Haryana

StateCommission

A/337/2014

Jagdish - Complainant(s)

Versus

Futur genral India life - Opp.Party(s)

21 Oct 2016

ORDER

 

STATE CONSUMER DISPUTES REDRESSAL COMMISSION,

HARYANA PANCHKULA

                                                First appeal No.337 of 2014

Date of the Institution: 28.04.2014

Date of Decision: 21.10.2016

 

Jagdish S/o Bhura Ram Punia r/o VPO Malkhera Tehsil Bhadra Distt. Hanumangarh (Rajasthan).

                                                                             .….Appellant

Versus

1.      Future Generali India Life Insurance Company  Limited,G.T.Road, Fatehabad through its Branch Manager and another.

2.      Future Generali India Life Insurance Company Limited,  Corporate office-Indiabulls Finance Centre,Tower 1, 12 and 15 Floor, Senapati Bapat Marg, Elphinstone (W) Mumbai 400013 through its Chairman cum Managing Director.

                                                                             .….Respondents

 

CORAM:    Mr.R.K.Bishnoi, Judicial Member

                    Mrs. Urvashi Agnihotri, Member

 

Present:-      Mr.R.S.Sihag, Advocate counsel for the appellants.

Mr.Hitender Kansal, Advocate counsel for the  respondents.

 

O R D E R

URVASHI AGNIHOTRI, MEMBER:

1.      This appeal has been filed by Jagdish against the Order dated 06.02.2014 passed by the learned District Consumer Disputes Redressal Forum, Fatehabad (In short “District Forum”), whereby the complaint of the appellant-complainant has been dismissed.

2.      Briefly stated, Mrs. Bala Devi had got herself insured with the opposite parties (O.Ps.) and complainant was nominee in respect of the said policy.  Mrs. Bala Devi expired. Nominee of  Bala devi submitted the claim with the O.Ps., but, they repudiated the claim vide letter dated 30.08.2012 on the ground, that insured was suffering from Acute cholecystits pain in abdomen.

3.      Aggrieved against the deficiency in service of the O.Ps, complainant approached the District Forum by filing complaint for issuance of directions to the respondents to pay insured amount alongwith  18% interest and also Rs.25,000/- as compensation on account of mental agony etc.

4.      The Opposite parties challenged the very maintainability of the complaint.  On merits, it was pleaded that nominee was not the sole beneficiary under a life insurance policy, whereas he was only trustee of said money, therefore complainant cannot be considered as consumer as per Consumer Protection Act, 1986 (In short “Act”). The life insured  did not disclose all the material information with the insurance company. After death of the life assured, insurance company investigated the case and found that life assured was earlier admitted in SMS Medical College & Hospital Jaipur for Cholecystits. They rightly repudiated the claim of complainant.  Thus there was no deficiency in service on the part of the O.Ps.

5.      The learned District Forum accepted the pleas of the O.Ps – insurance company and dismissed the complaint being devoid of merit thereby upholding the repudiation of the claim.  

6.      We have heard the learned counsel for the parties and have also gone through the record. 

7.      From its perusal its stands established, that the complainant got himself recorded as nominee of Bala Devi, who was insured with the O.Ps at the time of taking out the insurance policy. Bala Devi at one time was suffering from Acute Cholecystitis pain in Abdomen for the treatment whereof she was admitted in SMS Medical College and Hospital, Jaipur. Without waiting for her recovery from illness she left the Hospital as LAMA i.e. Left against medical advice. Soon thereafter she died. None of these facts were disclosed by Bala Devi while getting herself insured. After her death, the complainant Jagdish filed claim before the insurance company and even at that stage, he did not disclosed the aforesaid factual position. The same situation continued even at the time of filing the present complaint before the District Forum as none of these facts were disclosed by the complainant Jagdish in the complaint. The Insurance Company-  O.Ps in their detailed written statement has sworn affidavit to its officers and has submitted before the District Forum that Bala Devi got the insurance policy on 20.12.2011 and within less than a month thereafter, she died on 18.01.2012. In these circumstances, the insurance company has rightly placed reliance on the statutory provisions of Section 45 of the Insurance Act, 1938 to contend that the death of the insured occurred before the expiry of two years from the commencement of the insurance policy. We entirely agree with the approach and conclusions arrived at by the learned District Forum and uphold their decisions to dismiss the complaint. Consequently, we do not find any merit in the appeal and dismiss the same, thereby dismissing the complaint.

 

October 21ST, 2016

Mrs.Urvashi Agnihotri, Member, Addl.Bench

R.K.Bishnoi, Judicial Member Addl.Bench

R.K.