IN THE KODAGU DISTRICT CONSUMER DISPUTES REDRESSAL FORUM MADIKERI

SRI. C.V. MARGOOR,PRESIDENT

O R D E R

1. This complaint filed by Smt. Meenakshi w/o. late Sanna Hanumaiah, resident of Alur against the Branch Manager, Life Insurance Corporation of India, Somwarpet Taluk, Kodagu District with a prayer to pay the policy amount of Rs.1,50,000/- due to death of her husband along with compensation.
2. The late husband of complainant Sanna Hanumaiah had taken the policy No.722482518 on 15/02/2003 from the opponent.  The husband of complainant was died on 04/02/2004 due to heart attack.  The complainant has made as nominee while taking LIC policy by the late Sanna Hanumaiah.  The husband of complainant had taken other policies and the opponent had paid the policy amount after their maturity.  But the opponent has not paid this policy amount bearing policy No.722482518 even after the death of late Sanna Hanumaiah.  The complainant has approached the opponent many times for payment of the policy amount but they have postponed the payment on one or the other reason.  Lastly the complainant has got issued a legal notice dated 24/06/2017 calling upon the opponent to make payment of the policy amount.  The opponent neither paid the policy amount nor replied to the notice.  Hence this complaint.

3. The opponent after the service of notice put in appearance through its learned counsel and filed written version admitting that while late Sanna Hanumaiah was working as Hostel Superintendent at Government Boys Hostel, Alur had taken policy No.722482518 on 15/02/2003 on monthly payment of premium.  The complainant was made as nominee for sum assured amount of Rs.1,50,000/-.

4. It is the case of opponent that on the death of life assured Sanna Hanumaiah the complainant being the nominee has submitted her claim.  The claim was repudiated by this opponent on 31/03/2004 for suppression of pre insurance illness.  The opponent has communicated the repudiation of claim of the complainant by registered post with acknowledgement due. The opponent further admitted that the complainant has got issued legal notice dated 24/06/2017 and for that the opponent was replied on 27/07/2017 clarifying the reasons for repudiation of the claim.  Therefore, no deficiency of service on behalf of this opponent as alleged by the complainant.  The last contention of opponent is that the complaint is barred by limitation period.  The repudiation docket and relevant papers are destroyed as per the corporate guide lines on 03/10/2009 after lapse of five years period.

5. The complainant filed her affidavit in lieu of evidence and got marked exhibits P1 to P5 documents.  On behalf of opponent one Mr.P. Rajashekar, Administrative Officer, Legal Department, LIC of India, Divisional Office, Mysore filed their affidavit evidence and got marked exhibit R1 record showing the destruction of records of late husband of complainant along with others.

6. Heard the arguments advanced by learned counsel for the complainant and opponent and the points that would arise for determination are as under;

1. Whether the complainant proves that the repudiation of claim by opponent is not justifiable and illegal?
2. Whether the opponent proves that the complaint is barred by limitation?
3. What order?

7. Our findings on the above points is as under;

• Point No.1:- In the Negative
• Point No.2:-In the Affirmative
• Point No.3:-As per final order for the below

R E A S O N S

8. Point No.1 to 3 :- The learned counsel for the complainant submitted that the late husband of complainant was died due to heart attack but he was not suffering from ill health prior to taking policy from the opponent.  As against this the learned counsel representing the opponent vehemently argued that the claim of the complainant was repudiated due to suppressing material fact of ill health by the insured while taking policy.  All the documents pertaining to the policy of late husband of complainant has been destroyed as per the corporate guide lines. The opponent has intimated the repudiation of the claim to the complainant in the year 2004 whereas, this complaint is filed in the year 2017 as such it is clearly barred by time.

9. The opponent has not disputed issue of policy to the late husband of complainant on 15/02/2003.  Exhibit P3 is copy of policy issued by the opponent in the name of late husband of complainant and the date of commencement of risk is from 15/02/2003.  Exhibit P3 reveals that the late husband of the complainant has insured for a sum of Rs.1,50,000/- and mode of premium on or before 15^th of every month.  Exhibit P2 is death extract of late Sanna Hanumaiah and according to this he was died on 04/02/2004 at Ramakrishna Nursing Home, Hassan.  Exhibit P4 reply dated 27/07/2017 to the complainant legal notice Exhibit P1 dated 24/06/2017 where in it is stated that the death claim under the policy No.722482518 was repudiated on 31/03/2004 for the reason of suppression of pre insurance illness while proposing for assurance under policy.  Our decision with reasons there for was communicated to your client.  If your client was not satisfied with our decision, she should have made an appeal for reconsideration to our higher authority which we suggested in our letter of repudiation.  The claim was repudiated in the year 2004 that is 14 years back which may pleased be noted. 

10. Exhibit P4 itself indicates that the opponent has repudiated the claim on 31/03/2004 for suppression of pre insurance illness by late husband of the complainant.  The opponent has produced exhibit R1, copy of the office record for destroying the records as per corporate guide lines on 03/10/2009.   The policy docket of late Sanna Hanumaiah has been destroyed vide sl.no.119.  In view of destroying records during the year 2009 by the opponent head office the question of producing the proposal form submitted by late Sanna Hanumaiah does not arise.

11. The learned counsel for the opponent on the point of suppression of material information on the part of insured relied upon the decision of National Consumer Disputes Redressel Commission, New Delhi in Appeal No.545 of 2015 in case of Sunita Goyal v/s Bajaj Allianz Life Insurance Co.Ltd dated 07/09/2017 wherein it is held that insurance for Rs.50,00,000/- was taken by Mr. Jai Bhagwan, husband of appellant Sunita Goyal who expired on 30/03/2010.  The complainant filed the insurance claim with the opposite party along with all requisite documents.  The insurance company repudiated the claim informing that there was suppression of material information on the part of the deceased insured.  The State Commission concluded that the opponent insurance company was justified in repudiating the claim and dismissed the complaint.  The National Commission after examining the materials on record observed that the appellant/ complainant had not advanced any cogent and convincing reason which may justified the condonation of huge delay in filing appeal.  It is further noted that it was within the knowledge of deceased policy holder that he was suffering from serious ailments which he ought to have disclosed.  It therefore, dismissed the appeal both on grounds of limitation and merits and upheld the order passed by the State Commission.

In the case on hand also the opponent has repudiated the claim of complainant on 31/03/2004 and same has been intimated to her which can be found in exhibit P4 reply dated 27/07/2017.  The complainant has not denied that the opponent has repudiated the claim on 31/03/2004 and same has been intimated to her.  Inspite of intimating the complainant has falsely narrated in the complaint that she has been approaching the opponent and it has been postponing the payment by giving one or the other reason.  Therefore, the averments of the complaints are contrary to exhibit P4 reply which is not denied by the complainant.  Exhibit R1 produced by the opponent shows that as per the corporate guide lines it has destroy the records pertaining to the husband of complainant in the month of October,2009 along with others.  When the opponent has taken contention in the written version with regard to destroying the records, the complainant would have produced any other document showing that her husband was not suffering from any illness prior to taking policy on 15/02/2003.  Therefore, the opponent has rightly repudiated the claim of complainant.

12. The husband of complainant was died on 04/02/2004 vide exhibit P2 death certificate and the opponent has repudiated the claim of the complainant on 31/03/2004.  Earlier the complainant has filed Consumer case No.141/2017 before the District Consumer Disputes Redressal Forum at Hassan and exhibit P5 order sheet of said complaint indicates that on 26/09/2017 the District Consumer Forum  Hassan dismissed the complaint at the stage of admission observing that the policy questioned in this complaint belongs to LIC of Somwarpet Branch, Kodagu District.  Hence this complaint is not maintainable before this Forum.

13. The learned counsel for the opponent submitted that this complaint is bared by limitation as this complaint has been filed after 14 years from the date of intimation of the repudiation of the claim.  The complainant filed an application under Section 5 of the Limitation Act to condone the delay in filing complaint.   The complainant filed her affidavit in support of  I.A No.1 that on 04/02/2004 her husband was died on account of heart attack.  After the death of her husband the opponent has paid the amount of other policy but did not pay the amount of this policy No.722482518 which was insured on 15/02/2003.  The complainant further sworn to the fact that the policy will be in force till 15/02/2019.  When the opponent has postponed the payment by giving one or other reason, she has got issued legal notice dated 24/06/2017.  The contention taken in the affidavit filed in support of I.A that the policy will be in force till 15/02/2019 is not acceptable since the existence of policy came to be end on the death of late Sanna Hanumaiah husband of complainant on 04/02/2004.  The complainant has not produced any document to show that she has paid the monthly premium even after the death of her husband from 04/02/2004 till filing the complaint.  The complainant has not denied the contents of exhibit P4 reply that the opponent has repudiated the claim on 31/03/2004 and the same was intimated to her.  The cause of action arose to the complainant to file the complaint on 31/03/2004 and she would have filed the complaint on or before 31/03/2006.  But this complaint has been filed after 12 years from the date of expiry of limitation period of two years as per section 24 A of the Consumer Protection Act.  Absolutely the complainant has not made out any grounds to condone the delay of 12 years to file this complaint.  Therefore, the complaint is liable to be dismissed on two fold namely on the point of limitation and merits.  Accordingly, we proceed to pass the following;

O R D E R

1. The complaint filed by Smt. Meenakshi w/o.late Sanna Hanumaiah fails hence, it is dismissed without cost.
2. Furnish the copy of order to the complainant and opponent at free of cost.

(Dictated to the Stenographer, got it transcribed, corrected and pronounced in the open Forum on this 19^th day of JANUARY, 2019)

                                                  (C.V. MARGOOR)

                                                      PRESIDENT 

                                                (M.C. DEVAKUMAR)

                                                        MEMBER