BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM
CACHAR :: SILCHAR
Con. Case No. 28 of 2017
Amir Hussain Laskar
S/O- Late Babur Uddin Laskar
Vill- Tundurkandi, P.O- Sonaimukh,
Pin- 788119,Cachar, Assam……………………………………. Complainant.
-V/S-
1. The Divisional Manager,
Reliance Nippon Life Insurance Co. Ltd.
Hospital Road, Silchar P.S- Silchar.
Dist- Cachar (Assam) ……………………..……………… O.P.No.1.
2. Chief Operating Officer,
Relaince Nippon Life Insurance Co. Ltd. Reliance Centre
5th Floor, Off Western express Highway,
Santacruz East, Mumbai- 400055.……………………..………. O.P.No.2.
3. The Officer-In-Charge, Reliance Nippon Life Insurance Co. Ltd.
9th Floor, R-Tech Park Nirden Compound,
Goregaon (E), Mumbai- 400063………………………….. Principal O.P.No.3
4. Dr. Sarab Uddin Ahmed Medical M.S.C, Palonghat, i/c Palonghat M.S.C,
Dist- Cachar, Vill- Uttarkrishnapur Part-I, Sonai Road,
Pin- 788006. ……………………………………………… Proforma O.P.No.4.
Present: - Sri Bishnu Debnath, President,
District Consumer Forum,
Cachar, Silchar.
Sri Kamal Kumar Sarda, Member,
District Consumer Forum,
Cachar, Silchar.
Appeared: - Mr. Dilip Kumar Das, Advocate for the complainant.
Mr. Rahul Nath, Advocate for the O.Ps.
Date of Evidence 03-12-2018, 15-12-2018, 05-0102019
Date of written argument 04-02-2019, 26-02-2019
Date of oral argument 18-03-2019
Date of judgment 28-03-2019
JUDGMENT AND ORDER
Sri Bishnu Debnath
- Amir Hussain Laskar brought this case against the Reliance Nippon life Insurance Co. Ltd. and its officer for award of compensation and sum insured in connection with Insurance policy No.51618516.
- Brief facts:-
Father of the Complainant purchased life Insurance Policy No.51618516 on 26/04/2014 from the O.P. Insurance Co. Ltd. for his life. The sum Insured was Rs.3,05,248/-. But after 5 (Five) days of Policy, he died. Accordingly, the complainant being nominee made correspondent with O.P. Insurance Company but the O.P. Insurance Company repudiated the claim on the plea that the deceased Babur Uddin Laskar suppressed his disease of hypertension and diabetes at the time of purchasing the Insurance Policy. Being aggrieved the instant complaint brought.
- Notice issued to the O.P. They submitted their W/S. In the W/S stated inter alia that the deceased life Insured suppressed the material fact of his ailment of diabetes & hypertension at the time of purchasing policies. The ground is more specifically mentioned in paragragh 3 of W/S below:- “Further the deceased life assured answered in negative all the material questions in the proposal Form. He has suppressed the vital information regarding his disease about hypertension and diabetes since December 2013 and that he was hospitalized for the said disease earlier, before the issuance of the insurance policy and was diagnosed for the same”.
- During hearing, the complainant submitted his deposition supporting affidavit and exhibited some documents including a certificate of the In-charge of Medical Sub Centre, Palonghat to established the fact that Babur Uddin Laskar died due to diarrhea and dehydration vide Ext.5 & 8. The O.P.No. 1 to 3 examined their Manager Subhashis Bhattacherjee as DW-1 and exhibited insurance proposal documents, medical report of Palonghat Medical Sub-Centre including a prescription dated 22/12/2013 for treatment of deceased Babur Uddin Laskar for Hypertension & diabetes and repudiation letter. The O.P.No.1 to 3 also examined the proforma O.P i.e the In-charge of Palonghat Medical Sub-Centre to diminish the evidentiary value of Ext.5 & 8.
- After closing evidence, both the Complainant and O.P.No.1 to 3 submitted written argument. I have also heard oral argument and perused the evidence on record.
- In this case it is crystal clear from the evidence on record that claim has been repudiated on the plea that the deceased life insured suppressed his ailment of diabetes & hypertension. The complainant did not agreed rather state that the deceased died due to diarrhea, dehydration and abdomen pain. To support that plea, exhibited a certificate of In-charge of Palonghat Medical Sub-Centre, vide Ext 5. As per that certificate the said In-charge of Medical Sub Centre examined the policy holder Babur Uddin Laskar on 30/04/2014 and on that date he diagnosed that Babur Uddin Laskar was suffering from diarrhea, dysentery, dehydration. But the O.P did not agree rather stated that as per prescription dated 22/12/2013 the deceased Babur Uddin Laskar was suffering from hypertension & Diabetes. Of course, it is a fact that Babur Uddin Laskar died on 01/05/2014 i.e on the following day of visit to proforma O.P.No.4.
- Anyhow, the O.P.No.1 to 3 brought the proforma O.P.No.4 as D.W-2. The said D.W.2 clearly deposed that he examined Babur Uddin Laskar on 30/04/2013 for the complaint of diarrhea, dehydration and abdomen pain and on the following day i.e on 01/05/2014 said Babur Uddin Laskar died due to serious condition.
- The Ld. Advocate of the O.P. during argument tried to convince this District Forum that opinion of proforma O.P is not acceptable because he is not a medical practitioner. He also stated that the certificate issued by the said proforma O.P i.e Ext.8 should not be taken into consideration as reliable piece of evidence and consequently, the fact furnished in Ext.8 to be treated as unreliable.
- I have also agreed with the submission of the Ld. Advocate of the O.P. in that aspect because the O.P.No.4 cannot be treated as Medical expert. That is why, his opinion cannot be treated as Medical opinion. If that is the legal aspect the same legal aspect ought to be applied in respect of alleged prescription dated 22/12/2013 because the O.P.No.1 to 3 tried to established the fact that the said prescription issued by In-charge of Palonghat Medical Sub-Centre i.e the O.P.No.4. which speaks that deceased Babur Uddin Laskar died due to hypertension and diabetes.
- From the evidence on record and perusal of pleading of the parties it is of opinion that the O.P.No.1 to 3 repudiated the claim on the basis of alleged information received from the Medical prescription dated 22/12/2013 allegedly issued by the O.P. No.4. Moreover, the O.P. No.4 denied the genuinity of the prescription dated 22/12/2013. So, in the case the O.P.No. 1 to 3 could not able to established the alleged fact that deceased life insured Babur Uddin Laskar died due to hypertension and diabetes.
- Therefore, in my considered view the repudiation of insurance claim is unjustified. Hence the O.P.No.1 to 3 are both severally and jointly pay sum insured along with compensation for mental agony of Rs.20,000/- and cost of proceeding of Rs.5,000/-.
- The aforesaid awarded amount to be paid within 45 days from today in the name of the President, District Forum by cross-cheque and on receive the said awarded amount the complainant will be required to appear with all legal heirs of the deceased to get the awarded amount with equal share. In that aspect the Complainant is to produce a next kin certificate from Deputy Commissioner, Cachar. If the O.P. fail to pay the awarded amount within the stipulated period above, they will be both severally and jointly liable to pay the aforesaid amount with interest at rate of 10% per annum.
- With the above, this case is disposed of on contest. Supply free certified copy of judgment to the parties of this litigation. Given under my hand and seal of this District Forum on this the 28th day of March, 2019.
