BEFORE THE KARNATAKA STATE CONSUMER DISPUTES REDRESSAL COMMISSION, BANGALORE.

DATED THIS THE 7^th DAY OF JULY 2021

PRESENT

MR. RAVISHANKAR                          : JUDICIAL MEMBER

MRS. SUNITA CHANNABASAPPA BAGEWADI :     MEMBER

                                                                                        APPEAL NO. 174/2012

V/s

ORDER

MRS. SUNITA CHANNABASAPPA BAGEWADI , MEMBER

1.      The appellants/Opposite Parties have preferred this appeal being aggrieved by the Order dt.30.11.2011 passed in CC.No.68/2011 on the file of District Consumer Disputes Redressal Commission, Gulbarga.

2.      The facts leading to the appeal are as hereunder;

It is the case of the complainant that the husband of the complainant had obtained “Bajaj Allianz Fortune Plus” Policy from the Opposite Parties bearing policy No.0123751053 for an assured sum of Rs.10 lakhs which commences from 24.02.2009 and the term of the policy is 20 years and it would mature on 24.02.2029.  Such being the case, on 02.02.2010 the husband of the complainant suffered chest pain and immediately approached the doctor and took treatment.  Again on 28.02.2010 he suffered chest pain and consulted the same doctor and took treatment.  On 30.08.2010 again husband of the complainant suffered chest pain and got admitted to the hospital, but on the same day he died.  By virtue of the policy, the complainant being the nominee had claimed for the sum assured with relevant documents, but, the Opposite Party repudiated the claim for want of non-disclosure of material facts regarding pre-existing disease i.e. diabetic mellitus and the Opposite Party No.1 had returned the account value of Rs.2,71,805/- under the caption policy and amount is credited in the complainant account in Syndicate Bank, Super Market Branch, Gulbarga.  Aggrieved by this, the complainant filed a complaint before the District Commission, wherein the District Commission allowed the complaint and directed the Opposite Parties to pay an assured sum of Rs.10 lakhs to the complainant with all benefits therein after deducting the amount of Rs.2,71,805/- which is already paid along with litigation expenses.

3.      Aggrieved by the said Order, the appellants/ Opposite Parties are in appeal.  Heard the arguments.

4.      On going through the memorandum of appeal, certified copy of the Order and the materials on record, we noticed that it is not in dispute that the complainant’s husband had obtained “Bajaj Allianz Fortune Plus” Policy from the Opposite Parties bearing policy No.0123751053 for an assured sum of Rs.10 lakhs which commences from 24.02.2009 and the term of the policy is 20 years and it would mature on 24.02.2029.  The main contention of the appellant is that the Opposite Parties had repudiated the death claim of the husband of the complainant due to non-disclosure of the material facts regarding the health of the complainant’s husband.  The complainant and her husband (life assured) suppressed the pre-existing disease while the life assured answering in the proposal form about the diabetic mellitus.

5.      After considering the materials on record, the District Commission has rightly directed the appellant to pay the sum assured of Rs.10 lakhs after deducting the amount of Rs.2,71,805/- which was already paid to the complainant which is just and proper.  In Ex.P11, the blood and urine report, the date mentioned on the report was 02.02.2001 instead of 02.02.2010 which cannot discloses that the husband of the respondent has suffered from cardiac mellitus from 2001.  All the documents relating to hospitalization of the husband of the respondent was in the year 2010 except the blood and urine test report.  Moreover, in the lower court, Dr. V.A. Harsur who treated the deceased had examined and he deposed in reply to the interrogatories by PW-2 by way of affidavit and also issued a letter that there is typographical mistake in the ‘year’ in the blood and urine test report.  Hence, the District Commission commended that mere typographical mistake in the ‘year’ of blood and urine test report cannot lead to interference that the life assured had suppressed the said fact from the appellant.  Ofcourse we agree about the opinion given by the District Commission because the diabetic mellitus is a life style disease and easily controllable with medicines when it may occurs in persons at any time.  It was not a fatal disease to say that the life assured suppressed the material fact at the time of taking the policy.

6.      In the present case, the husband of the respondent availed policy on 24.02.2009 and he has paid first premium of Rs.1,00,000/- on the same day.  After a lapse of 1 ½ years, the complainant’s husband suffered chest pain and died on 30.08.2010 in the hospital.  After submitting the claim form, the appellants instead of settling the claim of sum assured, the appellants paid only Rs.2,71,805/- to the respondent contending that the respondent has suppressed the material facts.  However, the appellants have not produced any documents to prove that the deceased had taken treatment for diabetic mellitus in any hospital before taking the policy except the blood and urine test report.  Hence, in our opinion, the mere clerical mistake in the year of bold and urine test report, the appellants cannot escape its liability towards the death claim.  Hence, there is no any irregularity or illegality in the order passed by the District Commission.  The order passed by the District Commission is just and proper.  Hence, the following;

ORDER

The appeal is dismissed.

The amount in deposit shall be transmitted to the District Commission for disbursement of the same to the complainant.

Forward free copies to both parties.

Sd/-                                                                      Sd/-

MEMBER                                         JUDICIAL MEMBER

KCS*