BEFORE THE DISTRICT CONSUMER FORUM :: WARANGAL
Present: Sri P.Praveen Kuimar, B.Com., LL.B., Member-cum-FAC President.
And
Smt.S.B.Bhargavi, B.A., LL.M., Member.
Friday, the 17thday of April, 2015.
CONSUMER COMPLAINT No.16/2014
Date of filing : 31-12-2013 Date of Disposal: 17-04-2015
Between:
Erragokula Laxmi, W/o.Swamy,
Age:52 yrs, Occ:Household,R/o.New Bus Stand,
Rajupet (V & P), Rajupet Mandal,Nalgonda District-508 105.
… Complainant
AND
The Branch Manager , Life Insurance Corporation of India,
Jangaon Branch Office,H.No.1-2-351,
Siddipet Road, Jangaon (P & M),
Warangal Dist-506 167.
2. The Sr.Divisional Manager,
Life Insurance Corporation of India,
Divisional Office, Jeevan Prakesh,
Near Dr.B.R.Ambedkar Statue, Balasamudram,
Hanamkonda, Warangal Dist.
… Opposite parties.
This complaint is coming before us for final hearing on 02-04-2015, in the presence of Sri K.Karunakar, Advocate for the Complainant and Sri B.Bairava Prasad, Advocate for Opposite Parties and on perusing the material papers on record, and having stood over for consideration till this day, the Forum passed the following:
CC 16/2014
ORDER
Sri Patel Praveen Kumar, FAC President.
1. The complainant filed this complaint under section 12 of the Consumer Protection Act, 1986 to direct the Opposite Parties to pay sum assured amount of Rs.50,000/- interst on sum assured @9% p.a. from 08-03-2012 i.e, from the date of repudiation of claim to 30-12-2013 is Rs.7,950/-, vested bonus as per status report of policy is Rs.6,300/-, mental and physical agonies and compensation is Rs.15,000/-, travelling expendiure Rs.1,000/-, legal expenditure Rs.2,500, to pay all other benefits as per table 91 of policy and award costs.
2. The brief averments of the complaint are that the complainant is the mother of the deceased/lif assured E.Rekha who died on 17-08-2011 due to stomac pain. During her life time the deceased E.Rekha obtained New Janaraksha Plan with Accident Benefits vide Poicy No.687975643 from opposite party No.1 for a sum of Rs.50,000/-commenced from 09-10-2007, for which the complainant is the nominee. The complainant on 17-12-2011 submitted the claim forms along with required documents to opposite party No.1 and requested to settle the claim under the above said policy. The opposite party No.2 repudiated the claim vide letter dated 08-03-2012 on false and flimsy grounds. As per the statement of account given by the complainant in her complaint she is entitled Rs.82,750/- in all from the opposite parties. The act of opposite parties amounts to deficiency of service. Hence this complaint.
3. The Opposite Parties filed the Written Version stating that it is true the deceased life assured had taken the above said policy for sum assured amount of Rs.50,000/-. The deceased life assured was a minor i.e, aged 11 years as on the date of signing her proposal for insurance i.e, 09-10-2007 and as per the Bonafide Certificate bearing Adm.No.354 dated 14-02-2012 issued by the Head Master, ZPHS, Rajupet, Nalgonga District, the date of birth of life assured is 01-12-1996 and she studied from Class VI in the Academic Year 2007-2008 to Class X in the Academic Year 2011-2012. The Bonafide Certificate issued by the School is the direct, positive, cogent evidence to show that the life assured was minor as on the date of sigining her proposal for insurance.
4. Further stated that the deceased life assured had answered to the question No.1 requiring to give the age of proposer at the time of taking the proposal, she answered the same as 20 yrs, whereas her actual age at the time of taking the proposal was 12 years only. The opposite parties corporation had the evidence to show that the deceased life assured had grossly overstated her age at the time of proposing for insurance. The New Janaraksha Plan offered only to persons with a Minimum Age at Entry of 18 years completed. Had she disclosed her actual correct age, the above said policy would not have been accepted her proposal at all, therefore there is no deficiency of service on their part and prayed this forum for dismissal of the complaint.
4. The Parties filed their respective proof Affidavits. While the Complainant marked Exs.A-1 to A-10 and the Opposite Parties marked Exs.B-1 to B-5.
5. Now the points for consideration are:
1) Whether there was any deficiency of service on the part of the Opposite Parties?
2) Whether the complainant is entitled for the claim as prayed for. If so, to what Relief?
6. Point NO.1
It is the main contention of the complainant is that that the complainant is the mother of the deceased/lif assured E.Rekha who died on 17-08-2011. During her life time the deceased Rekha obtained New Janaraksha Plan with Accident Benefits vide Poicy No.687975643 from opposite party No.1 for a sum of Rs.50,000/-commenced from 09-10-2007, for which the complainant is the nominee. The complainant on 17-12-2011 submitted the claim forms along with required documents to opposite party No.1 and requested to settle the claim under the above said policy. The opposite party No.2 repudiated the claim vide letter dated 08-03-2012 on false and flimsy grounds.
7. On the other hand the opposite parties contends that the deceased life assured was a minor i.e, aged 11 years as on the date of signing her proposal for insurance i.e, 09-10-2007 and as per the Bonafide Certificate bearing Adm.No.354 dated 14-02-2012 issued by the Head Master, ZPHS, Rajupet Nalgonga District, the date of birth of life assured is 01-12-1996 and she studied from Class VI in the Academic Year 2007-2008 to Class X in the Academic Year 2011-2012. As such her age was overstated by the deceased life assured, therefore there is no deficiency of service on their part.
8. It is an admitted fact that the deceased E.Rekha during her life time obtained New Janaraksha Plan with Accident Benefits vide Poicy No.687975643 from opposite party No.1 for a sum of Rs.50,000/-commenced from 09-10-2007, for which the complainant is the nominee. On 17-08-2011 the daughter of the complainant died due to stomach pain.
9. The opposite parties disputes the fact that at the time of obtaining the said policy, the deceased life assured overstated her age as (20) years where as from her Bonafide Certificate shows that her age was 12 years only at the time of filling the proposal form. As such her age was overstated by the deceased life assured by almost 8 years.
10. After perusing the material on record Ex.A-2 is the Agent’s Confidential Report, whereinthe age of deceased life assured shown as 20 years and in Column No.1(A) How long did you know the life proposed, Answer is since one year. By this we can say that the agenet is very much aware of the actual age of the deceased life assured at the time of filling of the proposal form.
11. Ex.B-3 is the Bonafide Certificate of the deceased life assured filed by the opposite parties wherein the date of birth of the deceased was shown as 01-02-1996, but in the proposal form, her date of birth was shown as 01-07-1987 i.e, she was 11 years of age at the time of obtaining the policy. Due to illiteracy some of the parents in general may understates or overstages their children’s age at time of admission into schools. As such we are not considering the Bonafide Certificate as cogent evidence in this case.
12. Agent’s Confidential Report under Ex.A-2 is taken into consideration that anybody can recognise by seeing the person whether he is a minor or major except some exceptional cases. The agent can assess the age of the deceased life assured whether she is a major or minor, since he knows her for one year. The agent is very much aware about the age of the deceased life assured who obtained the signatures on the proposal form. Basing on that information, the opposite parties issued the policy in the name of the deceased life assured.
13. We are considereing Ex.A-2 as such the deceased was major at the time of obtaining the policy. The repudiation by the opposite parties on this sole ground is not justified.
14. For the foregoing reasons stated above, we are of the opinion that there is deficiency of service on the part of the opposite parties, hence we hold this point.
15. Point NO.2: To What Relief:- As we held that there is deficiency of service on the part of the opposite parties as stated supra, this point is also decided in favour of the the complainant against the opposite parties.
16. In the result, this complaint is allowed and the opposite parties are jointly and severally liable to deposit in this Forum a sum of Rs.50,000/- (Rs.Fifty thousand only) towards sum assured amount with interest @7.5% p.a. from the date of filing of the complaint i.e, 31-12-2013 till the date of realization and Rs.10,000/- (Rs.Ten thousand only) towards mental agony and costs within one month..
(Dictated to Stenographer, transcribed by her, corrected and pronounced by us in the open Forum on this 17th day of April, 2015).
Lady Member FAC President District Consumer Forum, Warangal.
APPENDIX OF EVIDENCE WITNESSES EXAMINED
On behalf of Complainant On behalf of Opposite Parties Affidavit of complainant filed. Affidavit of Opposite Parties filed.
EXHIBITS MARKED ON BEHALF OF COMPLAINANT
Ex.A-1 is the Attested copy of proposal form.
Ex.A-2 is the Attested copy of Agent’s Confidential Report.
Ex.A-3 is the Attested copy of proposal review slip.
Ex.A-4 is the Attested copy of Policy Bond.
Ex.A-5 is the Attested copy of status report of the Policy.
Ex.A-6 is the Attested copy of death intimation letter.
Ex.A-7 is the Attested copy of claimant’s statement.
Ex.A-8 is the Attested copyof Medical Attendant’s Certificate.
Ex.A-9 is the Attested copy of certificate of hospital treatment.
Ex.A-10 is the attested copy of repudiation letter dated 08-03-2012.
ON BEHALF OF OPPOSITE PARTIES
Ex.B-1 is the original proposal for insurance.
Ex.B-2 is the original copy of Policy Bond.
Ex.B-3 is the original Bonafide Certificate of A.Rekha.
Ex.B-4 is the Attested copy of Life Insurance Plan Circular.
Ex.B-5 is the repudiation letter from opposite parties to the complainant,dt.08-03-2012.
Lady Member FAC President District Consumer Forum, Warangal
