THE KARNATAKA STATE CONSUMER DISPUTES
REDRESSAL COMMISSION, BANGALORE. (ADDL. BENCH)
DATED THIS THE 22nd DAY OF APRIL 2022
PRESENT
SRI RAVI SHANKAR – JUDICIAL MEMBER
SMT. SUNITA C.BAGEWADI – MEMBER
APPEAL NO. 346/2021
Smt. Uma W/o Shivarudraiah Halegoudru
Age:64 years, Occ:Housewife,
Mudenuru, Hanumanahalli,
Haveri-581 123.
….Appellant/s.
(By Sri/Smt/ M.V.Mudgal, Adv.,)
-Versus-
The Managing Director,
ICICI Prudential Life Insurance Co Ltd.
Unit No.1A & 2A, Raheja Tipco Plaza,
Rani Sati Marg, Malad (East),
Mumbai-400 097.
……….. Respondent/s
:ORDERS ON ADMISSION:
BY SRI RAVI SHANKAR – JUDICIAL MEMBER
The complainant filed this appeal against the dismissal order made by Haveri District Commission in C.C.No.22/2020 and submits that her husband had obtained insurance policy from Opposite Party Insurance Company on 30.01.2017 for sum assured of Rs.27,00,000/- by paying annual premium of Rs.5,914/- and after acceptance of the premium, the Opposite Party has issued policy bearing No.20645639. After receipt of the policy, the husband of the complainant died on 12.02.2017 due to heart attack at Mudenuru, Hanumanahally Village, Ranibennuru Taluk, Haveri District. Being the beneficiary of the policy, the complainant claimed for assured amount, for which the Opposite Party instead of settling the claim has refunded premium amount of Rs.5,914/- on 02.04.2020 and repudiated the entire claim of the complainant on the ground of suppression of material facts. Hence, the complainant filed a complaint before the District Commission alleging deficiency of service and claimed for settlement of the entire assured amount.
2. After trial, the District Commission dismissed the complaint on the reason of suppression of material facts before taking the policy. Hence, the complainant/Opposite Party is before this Commission.
3. We have heard the arguments of appellant on admission.
4. On going through the memorandum of appeal, certified copy of the order, we noticed here that the husband of the complainant had obtained ICICI Pru iProtect Smart Life Insurance policy bearing No.20645639 on 30.01.2017 for an assured amount of Rs.27,00,000/- and paid an amount of annual premium of Rs.5,914/-. Immediately after lapse of 13 days from the date of obtaining the policy, the husband of the complainant died due to heart attack and since the claim is early claim, the Opposite Party/Company made investigation and noticed that the husband of the complainant was suffered from kidney disease and he was also chronic alcoholic. The said facts were not disclosed by the insured at the time of making proposal. Apart from that, the Investigation Team of the Opposite Party/Company has noticed that the complainant had obtained two other polices from different Insurance Companies for sum assured of 9,10,000/- and Rs.3,73,460/- before obtaining the said policy and also noticed that the husband of the complainant was unemployed and was not able to purchase the policy and not disclosed proof of income. Basing on these, they have repudiated the claim of the complainant and refunded the premium amount since it was a fresh policy. The District Commission after considering the said material facts, has dismissed the complaint by referring the decision reported in civil appeal No.4261/2019 between Reliance Life Insurance Co. Ltd. & ampi Anr. V/s. Rekhaben Nareshbhai Rathod, wherein the Hon’ble Apex Court has held as under:-
“The insurer had sought information with respect to previous insurance policies obtained by the assured. The duty of full disclosure required that no information of substance or of interest to the insurer be omitted or concealed. Whether or not the insurer would have issued a life Insurance Cover despite the earlier cover of insurance is a decision which was required to be taken by the insurer after duly considering all relevant facts and circumstances, The disclosure of the earlier cover was material to an assessment of the risk which was being undertaken by the insurer. Prior to undertaking the risk, this information could potentially allow the insurer to question as to why the insured had in such a short span of time obtained two different life insurance policies. Such a fact is sufficient to put the insurer to enquiry”.
5. We found there is no any deficiency in service on the part of Opposite Party in repudiating the settlement of the claim in paying the entire assured amount as because the insured has to disclose his source of income and his health condition at the time of proposal for the policy, whereas he has not disclosed the same at the time of obtaining the proposal. The date of birth also was in dispute as per the ANGANAWADI records. The death of the life assured was 11.12.2016 itself which prior to the issuance of the insurance policy. Considering the said above facts, the suspicious circumstances arose with regard to the policy taken by the husband of the complainant. Hence, the repudiation made by the Opposite Party is not amounts to deficiency in service and the District Commission has rightly appreciated the facts and dismissed the complaint, which is not against to law and there is no any irregularity in the order. Hence, no interference is required. Accordingly, we proceed to pass the following:-
:ORDER:
The appeal is dismissed at the stage of admission itself.
The impugned order dated:26.02.2021 passed by Haveri District Consumer Commission in C.C.No.22/2020 is confirmed.
Send a copy of this order to both parties as well as Concerned District Commission.
Sd/- Sd/-
Member. Judicial Member.
Tss
