: 1. Shri.A.T.Munnoli<br /> B.A., L.L.B (Spl.) - President <br /> <br /> 2. Smt.Y.V.Uma Shenoi<br /> M.Sc., B.Ed., - Member<br /> <br /> 3. Shri. Shivakumar.J.<br /> B.A., L.L.B., - Member<br /> <br /> CC 2/10 DATED 11.03.2010<br /> ORDER<br /> <br /> Complainant 1. Sri. B.S. Rosy Reddy S/o Subba Reddy, # 920/A, 5th Main, Aravinda Nagar, Off: Adi Chunchanagiri Road, Mysore-570023.<br /> 2. B. Srinivasa Reddy, S/o B.S. Rosi Reddy.<br /> 3. Sri. Vishnu Vardhan Reddy, S/o B.S, Rosi Reddy,<br /> # 2 and 3 are at # 920/A, 5th Main Aravinda Nagar Off: Adi Chunchanagiri Road, Mysore-570023.<br /> # 2 and 3 are Represented by their General Power of Attorney Sri. B.S. Rosy Reddy, # 920/A, 5th Main Aravinda Nagar, Off: Adi Chunchanagiri Road, Mysore-570023.<br /> <br /> (By Sri. O.S.B., Advocate)<br /> <br /> Vs. <br /> Opposite Party 1. Bajaj Allianz Life Insurance Co., Ltd., GE Plaza, Airport Road, Yerwada, Pune-411006.<br /> 2. Bajaj Allianz Life Insurance Co., Ltd., Mysore Branch, Saraswathipuram, Mysore <br /> (By Sri. AKJ for O.P.2, O.P.1 is exparte)<br /> <br /> Nature of complaint : Deficiency in service<br /> Date of filing of complaint : 01.01.2010<br /> Date of appearance of O.P. : 18.01.2010<br /> Date of order : 11.03.2010<br /> Duration of Proceeding : 1 Month 21 days<br /> <br /> <br /> PRESIDENT <br /> <br /> <br /> <br /> MEMBER<br /> <br /> <br /> MEMBER<br /> <br /> <br /> Sri. A.T.Munnoli,<br /> President<br /> <br /> <br /> 1. Under Section 12 of the Consumer Protection Act, the complainants have filed the complaint seeking directing to the opposite parties to pay a sum of Rs.60,000/-, the Insurance Policy amount, Rs.50,000/- damages, interest and cost.<br /> <br /> 2. In the complaint it is alleged that, wife of the first complainant and the mother of the second and third complainants by name D. Eswaramma had obtained the Insurance Policy on her life from the opposite parties, dated 06.03.2008. At that time she was hale and healthy. On 07.01.2009, she was admitted to Apollo BGS Hospital, he was newly detected Type-II diabetes mellitus. She passed away on 10.01.2009 in the hospital. On 20.04.2009, the complainants had submitted claim statement to opposite parties along with required particulars and documents. The complainants have received reply rejecting the claim. It was on the alleged ground that, the complainants suppressed prior surgery done more than twenty five years ago. It was nothing to do with the health status of the deceased insured. Further, no such condition is imposed in the policy. Reason for the death has been noted in the certificate issued by the doctor as newly detected Type- II diabetes mellitus. On these ground, it is prayed to allow the complaint.<br /> <br /> 3. The first opposite party despite due service of the notice, has remained exparte.<br /> <br /> 4. The second opposite party in the version has contended that, the insured did not disclose previous ailment of surgery undergone and on that ground, the claim was repudiated. The review committee reversed the order of repudiation of the branch office. Accordingly, a cheque dated 06.09.2009, for Rs.60,000/- was sent to the first complainant. Hence, there is no deficiency in service on the part of the opposite parties. The cheque was sent to the last noted address. It returned with endorsement addressee left.<br /> <br /> 5. To prove the facts alleged in the complaint, the first complainant has filed his affidavit and produced certain documents. On the other hand, the Manager of the opposite party has filed his affidavit and produced certain documents. We have heard the arguments of both the learned advocates for the complainant and the opposite parties and perused the records.<br /> <br /> 6. Now the points arises for consideration are as under:-<br /> 1. Whether the complainants have proved any deficiency in service on the part of the opposite parties and that they are entitled to the reliefs sought?<br /> 2. What order?<br /> <br /> 7. Our findings are as under:-<br /> Point no.1 : Partly in affirmative.<br /> Point no.2 : As per the order.<br /> <br /> REASONS<br /> 8. Point no. 1:- Admittedly, Smt. B. Eswaramma had valid Insurance Police of the opposite parties. After her death, complainants have submitted claim petition. Admittedly, it was repudiated by the opposite parties. Of course the second opposite party in the version has contended that, said repudiation by the Branch office was set aside by the review committee. The fact that, the second opposite party repudiated the claim and the review committee set aside it, itself prima-facie, establish deficiency in service on the part of the opposite parties.<br /> <br /> 9. It is true that from the records, it is found that, the second opposite party had sent a cheque, for Rs.60,000/-, the policy amount and that has been returned undelivered by the with an endorsement addressee left. So also it is relevant to note that, the second opposite party offered the said cheque to the complainants before the Forum, but the learned advocate for the complainants was not ready to accept the said cheque, on the ground that, the opposite parties in addition to the Insurance Policy amount, shall have to pay cost and compensation. Under the circumstances, so for concerned to payment of policy amount, there is no dispute. Now, only dispute is payment of cost and compensation.<br /> <br /> 10. As noted earlier, the claim petition submitted by the complainants was repudiated by the opposite parties. Admittedly, said repudiation was set aside by the review committee observing that, cause of death not related to undisclosed facts on which claim was repudiated. Hence, the repudiation was prima-facie illegal or incorrect. Soon after receipt of the intimation of the repudiation, the complainants had sent a notice to the opposite parties narrating the entire facts particularly stating that, the cause of death and the reason for repudiation are not related and by the notice dated 21.07.2009 opposite party was called upon to settle the claim failing which the complainants will approach the court of law. As found from the seal on the covering letter, though the cheque is dated 25.09.2009 and the covering letter dated 08.10.2009, it was entrusted to courier on 23.10.2009. It is true, the courier service returned undelivered stating left, return to sender on 07.11.2009. Hence, firstly, it is clear that, there is delay of about 4 months in sending the said cheque after the notice of the complainants. Regarding address, it is submitted for the complainants by the learned advocate that, said fact in the normal course also could have informed the advocate for the complainants who had issued notice. Even otherwise considering inordinate delay in sending the cheque, under the circumstances, deficiency on the part of the opposite parties has been established.<br /> <br /> 11. Considering the facts and the material on record, the opposite parties are liable to pay interest on the claim amount and so also cost of the proceedings. It is submitted by the learned advocate for the complainants that, the mode adopted by the opposite parties Insurance Company is to repudiate the claim and in case the claimants coming to know of the repudiation if keep quite then the matter will come to an end and in case the claimants further persuade the matter then the Insurance Company some times come forward to settle the claim. Considering this submission and the facts of the case on hand, it is just to award some compensation also to the complainants.<br /> <br /> 12. Accordingly, our finding on the point is partly in affirmative.<br /> <br /> 13. Point No. 2:- From the discussion made above and conclusion arrived at, we pass the following order.<br /> <br /> ORDER <br /> 1. The complaint is partly allowed.<br /> 2. The opposite parties jointly and severally are hereby directed to pay a sum of Rs.60,000/-, policy amount to the complainants with interest at the rate of 12% p.a. from the date of receipt of the claim petition. This amount shall be paid within a month from the order.<br /> 3. Further, the opposite parties jointly and severally shall pay a sum of Rs.10,000/- compensation to the complainants towards mental agony and other inconvenience caused, within a month from the date of the order, failing which the amount will carry interest at the rate of 12% p.a.<br /> 4. Also the opposite parties shall pay a sum of Rs.2,000/- cost of the proceedings to the complainants.<br /> 5. The opposite parties are at liberty to take back the cheque that has been produced in this case.<br /> 6. Give a copy of this order to each party according to Rules.<br /> <br /> (Dictated to the Stenographer, transcribed by her, transcript revised by us and then pronounced in the open Forum on this the day 911th March 2010)<br /> <br /> <br /> <br /> (A.T.Munnoli) <br /> President <br /> <br /> <br /> (Y.V.Uma Shenoi)<br /> Member<br /> <br /> <br /> (Shivakumar.J.)<br /> Member<br /> <br /> <br />