OFFICE OF THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, ANGUL
PRESENT:- SRI DURGA CHARAN MISHRA.
PRESIDENT
A N D
Mrs. S.MALLICK & Sri K.K.Mohanty,
MEMBER .
Consumer Complaint No. 74 of 2013
Date of Filling : - 06.09.2013.
Date of Order :- 25.10.2016.
Gitanjali Sahoo,W/O.Late Nirmal Sahoo,
Vill-New Balanda,P.O. Handidhuan,P.O:-
Colliery,S.D:- Talcher,Dist.Angul.
_________________________Complainant.
Vrs.
- Branch Manager,L.I.C of India,
Talcher Branch,At/P.O-Talcher,Dist.Angul.
02.Divisional manager,L.I.C of India,Cuttack
Division,At/P.O/Dist:- Cuttack.
_________________________ Opp. parties.
For the complainant :- Sri S.Behera & associates(Advs.)
For the opp.parties :- Sri R.P.Pattanaik & associates(Advs.)
: J U D G E M E N T :
Sri D. C. Mishra, President.
The complainant has filed this case with prayer to direct the opp.parties to award the maturity value of the policies of her deceased husband along with compensation for deficiency of service and cost of litigation.
2. The case of the complainant in short is that, Nirmal Sahoo had made insurance policy No. 584346735 on dt. 14.08.2001 for Rs. 40,000.00 only which was revived on dt. 13.01.2004 and dt. 09.03.2005 and the policy continued. Again on dt. 24.04.2007 , the said Nirmal Sahoo made another policy bearing No. 589415479 for Rs. 30,000.00 only. While both the policies were continuing , the insured Nirmal Sahoo expired on dt. 04.11.2007.So the complainant Gitanjali Sahoo being the legal married wife of deceased Nirmal Sahoo made insurance claim for the aforesaid policies but the insurance authorities repudiated the claim with plea of suppression of facts. Then the complainant regularly approached the insurance authorities and made correspondence but in vain. So she has filed this complaint seeking the reliefs as already stated in para No. 1.
2. The opp.parties have contested the case by filing written version stating that the case of the complainant is barred by law of limitation and since there are early claims i.e within two years of making the policies, payment cannot be made as there is suppression of material fact, during making and revival of the policies. So they have prayed to dismiss the case.
3. In view of the rival pleadings of the parties the following issues arises for consideration :-
Issues :-
- Whether there is any cause of action to file this case.
- Whether the case is barred by law of limitation or any other law?
- Whether the insurer had suppressed the material facts regarding his disease and treatment and gave false declaration when policies were made ?
- To what reliefs the complaiant is entitled to ?
: F I N D I N G S :
Issue No.(i) & (ii):- The complainant has mentioned in her complaint that she has made correspondences on various dates to L.I.C authorities i.e on 01.08.2008, 01.09.2009, 01.10.2010, 01.11.2012,01.12.2012 and lastly on 06.08.2013 for early settlement of her claims. Thus after death of insurer, the complaint was regularly approaching the authorities regarding her claim and she has not neglected in any more. In the written version the opp.parties have not specifically denied this fact. Thus the case of the complainant is not barred by law of limitation.
Since the opp.parties did not settle the claim of complainant, she has cause of action to file the case.
Issue No.(iii):- According to the provision of C.P.Act, the plea of suppression of material facts regarding disease and treatment can be taken within two years of the commencement or revival of the policies. Policy No. 584346735 was commenced on dt. 14.08.2001 and fully revived on dt. 13.01.2004 and dt. 09.03.2005.Thus, the plea of suppression of fact regarding this policy can be taken only within two years of the last revival. After two years the opp.parties cannot take such a plea. So this plea of the opp.parties regarding policy No. 584346735 is devoid of any merit and the opp.parties shall pay matured amount to the complainant immediately.
As regards policy No. 589415479, the opp.parties have communicated final repudiation letter on dt. 05.04.2009 (Annexure-I) stating about suppression of fact by the insured regarding his treatment and disease. This intimation has been given within two years of commencement of policy. In support of the claim of the opp.parties, they have furnished a bunch of treatment receipts and prescription of insured out of which Annexure-I,II,III & IV reveals that the insured was suffering from Tubercular Lymphadenitis from 2003 to 2007 but allegedly the insured has suppressed it. The opp.parties have taken the plea in right time i.e within the time allowed by C.P.Act, 1986. Though the complainant’s counsel has merely disputed the facts during argument but nothing has been pleaded/proved in support of her dispute. So the complainant is not entitled to get the amount in respect of policy No. 589415479.
Issue No.(iv):- In view of the discussions made above in issue No. (i),(ii) & (iii) , the complaint is entitled to get maturity value Rs. 40,000.00 of policy No. 584346735. Since the opp.parties have unnecessarily withheld the claim of the complainant, they are liable to pay 7% simple interest per annum on the matured amount from the date of death of insured i.e from dt. 04.11.2007 upto the date of actual payment along with cost of litigation.
4. Hence ordered :- : O R D E R :
The case is partly allowed on contest against the opp.parties. The opp.parties shall pay the matured amount of Rs. 40,000.00 (Forty Thousand) only of policy No. 584346735 to the complainant along with 7% simple interest per annum on the said amount from dt. 04.11.2007 till the actual payment is made. Also the opp.parties shall pay Rs. 5,000.00 (Rupes Five Thousand) only towards cost of litigation. This order shall be complied by the opp.parties within 45(forty-five) days of receipt of this order. The complainant will not get benefit from policy No. 589415479 .
Order delivered in the open forum
today the 25th Octoberr,2016 with hand and seal of this Forum.
Typed to my dictation
and corrected by me Sd/-
(Sri D. C. Mishra)
Sd/- President.
(Sri D. C. Mishra)
President .
Sd/-
(Mrs. S. Mallick)
Sd/- Member.
(Sri K.K.Mohanty), Member.
