Before the District Consumer Disputes Redressal Forum, Rohtak.
Complaint No. : 512.
Instituted on : 01.09.2017.
Decided on : 29.10.2018
- Ishrat w/o Late Mumtaj Ahmad aged 42 years s/o Rashid Ahmad.
- Azima d/o Late Mumtaj Ahmad aged 23 years.
- Tabshum d/o Late Mumtaj Ahmad aged 18 years.
- Saniya(M) d/o Late Mumtaj Ahmad aged 16 years.
- Kalu s/o Late Mumtaj Ahmad aged 19 years.
- Shoyab s/o Late Mumtaj Ahmad aged 18 years.
- Talib(m) s/o Late Mumtaj Ahmad aged 15 years.
- Masum(m) s/o Late Mumtaj Ahmad aged 11 years.
All rs/o 899/11, Balak Nath colony, Jind Road, Rohtak, Distt. Rohtak.
………..Complainants.
Vs.
- EXIDE Life Insurance Co. Ltd., through its Managing Director.
JP Techno Park, 1st Floor No.3/1 Millers Road, Banglore-560001(Karnataka).
- Branch Office-1st Floor, Appu-Ghar Complex Opp. ADC Office, Rohtak, Distt. Rohtak.(service to respondent/OP No.1, is to be effected through respondent No.2).
……….Opposite parties.
COMPLAINT U/S 12 OF CONSUMER PROTECTION ACT,1986.
BEFORE: SH.NAGENDER SINGH KADIAN, PRESIDENT.
SH. VED PAL, MEMBER.
SMT. SAROJ BALA BOHRA, MEMBER.
Present: Sh. R.S.Rajain, Advocate for the complainant.
Sh.Naveen Chaudhary, Advocate for the opposite parties.
ORDER
NAGENDER SINGH KADIAN, PRESIDENT:
1. Brief facts of the case are that husband of complainant No.1 namely Mumtaj Ahmad had got his life insured with respondent for a sum of Rs.506341/- vide policy No.03090278 dt. 31.03.2015. The policy was issued on 09.04.2015. That the husband of complainant had taken the policy on the advice of agent Sh. Sohan Kumar, agent of OP. That before taking the policy, the life assured was medically examined by the doctors of the insurance company who had given clearance certificate of fitness accordingly. That the life assured Mumtaj Ahmad had died on 30.05.2015. That after the death of his husband, complainant No.1 had applied for death claim and submitted all the relevant documents but the OPs has repudiated the claim of the complainant vide its letter dated 21.03.2016 alleging that “Not disclosed in proposal form that he was diagnosed to have cancer prior to proposal date”. That the act of opposite parties is illegal and amounts to deficiency in service. As such, it is prayed that the OPs may kindly be directed to pay the amount of insurance of Rs.506341/- alongwith, interest, compensation and litigation expenses as explained in relief clause to the complainants.
2. Notice of the complaint was issued to the opposite parties. Opposite parties in their written reply has submitted that the LA has concealed the prior existence of illness in the proposal form from the OP No.1 & 2 by providing wrong declarations. Had the LA revealed the critical material information of his past health history, then the OPs would not have accepted the health declaration and issued the Insurance Policy. That Registration Card of Kamalnath Ashram, dated 26.03.2014 bearing No.1889 for treatment of CA clearly confirms that LA had pre-existing illness of Cancer prior to submission of proposal form for opting Life Insurance Policy. That the claim has rightly been repudiated on account of concealment of material fact. Opposite parties prayed for dismissal of complaint with costs.
3. Both the parties led evidence in support of their case.
4. Ld. Counsel for the complainant in his evidence has tendered affidavit Ex.CW1/A, Ex.CW1/B, documents Ex.C1 to Ex.C11 and closed his evidence. On the other hand ld. Counsel for the opposite party has tendered affidavit Ex.RW1/A, documents Ex.R1 to Ex.R10 and has closed his evidence.
5. We have heard ld. counsel for the parties and have gone through material aspects of the case carefully.
6. The perusal of letter Ex.R9 dated 21.03.2016 shows that the claim of the complainant was repudiated on the ground that the deceased LA was suffering from cancer at the time of commencement of policy on dated 31.03.2015. He took treatment from Kamal Nath Ashram Gehankar, Tehsil Tijara, Rajasthan. As per the respondent officials a false and fabricated declaration under section VII has been made by the deceased LA and the perusal of document Ex.R9, page no.3 itself shows that the deceased was suffering from cancer at the time of death and at the time of commencement of policy.
7. As per record policy was issued on dated 31.01.2015 after receiving an amount of Rs.25772/- as premium from the deceased LA. The perusal of page no.3 of Ex.R9 reveals that the same is very dull and is invisible and moreover this document was not issued by any Doctor or any expert. No affidavit filed by the concerned person who issued this document. Hence this document is of no help to the respondent. The claim has been repudiated on the false and flimsy ground. As such complainant and her LRs are entitled for the claim amount against the policy No. 03090278 from the opposite parties.
8. In view of facts and circumstances of the case, complaint is allowed and it is directed that opposite parties shall pay the amount of insurance policy of Rs.506341/- to the complainants alongwith interest @ 9% p.a. from the date of filing the present complaint i.e. 01.09.2017 till its actual realization. It is further directed that complainant no.1 Ishrat w/o Late Mumtaj Ahmad is entitled for an amount of Rs.156341/-(Rupees one lac fifty six thousand three hundred forty one only) and remaining amount i.e. 350000/-(Rupees three lac fifty thousand) shall be paid to the remaining complainants i.e. complainant No.2 to 8 in equal share alongwith interest. Opposite parties shall also pay an amount of Rs.5000/-(Rupees five thousand only) as compensation on account of mental agony and harassment and Rs.2000/-(Rupees two thousand only) as litigation expenses to the complainant No.1 within one month from the date of decision.
9. Copy of this order be supplied to both the parties free of costs.
10. File be consigned to the record room after due compliance.
Announced in open court:
29.10.2018.
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Nagender Singh Kadian, President
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Ved Pal Hooda, Member.
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Saroj Bala Bohra, Member.