In  the  Court  of  the

Consumer Disputes Redressal Forum, Unit -I, Kolkata,

8B, Nelie Sengupta Sarani, Kolkata-700087.

CDF/Unit-I/Case No.   174 / 2010.

1)                   Sri Soumendra Kumar Ghosh,

19S, Durga Prasanna Paramsansa Road, Kolkata-700047.                       ---------- Complainant

---Versus---

1)                   Birla Sun Life Insurance Co. Ltd.,

6^th Floor, Vaman Centre, Makhwana Road,

Off. Andheri-Kurla Road, Andheri(East), Mumbai-400059.

2)                   The Managing Director,             Birla Sun Life Insurance Co. Ltd.,

6^th Floor, Vaman Centre, Makhwana Road,

Off. Andheri-Kurla Road, Andheri(East), Mumbai-400059.

3)                   The Branch Manager, Birla Sun Life Insurance Co. Ltd.,

2^nd Floor, Block-A, J.K. Millennium Centre,

46D, J.L. Nehru Road, Kolkata-700071.                                                     ---------- Opposite Parties

Present :           Sri Sankar Nath Das, President.

                        Dr. Subir Kumar Chaudhuri ,Member

                        Smt. Sharmi Basu ,Member

Order No.   21    Dated  30/04/2012.

The petition of complaint u/s 12 of the C.P. Act, 1986 has been filed by the complainant Soumendra Kr. Ghosh and against the o.p. Birla Sun Life Insurance Co. Ltd. The case of the complainant in short is that the mother of the complainant had a life insurance  policy with o.p. nos.1,2 and 3 bearing policy no.001586552 which started from 28.3.08 to 28.3.10 with an annual premium of Rs.50,000/- and the sum assured was Rs.2,50,000/-. Here it is to be mentioned that the complainant is the nominee of the insurance policy. Further case of the complainant is that the policy was issued after full check up of the complainant with all formalities. Due to sudden illness of he insured i.e. mother of the complainant, she was admitted to Sri Aurobindo Seva Kendra and was under the treatment of Dr. S.R. Pal and ultimately she expired on 13.10.08. It is further stated by the complainant that thereafter on 18.12.08 the complainant submitted the claim form and on 30.12.08 the claim of the complainant was repudiated by the o.p. company on the ground of pre-existing disease. Thereafter, the complainant verbally and in writing requested the o.ps. to reconsider the issue of settlement of the claim of the complainant but all in vain. Hence the instant case lodged by complainant with the prayer contained in the prayer portion of the petition of complaint.

            O.p. nos.1,2 and 3 had entered their appearances in this case by filing w/v and evidence and denied all the material allegations labeled against them and prayed for dismissal of the case.

Decision with reasons:-

            We have gone through the pleadings of the parties, evidence and documents in particular. It is settled principle of law that with the payment of premium the liability of insurance company commences on the mere ground of pre-existing disease like hypertension, diabetes etc. o.p. cannot shirk off its responsibility from making payment of the insurance claim of the complainants and it is the duty of o.ps. to take steps for all sorts of medical check up of the insured, prior to giving effect to insurance policy and from the record we do not find any piece of paper in support of the contention of o.ps.

            That being the position and on perusal of the entire materials on record we are of the view that o.p. company is not justified in repudiating the claim of the complainant being a service provider and had sufficient deficiency to its consumer / complainant within the purview and scope of the C.P. Act.

            Hence, ordered,

            That the petition of complaint is allowed on contest against all the o.ps. with cost. O.p. nos.1 to 3 are jointly and severally directed to pay to the complainant a sum of Rs.2,50,000/- (Rupees two lakhs fifty thousand) only together with interest @ 9% p.a. from the date of repudiation of the claim till the date of realization and are further directed to pay compensation of Rs.10,000/- (Rupees ten thousand) only for his harassment and mental agony and litigation cost of Rs.3000/- (Rupees three thousand) only within 45 days from the date of communication of this order, i.d. an interest @ 9% shall accrue over the entire sum due to the credit of the complainant till full realization.

            Supply certified copy of this order to the parties.

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     MEMBER                            MEMBER                        PRESIDENT