BEFORE THE SOUTH MUMBAI  DISTRICT  CONSUMER DISPUTES REDRESSAL FORUM,

                                                                         O.No.

Complaint No.SMF/MUM/CC/2010/274

   Date of filing :  29/09/2010                                                                                                    

                                                                                Date of Order: 06/10/2017

Mr. Jagdish Gop Varjani,

402, Bldg. No. 16, Ajmera Towers,

Yogi Dham, Kalyan (W),

Dist. Thane  - 400 086.                              ..… Complainant         

        V/s.

HDFC Standard Life Insurance Co.Ltd.,

Regd Office :

Ramon House, H.T. Parekh Marg,

Backbay Reclamation, Churchgate,

Mumbai – 400 020.                                 

Represented by The  Chairman                                                ….. Opposite Party

Coram:

Shri. G.K. Rathod                :   Hon’ble President

Shri. S.R. Sanap                   :   Hon’ble Member

Appearance:        Complainant     -     Adv. Smt. Anita Marathe

                              Opposite Party –   Adv. Shri. A.S. Vidyarthi /

 Adv. Smt. Kajrekar

// JUDGMENT//

PER SHRI. G.K. RATHOD – HON’BLE  PRESIDENT

                   The Complainant’s case is that Mr. Gop H. Varjani was a self employed businessman doing business in electrical goods. He has invested money in Life Insurance Policies with the object of getting the benefits of the savings in his old age and also covering the risk to his life by securing the well being of his family in the event of his death. Therefore, he has taken the Life Insurance Policies from the Opponent. Unfortunately, Mr. Gop expired due to snake bite on 14/5/2009.  The cause of death was investigated by the Competent Authority and the final cause of death is certified due to snake bite.  The Complainant reported the death of the Life Assured under the policy to the Opposite Party and making a claim for the  benefits assured under the policy.  The Opposite Parties rejected his claim on false and frivolous grounds as the deceased Gopi has not disclosed material facts on the proposal form.  He has filed a FIR copy on record, Police Investigation Report, Post Mortem Report, Death Certificate of Grampanchayat, Goveli, Tal. Kalyan. There is a deficiency in service on the part of the Opponent and therefore, he has claimed a relief that amount of Rs. 5,00,000/- with interest @ 12% p.a. from 15/5/2009 till realization and also claimed amount of Rs. 1,00,000/- towards compensation for mental agony and inconvenience. also claimed an amount of Rs. 30,000/- for cost of the proceedings.  

(2)              To rebut the claim, the Opponent has filed written statement on 8/11/2010 and denied all the complaints of the Complainant in toto.  It is further alleged that the Complainant has suppressed the facts while submitting his proposal of insurance.  It is submitted that as per the Term Assurance Plan dtd. 17/7/2007, for the questions mentioned at Sr.No.5, Do you have any insurance cover of premium paying and/or paid up policies, he answered ‘Yes’.  It is further submitted that the duration  of coverage under the policy was almost 9 months.  It is further submitted that the Complainant was having several policies but he has not disclosed this fact in his proposal. Therefore, his claim was repudiated.  The case is false, the Complainant is not entitled for any relief and his claim was rightly repudiated.

(3)              From the above facts and circumstances, the following points arouse for  determination.

Reasoning :-

(4)              We have gone through the contents of the complaint, affidavit evidence, written arguments, written statement, affidavit evidence, written arguments and documents placed on record by the parties.  There is no dispute regarding the policy and cause of death.  Only the claim was repudiated that the facts were not disclosed in the proposal form.  It is pertinent to note that Complainant was paid  premiums regularly. The Ld. Counsel for the Complainant has relied upon Judgments of Hon’ble National Commission.  The ratio of the case laws applicable to the present case, the  facts are almost the same.  Therefore, we are of the view that there is no fundamental breach of the Contract and the Insurer failed to prove that Gop Varjani fraudulently suppressed the material facts. 

(5)              The Complainant being a Nominee of late Gop Varjani entitled to receive the amount in respect of the policy No. 12022285 having sum assured Rs. 5,00,000/-,  as also, the Complainant is entitled for compensation and costs.  In view of the above observations, we answered the point Nos. 1 and 2 in the affirmative.            

(6)              Accordingly, we proceed to pass the following order :    

//O R D E R//

1. The complaint is partly allowed.

2. The Opponentshall pay the claim amount of Rs. 5,00,000/- with interest @9% p.a. from15/05/2009 till its realization to the Complainant.

3. The Opponent also shall pay the amount of Rs. 10,000/- for mental agony and inconvenience, as also Rs.2,000/- towards costs to the Complainant.

4. The Opponent to comply the aforesaid order within aperiod of (30) days from the date of receipt of this order.

5. Certified copy of this order be supplied to both the parties free of costs.

    

    

                      (Shri. S.R. Sanap)                                       (Shri.G.K. Rathod)

     Hon’ble  Member                                       Hon’ble President

    

   Note:-  As the pleadings, affidavits, documents, written arguments of the parties are in English, the order in the proceeding is passed for the better knowledge of the parties in English.

   vns