A.P. STATE CONSUMER DISPUTES REDRESSAL COMMISSIONAT HYDERABAD.
F. A. 1331/2007 against C.C. 85/2007, Dist. Forum, Ongole
Between:
Atla Nagamani
W/o. Venkateswarlu
R/o. Y. Kothapally
Yerragondapalem Post.
Prakasham Dist. *** Appellant/O.P.
And
1) The Branch Manager
LIC of India, Makapuram
Prakasham Dist.
2) The Divisional Manager
LIC of India, Durgamitta
Nellore.
3) The Zonal Manager
LIC of India,
South Central Zonal Office
Jeevan Bhagya, Secretariat Road
Saifabad, Hyderabad-500 063. *** Respondents/
Ops.
Counsel for the Appellant: M/s. M. Krishna Kishore.
Counsel for the Resp: M/s. Aruna Mantripragada
CORAM:
HON’BLE SRI JUSTICE D. APPA RAO, PRESIDENT
SMT. M. SHREESHA, MEMBER
&
SRI R. L. NARASIMHA RAO, MEMBER.
TUESDAY, THIS THE SIXTH DAY OF JULY TWO THOUSAND TEN
Oral Order: (Per Hon’ble Justice D. Appa Rao, President)
*****
1) Appellant is unsuccessful complainant.
2) The case of the complainant in brief is that her mother Eswaramma had taken policy for Rs. 1 lakh commencing from 28.4.2005 to 28.4.2021 keeping her as her nominee. After the death of her step mother Nagamma who had three children, her father Velugondaiah married Easwaramma her mother. Her mother died of chest pain suddenly on 13.5.2006. When she made the claim it was repudiated on the ground that Eswaramma suppressed her age and that she was 71 years old. There was no suppression of age. The repudiation was unjust and therefore prayed that the amount covered under the policy be paid together with compensation and costs.
3) The insurance company resisted the case. While admitting issuance of policy it alleged that it could know the age of Eswaramma as 70 years though she declared it as 40 years. When the claim was made, an enquiry was conducted and it was found out that when Nagamma first wife died 26 years ago, Eswaramma mother of the complainant was married. The deceased died at 71 years. The policy was issued on a false statement given by her. Family details were not given properly. When she mentioned her age as 42 years and her husband as 45 years, the fact remains they were aged 71 and 72 years respectively. In fact sons’ ages are more than her age. For the policy issued in favour of Devi Reddy Pedda Venakteswara Reddy, his mother’s age is shown as 71 years and brothers and sisters ages are 38, 25,44,42,35 and 23. For the policy issued in favour of Devi Reddy Chinna Venakteswara Reddy his mother’s age is shown as 70 years and brothers and sisters ages are 40, 25,44,42,35 and 23. The school records obtained from M.P.P. School, Nagarayapalem of Prakasham district confirm the same. Since the assured had suppressed the ages, she was not entitled to any amount, and therefore prayed for dismissal of the complaint with costs.
4) The complainant in proof of her case filed her affidavit evidence and got Exs. A1 to A13 marked, while the respondents filed Exs. B1 to B14 without examining any witness.
5) The Dist. Forum after considering the evidence placed on record opined that the record sheet of D. Chinna Venkateswara Reddy shows that he was born on 25.4.1961. By 2005, son of the deceased was 44 years of age. In fact she should be more than 15 years older than D. Chinna Venkateswara Reddy. As such the age of the deceased by 2005 could be 59 years. However, she mentioned her age as 40 years at the time of taking of policy and there was suppression and accordingly dismissed the complaint with direction to the insurance company to return the premium of Rs. 13,618/- with interest @9% p.a. from 28. 4. 2006 till the date of realization.
6) Aggrieved by the said decision, the complainant preferred the appeal contending that the Dist. Forum did not appreciate the facts in correct perspective. The Dist. Forum had confused the relationships and ages etc. In fact the respondents did not file affidavit evidence and the record that was filed is not authenticated nor could be taken ex-facie as true facts and therefore prayed that the complaint be allowed in toto.
7) The point that arises for consideration is whether the order of the Dist. Forum is vitiated by mis-appreciation of fact or law?
8) It is an undisputed fact that the complainant’s mother Eswaramma had taken a policy for a sum of Rs. 1 lakh commencing from 28.4.2005 keeping the complainant as her nominee. She mentioned her age as 40 years vide Ex. B1 proposal filed by her before taking of the policy. She mentioned the age of her father as 70 years and mother as 65 years. She mentioned the age of her husband as 45 years. She was an illiterate.
She subscribed her thumb impression in the declaration as well as to the proposal form. A panel doctor of the insurance company, Dr. G. Kanaka Durga endorsed these facts. Since she was an illiterate the insurance company after obtaining declaration of her age vide Ex. B3 and obviously in the light of report of the medical officer issued Ex. B2 policy having collected the entire premium. Admittedly assured Eswaramma died on 13.5.2006 vide death certificate Ex. B4 due to heart attack. When claim was made an enquiry was conducted both by the agent as well as development officer and they had categorically mentioned at coloumn No. 3 “deceased D. Eswaramma blessed with 4 daughters and 3 sons. 1st daughter’s age as per policy No. 671794185 of D. V. P. Eswara Reddy son of D. Eswaramma is 44 years. As per the above policy D.V.P. Eswara Reddy – DOB 30.6.1960 school certificate admitted. As per this policy D. Eswaramma’s age is 71 years. Husband of D. Eswaramma died 10 years back, cause of death is suicide. However in coloumn No. 10 it was mentioned “as per my enquiry the deceased has died due to chest pain.”
At colomn No. 11 they noted that “she is staying in son-in-law’s house at Yerragondapalem of Prakasham district. Contrarily at coloumn No. 18 they mentioned that she died of “heart attack. Died on 23.5.2006 – sudden death”. At coloumn No. 35 it was mentioned
“As per my enquiry it is not a genuine claim. Having no income. Husband died 10 years back and she is staying in son-in-law’s house at Yerragondapalem. As per her son’s policy No. 67194185 her age was 71 – status report enclosed for your information. May be refunded premium only otherwise repudiate the claim.”
9) Obviously in proof of above, the insurance company filed the Ex. B6 policy of Devireddy Chinna Venkateswara Reddy, S/o. Peda Velugonda Reddy, keeping his wife Smt. Koti Ratnam as his nominee and his age was mentioned as 38 years. The insurance company filed the proposal form submitted by him marked as Ex. B7. He mentioned the ages of her sisters and brothers and sons besides the parents. They have collected a copy of record sheet pertaining to date of birth of Devireddy Chinna Venkateswara Reddy wherein his date of birth was mentioned as 25. 4. 1961. His father name is noted as ‘Devi Reddy Velugonda Reddy’. It has also filed Ex. B9 policy pertaining to Devi Reddy Pedda Venkateswara Reddy, S/o. D. Peda Velugonda Reddy keeping his wife Smt. D. Narayanamma as his nominee and his age was mentioned as 40 years. The insurance company filed the proposal form submitted by him marked as Ex. B10. He mentioned the ages of her sisters and brothers and sons besides the parents. They have collected extracts from school record pertaining to date of birth of Devireddy Pedda Venkateswara Reddy wherein his date of birth was mentioned as 30.6.1960 His father name is noted as ‘Devi Reddy Velugonda Reddy’. From this they link up those policies with that of the policy of the complainant’s mother. A story was cooked up stating that the age of her husband was 72 years while her age was 71 years and in fact their children Devi Reddy Chinna Venkateswara Reddy and Devi Reddy Pedda Venakteswara Reddy were aged 38 and 40 years respectively. Therefore their parents Eswarmma and Velugondaiah must be 71 and 72 years respectively.
10) At the outset, we may state that the complainant had explained all this by issuing notices Ex. A6, A7, A8 which they have received under acknowledgements. She mentioned that her father D. Velugondaiah, had two wives , first wife being Nagamma and second wife her mother Eswaramma. Importantly Nagamma had three children viz., Devi Reddy Venkateswarlu, aged 35 years, Devi Reddy Lakshmaiah, aged 30 years, and Devi Reddy Chinna Venkateswarlu, aged 28 years. They are all married and staying at Naragayapalem of Vindukonda mandal. Later her father married Eswaramma and gave birth to her. While mentioning these details, she categorically stated that “Even the husband by name Velugondaiah, of the deceased Eswaramma is not completed 60 years till now.” The insurance company by leading extraneous evidence without any enquiry whatsoever concluded that both of them had suppressed the ages and therefore she was not entitled to any amount. The insurance company intends to repudiate the amount payable to a woman taking advantage of her illiteracy. The insurance company dare not file the affidavits of either the agent or the development officer who certified the age of Eswaramma as 40 years. Having accepted the declaration of age of the deceased vide Ex. B3 attested by a notary and importantly the panel doctor having seen the assured could not have certified her age as 40 years of a woman aged 70 years. This is highly unnatural. Now they intend to contend that somebody had impersonated and therefore the doctor might have noted her age as 40 years. If really that were to be true, the insurance company could have sent the thumb impressions and find out whether any person had impersonated Eswaramma, for that matter.
11) The statement that was attested by the person belongs to the insurance company, it could not have been given weight to an enquiry made by the development officer, who has not even seen the persons. He made contrary entries in the enquiry report Ex. B5 at coloumn Nos. 3, 10, 18 and 35 which we have already excerpted. So they were all invented to deny the claim.
12) Evidently the father of the complainant is D. Velugondaiah. The said fact was mentioned in the policy Ex. B2. The entire record obtained by the insurance company pertains to ‘Devi Reddy Velugonda Reddy’ but not “Velugondaiah” The name of Devi Reddy Velugonda Reddy was mentioned in the policies taken by Devi Reddy Chinna Venkateswara Reddy and Devi Reddy Pedda Venkteswera Reddy. Name of father of the complainant cannot be linked with Devi Reddy Velugonda Reddy. There is no proof that they pertain to ‘Velugondaiah’. The insurance company did not bother to find out from the Village Administrative Officers or responsible revenue officials in the village to find out whether they are sons of ‘Velugondaiah.’ when the insurance company has accepted the name ‘Velugondaiah’ as husband of the complainant, we are unable to appreciate the version of the insurance company, that sons being aged 38 and 37 years and the age of the father and mother must have been 71 and 70 years and that there was suppression. It is important to note that the age of the assured takes prominence in view of the fact that sum assured and the premium would depend on her age and not that of her husband. This suppression could in no way entail repudiation of the claim by the insurance company. When the complainant asserts that her mother was second wife hardly 40 years of age and when there was no contrary evidence, gathering unrelated evidence pertaining to his first wife and children would in no way prove that the deceased had suppressed her age and therefore she was not entitled to the amount.
13) At the cost of repetition, we may state that there is no proof that the assured had suppressed her age. The insurance company did not let in any evidence except filing the documents. It is not known as to how the insurance company connects these documents with that of the assured. Assuming without admitting , even if it were to be true, it only relates to the first wife of assured’s husband. The repudiation is unjust.
14) In the result the appeal is allowed, consequently the complaint is allowed. The insurance company is directed to pay the amounts due under the policy together with interest @ 6% p.a. from the date of repudiation till the date of realization together with costs of Rs. 5,000/-. Time for compliance four weeks.
1) _______________________________
PRESIDENT
2) ________________________________
MEMBER
3) ________________________________
MEMBER
Dt. 06. 07. 2010.
*pnr
“UP LOAD – O.K.”
