Orissa

Cuttak

CC/251/2022

Prakash Sharma - Complainant(s)

Versus

Bharati Axa Life Insurance Co Ltd - Opp.Party(s)

M K Mohanty & associates

29 Apr 2024

ORDER

IN THE COURT OF THE DIST. CONSUMER DISPUTES REDRESSAL COMMISSION,CUTTACK.

C.C.No.251/2022

 

Mr. Prakash Sharma,

At:Nandi Sahi,Choudhary Bazar,

Cuttack G.P.O,Cuttack-753001,

                    Odisha.                                                             ...Complainant.

 

          Vrs.

 

1.        Bharati AXA Life Insurance Co. Ltd.,

Represented though its Director-cum-Chairman,

At: Unit No.190-4,19^th floor,

Prience Crascenzo ‘G’ Block,Bandra Kurla Complex,

BKC Road,Behind M.C.A,Ground East,

                  Mumbai-400051.

 

2.        Bharati AXA Life Insurance Co. Ltd.,

Represented through its Manager/Authorized Officer,

Spectrum Tower,3^rd Floor,Malad Link Road,

                  Malad(West),Mumbai-400064,Maharastra.                             …Opp.Parties

 

 

Present:         Sri Debasish Nayak,President.

                      Sri Sibananda Mohanty,Member.

 

 

Date of filing:    20.12.2022

Date of Order:  29.04.2024

 

For the complainant:           Mr. M.K.Mohanty,Adv. & Associates.

For the O.Ps              :            None.

 

Sri Debasish Nayak,President.

 

          Case of the complainant as made out from the complaint petition in short is that Late Urmila Devi Sharma, the mother of the complainant had obtained one insurance policy through O.P no.1 on 28.3.2019 vide policy number 5018968122 and it was for 12 years.  The annual premium of Rs.3,00,000/- was paid by the complainant which was valid upto 2021 and in that process three consecutive annual premiums were paid by the complainant.  On 12.9.2021, Urmila Devi Sharma, the life assured and mother of the complainant had succumbed to death due to heart attack at Ashwini Hospital,Cuttack.  The claim for the insurance policy alongwith all the relevant documents was submitted in the month of October,2021 by the complainant before the O.Ps but on 7.3.2022 the claim of the complainant was repudiated on the ground of non-disclosure of material information while executing the proposal for the said policy.  It was mentioned in the said repudiation letter dated 7.3.2022 that Urmila Devi Sharma was a known case of Diabetes and Hypertension for the last 20 years and was under treatment for the same.  The complainant has further mentioned in his petition that the last attending doctor had mentioned that Urmila Devi Sharma was a known case of CKD/RHD since 2020 but the policy was made in the year 2019.  Thus, the complainant has come up with his case before this Commission alleging deficiency in service on the part of the O.Ps who had repudiated his claim without any justification and has sought for direction to the O.Ps to pay him Rs.30,00,000/- as compensation towards  his mental agony and harassment alongwith another sum of Rs.20,000/- towards his litigation expenses.  He has further prayed for any other relief as deemed fit and proper.

Together with his complaint petition, the complainant has annexed copies of several documents in order to prove his case.

2.       Having not preferred to contest this case, all the O.Ps have been set exparte vide order dated 17.2.2023.

3.       The points for determination in this case are as follows:

i.          Whether the case of the complainant is maintainable?

ii.         Whether there was any deficiency in service and practice of unfair trade on the part of the O.Ps?

iii.        Whether the complainant is entitled to the reliefs as claimed by him?

Point no. II.

Out of the three points, for the sake of convenience point no. ii being the important point is taken up first for consideration here in this case.

On perusal of available documents in the case record, it is noticed that the deceased Urmila Devi Sharma had obtained the policy from the O.Ps on 28.3.2019.  She had died on 12.9.2021.  As per Annexure-4 which is copy of the last attending Doctor’s certificate, it is mentioned therein that the deceased Urmila Devi Sharma was a patient having known case of DM/HTN/CKDRHP since 2019 and was on regular treatment.  At the subsequent page of Aannexure-4, it is noticed that the said doctor has mentioned about the CKD/RHP in the case of deceased Urmila Devi Sharma was from 2020.  This goes to show that deceased Urmila Devi Sharma was having DM/HTN since 2019 and such fact was not at all disclosed by the said deceased policy-holder before the O.Ps for which the claim when raised after the death of the policy-holder Urmila Devi Sharma was repudiated by the O.Ps due to suppression of material fact which was communicated to the complainant through their letter dated 7.3.2022.  As such, this Commission finds no deficiency in service.  Hence, this point goes against the complainant.

Points no.i & iii.

From the discussions as made above, the case of the complainant is not maintainable and the complainant is not entitled to the reliefs as made by him.  Hence it is so ordered;

                                                          ORDER

The case is dismissed exparte against O.Ps and as regards to the facts and circumstances of the case without any cost.

Order pronounced in the open court on the 29^th day of April,2024 under the seal and signature of this Commission.                     

                                                                                  

                                                                                        Sri Debasish Nayak

                                                                                              President

                                                                                                   

 

                                                                                  Sri Sibananda Mohanty

                                                                                                             Member