STATE CONSUMER DISPUTES REDRESSAL COMMISSION,

U.T., CHANDIGARH

1]      Life Insurance Corporation of India, Bay No. 71-72, Sector 2, Panchkula, through its Branch Manager.

2]    Life Insurance Corporation of India, Divisional Office, Jeevan Prakash, 489, Model town, Karnal – 132001, through its Divisional Manager.

       Both the appellants through Authorized Officer, Smt. P.Kwatra, Manager(Legal & HPF), Life Insurance Corporation of India, Divisional Office, Sector 17, Chandigarh

……Appellants

V e r s u s

Karnail Singh s/o Late Sh. Narang Singh, r/o H.No.1, Mariwala Town, Manimajra, Chandigarh.

              ....Respondents

Appeal under Section 15 of the Consumer Protection Act, 1986.

BEFORE:   MR. JUSTICE SHAM SUNDER, PRESIDENT.

                MRS. NEENA SANDHU, MEMBER.

                SH.JAGROOP SINGH MAHAL, MEMBER

Argued by: Sh.Rajesh K.Sharma, Advocate for the appellants.

PER  JUSTICE SHAM SUNDER, PRESIDENT

1.               This appeal is directed against the order dated 05.10.2011, rendered by the District Consumer Disputes Redressal Forum-II, U.T., Chandigarh (hereinafter to be called as the District Forum only), vide which it accepted the complaint, and directed the Opposite Parties, as under:-

“In the light of the above observations, we allow the present complaint and direct the OPs to pay the assured sum of Rs.1,00,000/-, along with Vested Bonus the CC was entitled for , on the date of his lodging the claim. OPs are also saddled with a consolidated amount of compensation to the tune of Rs.20,000/-, along with Rs.7,000/- as litigation expenses. This order of ours shall be complied within 30 days of its receipt; where after the OPs shall be further liable to an interest @18% p.a. on the amount due towards them, apart from the litigation expenses.   

We further direct the OPs to investigate and fix up the responsibility on the erring officials who issued the said policy on an incomplete “Proposal Form”. The OPs shall complete this enquiry within “NINETY DAYS” from the receipt of this order and may recover the entire amount of compensation from such officials as we feel that the Tax Payers money is not wasted due to such acts of omission and commission of officers who fail in their duties and responsibilities”.

2.           The facts, in brief, are that Smt. Hardeep Kaur, wife of the complainant, subscribed to an Endowment Assurance Policy, bearing No. 176097186 dated 22.12.2008, for a sum of  Rs.1,00,000/-. The date of maturity of the said policy was 22.12.2029. The Premium of Rs.2,557/-, was payable bi-annually, in the months of June and December, every year. The complainant was nominated as a, nominee, in the policy issued, in the name of his wife. At the time of subscribing  to the policy, the benefits assured,  clearly mentioned, that, in the event of death of the insured, before the date of maturity, the nominee would receive Rs.1,00,000/-, alongwith Vested Bonus. The wife of the complainant,  died on 18.1.2009, due to heart attack, at her residence. At the time of subscribing to the policy, late Smt. Hardeep Kaur wife of the complainant was medically examined by a doctor, who was on the panel of the Insurance Company.  The doctor of the Insurance Company, did not find any abnormality, during the detailed examination of Smt. Hardeep Kaur, wife of the complainant and found her fit for being insured. It was stated that the agent, who had filled up the proposal form, on behalf Smt. Hardeep Kaur, wife of the complainant, did not supply copy of the same, so as to enable her, to crosscheck the same, with the insurance policy, which was supplied at a later stage. The complainant intimated the confirmation of death of the insured(Smt. Hardeep Kaur , wife of the complainant) to the Opposite Parties, and lodged the claim, with their Panchkula office.  The claim of the complainant was repudiated, vide their letter dated 9.9.2009, on flimsy grounds. It was further stated that repudiation of the claim of the complainant, was illegal and invalid.  It was further stated that the aforesaid acts of the Opposite Parties, amounted to deficiency, in rendering service. When the grievance of the complainant, was not redressed, left with no alternative, a complaint under Section 12 of the Consumer Protection Act, 1986 (hereinafter to be called as the Act only), was filed.

3.           The Opposite Parties, put in appearance, and filed written reply, wherein, it was pleaded that the complainant,  could not file the present complaint, being not a consumer as per the Act. It was further pleaded that the present complaint was pre-mature, as the complainant failed to provide necessary documents. It was further pleaded that the District Forum, at Chandigarh, had no territorial jurisdiction, to entertain and decide the complaint. It was admitted that Smt. Hardeep Kaur (now deceased), had subscribed to the policy aforesaid and filled up the proposal form, Annexure R-1. She had stated, in the proposal form, that she was not suffering from any of the ailments, such as diabetes; tuberculosis, low B.P. and high B.P. She had also stated that she was not suffering from any diseases, related to liver, stomach, heart, lungs, kidney, brain, nervous system. It was further stated by her, at the time of filling up the proposal form, that she was enjoying good health. It was further stated that as per the answers aforesaid, given by Smt.Hardeep Kaur, at the time of filling up the proposal form, she was insured. It was admitted that the complainant, husband of Smt.Hardeep Kaur, was the nominee in the Policy of the insured. It was further stated that at the time of filling up the proposal form, Smt.Hardeep Kaur, suppressed the material facts, with regard to the hypertension, with which  she was suffering for one year, prior to filling up of the same. It was further stated that the investigator of the Insurance Company, investigated the matter and came to the conclusion that since Smt.Hardeep Kaur, did not disclose the factum, that she was suffering from hypertension, at the time of filling up the proposal form, she suppressed the material facts, and, as such, her nominee was not entitled, to any amount, under the Policy. It was further stated that repudiation of the claim of the complainant, was, thus, legal and valid.  It was further stated that the Opposite Parties, were not deficient, in rendering service.  The remaining averments, were denied, being wrong.

4.           The Parties led evidence, in support of their case.

5.           After hearing the Counsel for the parties and, on going through the evidence, and record of the case, the District Forum, accepted the complaint, in the manner, referred to, in the opening para of the instant order. 

6.           Feeling aggrieved, the instant appeal, has been filed by the appellants/Opposite Parties.

7.           We have heard the Counsel for the appellants, and, have gone through the evidence and record of the case, carefully. 

8.           The Counsel for the appellants, submitted, that the insurance policy was issued by the Divisional Office Karnal, and the insured received the same from Panchkula Branch of the appellants. He further submitted that even the claim was lodged with Panchkula Branch of the Corporation and all the correspondence, was done with Panchkula Branch of the appellants. He further submitted that, thus,  no part of cause of action, arose to the complainant, within the territorial jurisdiction of Chandigarh, and, as such, the District Forum, at Chandigarh, had no Jurisdiction to entertain and decide the complaint. The submission of the Counsel for the appellants, in this regard, does not appear to be correct. The policy was received by Smt.Hardeep Kaur(deceased) at the address of House 1, Mariwala Town,  Mani Majra, U.T., Chandigarh, as is evident, from Annexure R-2 copy of the same. Admittedly, Smt.Hardeep Kaur, also died at Chandigarh. Under these circumstances, a part of cause of action, arose to the complainant, nominee of Smt.Hardeep Kaur, to claim amount, under the Policy, at Chandigarh. According to Section 11 of the Act, the complaint could be filed, at a place, where a part of cause of action, arose to the complainant. Since, as stated above, a part of cause of action, arose to the complainant, at Chandigarh, the District Forum Chandigarh, had jurisdiction to entertain and decide the complaint. In this view of the matter, the submission of the Counsel for the appellants, therefore, being devoid of merit, must fail, and the same stands rejected.

9.           It was next submitted by the Counsel for the appellants, that the complainant, being not a consumer, the complaint was not maintainable, but the District Forum, did not take into consideration, this factum, as a result whereof, it, fell into a grave error, in accepting the complaint. The submission of the Counsel for the appellants, in this regard, also does not appear to be correct. It was Smt. Hardeep Kaur, wife of the complainant, who purchased the policy bearing No. 176097186 dated 22.12.2008, for a sum of  Rs.1,00,000/-, the date of maturity of which was 22.12.2029. Admittedly,  Smt.Hardeep Kaur, has since demised. It was admitted by the Opposite parties, in their written statement, that Karnail Singh, husband of Smt.Hardeep Kaur, deceased is the  nominee, as per  the policy. Since, the complainant is the nominee of the deceased, as per the policy, after her death, he became the beneficiary. He being the beneficiary, as nominee, is entitled to the amount, after the death of the insured. He thus, falls within the definition of Consumer. Under these circumstances, the complainant had locus standi, to file a complaint. The submission of the Counsel for the appellants, therefore, being devoid of merit, must fail, and the same stands rejected.

10.         The next question, that arises for consideration, is, as to whether, Smt.Hardeep Kaur, suppressed the material facts, at the time of filling up the proposal form. No doubt, in the answers, given by Smt.Hardeep Kaur, at the time of filling up of the proposal form, she stated that she was enjoying good health and was not suffering from any disease. It was admitted by the Opposite Parties/appellants, in their written statement that the doctor, on their panel, examined Smt.Hardeep Kaur, before filling up the proposal form. He did not find during the course of medical examination of Smt. Hardeep Kaur, that she was suffering from hypertension. Had, Smt.Hardeep Kaur, been suffering from hypertension, at the time, she was examined by a duly appointed doctor, on the panel of the Opposite parties, he would have certainly found that factum and intimated them. It means that Smt.Hardeep Kaur, was not suffering from hypertension or any other disease(s). Under these circumstances, the question of suppression of material facts, with regard to the disease(s), with which Smt.Hardeep Kaur, was allegedly suffering by her, did not at all arise. The Counsel for the appellants placed reliance on Annexures R-4and  R-6 and affidavit of Dr. Naresh Kumar, B.A.M.S. (Regd. No.9387) Resident of H.No.834, Sector 17, Panchkula, by way of cross- interrogatories. Dr. Naresh Kumar, B.A.M.S. (Regd. No.9387),  admitted both these documents to be correct. He also stated that Smt.Hardeep Kaur was suffering from hypertension for the last one year, before her death and she was under his treatment for the same. Both these documents, are unreliable, as no patient register was produced by Dr. Naresh Kumar showing that,  as to on which date Smt.Hardeep Kaur, came to him, for her treatment,  and after examination, he found that she was suffering from hypertension. No copy of the prescription slip, was also produced by him, showing that she was diagnosed by him, as a patient of hypertension and he prescribed particular medicine(s), to her, for that disease. Even, he did not state, in his affidavit, that she was prescribed particular medicine(s). No registration certificate was also produced by Dr. Naresh Kumar, that he was registered as medical practitioner, for practicing in the allopathic system of medicines. Had, Smt.Hardeep Kaur, been treated by Dr. Naresh Kumar,  he would have certainly, entered her name, in the patient register, as also, issued her prescription slip. In the absence of production of primary evidence, referred to above, Annexures R-4 and R-6, two documents, relied upon by the appellants/Opposite parties, could not be taken into consideration.  These documents, being highly unreliable, were rightly discarded, by the District Forum. No reliable evidence was produced, by the appellants/Opposite Parties, showing that Smt.Hardeep Kaur, was suffering from hypertension, which resulted into her death. Even otherwise, even if it is assumed, that Smt.Hardeep Kaur, suffered from hypertension, she may not be aware of the same.  A person suffering from hypertension, comes to know of the same, only when symptoms of some disease(s) appear. Had, she been aware of hypertension with which she was allegedly suffering, and not disclosed the same, at the time of filling up the proposal form, it would have been said that she suppressed the material facts. Hardeep Kaur, deceased, thus, did not suppress the material facts at the time of filling up the proposal form. The District  Forum, was, thus, right in holding that the claim of the complainant, was illegally repudiated, by the appellants/Opposite Parties. In this view of the matter, the submission of the Counsel for the appellants, being devoid of merit, must fail, and the same stands rejected.

11.         No other point, was urged by the Counsel for the appellants.

12.         The order passed by the District Forum, being based on correct appreciation of evidence and law on the point, does not suffer from any illegality or perversity, warranting the interference of this Commission.

13.         For the reasons recorded above, the appeal, being devoid of merit, must fail, and the same is dismissed, at the preliminary stage, with no order as to costs. The order of the District Forum is upheld.

14.         Certified Copies of this order be sent to the parties, free of charge.

15.         The file be consigned to Record Room, after completion

Pronounced.

January 2, 2012

Sd/-

[JUSTICE SHAM SUNDER]

PRESIDENT

Sd/-

[NEENA SANDHU]

MEMBER

Sd/-

[SH.JAGROOP SINGH MAHAL]

MEMBER