BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM
CACHAR :: SILCHAR
Con. Case No. 12 of 2016
Md. Lalan Uddin S/O Lt. Ashai Mia,
Vill & P.O- Dakshin Mohanpur, P.S-Sonai
Dist. Cachar, Assam, Pin-788119 ……………..…………………… Complainant.
-V/S-
1. The Branch Manager, PNB Metlife India Insurance Co. Ltd.
Shillongpatty Dist.- Cachar, Assam O.P No.1.
2. The Chairman Committee, PNB Metlife India Insurance Co. Ltd.,
Brigade Seshmahal-5, Vani Vilas Road, Basavangudi
Bangalore-560004, Karnaaka (to be represented by O.P No.1) O.P.No.2.
Present: - Sri Bishnu Debnath, President,
District Consumer Forum,
Cachar, Silchar.
Sri Kamal Kumar Sarda, Member,
District Consumer Forum,
Cachar, Silchar.
Appeared: - Mr. Kishan Hazam & Rajina B.Laskar, Advocate for the Complainant.
Sri Niladri Roy, Advocate for the O.Ps.
Date of Evidence……………………….. 31-12-2016, 19-04-2017
Date of written argument……………… 30-08-2017, 02-11-2017
Date of oral argument………………….. 26-02-2018, 30-06-2018
Date of judgment……………………….. 25-07-2018
JUDGMENT AND ORDER
Sri Bishnu Debnath
- This case has brought under the provision of consumer Protection Act 1986 by nominee of life insured against Branch Manager, Silchar and Chairman of PNB Metlife India Insurance Co. Ltd., Kolkata for award of sum insured and compensation on account of repudiation of the death claim of life insured Ashai Mia vide insurance police No.20987310.
- The complainant brought the following fact for his reliefs as below:-
His father Ashai Mia purchased insurance policy No.20987310 on 31-12-2012 from O.Ps. But during the period of insurance the life insured Ashai Mia (DLI) expired on 30-01-2013 due to Acute Cerebrovascular accident. Accordingly, the complainant made claim. But the O.P repudiated the claim on the plea that the DLI died due to pre-existing deceased as mentioned above.
- However, the O.Ps in their joint W/S denied the allegation of disservice etc. and took defense plea that the DLI had a knowledge that he was suffering from aforementioned disease on the date of executing the proposal form to purchase the insurance policy but furnished false information in spite of diagnosed the disease since 2012. As such the opinion of the O.P is that the claimant is not entitled any relief.
- During hearing the complainant submitted his deposition and exhibited some documents including Death Certificate of DLI, repudiation letter, judgment of Insurance Ombudsman. The O.Ps also submitted deposition of Mr. V. Prashanth to deny the claims. After closing evidence both sides counsels submitted their written argument. During hearing Dr. Abdul Ahad Laskar the attending doctor of DLI has been examined as C.W-1. The Insurance Adviser Misba Uddin Laskar was also examined as C.W-2.
- In this case the crux point as whether the DLI had knowledge about his cerebrovascular disease on the date of execution the proposal form for Insurance. The O.P tried to establish the fact that the DLI was suffering from above disease since 2012 but when executed the proposal form on 31-12-2012 he suppressed that disease in the proposal form. Copy of the proposal form is available in the case record. All the answers in the coloum of disease in the form are written negative i.e. no. Anyhow, the O.P did not furnish any medical paper to establish the fact that the Disease as stated above has been diagnosed from the year 2012. On the other hand, the complainant deposed that his father i.e. DLI died due to cerebrovascular accident on 30-01-2013 and to establish that fact exhibited Death Certificate vide Ex-1. Cause of death is not written in Ext-1. That is why, I examined the attending doctor as C.W-1. The said Court witness deposed on oath to say that DLI expired on 30-01-2013 due to cerebrovascular accident. Not only that but also deposed that on the aforesaid date the patient Ashai Mia was brought to him before his chamber at Kachudaram Benhoor Medicos and he prescribed medicine and advised to visit higher centre. He also deposed that at the time he diagnosed the patient as acute cerebrovascular accident. He further replies to the question of the complainant that the patient may develop sudden cerebrovascular accident at any time without any prior presumption. He further replied in a question of the Ld. Advocate of the O.P that the date mentioned in the prescription issued by him for treatment of DLI was not his hand writing and same is manipulated. Of course, in the statement he stated that actual date in the prescription would be 30-01-2013 and not 30-12-2012.
- In view of above evidence on record and statement of the attending doctor, it is opined that the DLI died due to Cerebrovascular accident which was detected on 30-01-2013 and not prior to the date of execution of the proposal form. It is also clear from statement of the C.W-2 that on the date of execution of the proposal, the DLI was medically examined and doctor did not find any such symptom for suffering from any disease like high blood pressure, Heart decease or Cerebrovascular disease etc.
- As such in my considered view, the DLI did not furnish any false information to the proposal form. Thus, his legal heirs are entitled the sum insured and other death benefit in view of the insurance policy mentioned herein above. But the O.P without justification denied the claim. Hence, they are liable both severally and jointly to make payment of sum insured of Rs.5,00,000 (Rupees Five Lakhs)only and to pay compensation for mental agony of the legal heirs of DLI of Rs.5,000/- (Rupees Five thousand) only and also to pay cost of the proceeding of RS.2,000/- (Rupees Two Thousand) only.
- The O.Ps are directed to pay the aforesaid awarded amount within 45 days from today. In default, interest @ 10% P.A. on awarded amount to be charged w.e.f. the date of defaulter till realization of the full.
- The O.Ps are further asked to make payment of awarded amount with up to date interest in favour of the President District Forums and the legal heirs including the complainant are asked to appear with legal heirs certificate of competent authority to take their equal share of the realized amount.
- With the above, this case is disposed of on contest. Supply free certified copy of judgment to the parties. Given under may hand and seal of this District Forum on this the 25th day of July,2018.
