Before the District Consumer Disputes Redressal Forum, Rohtak.
Complaint No. : 334.
Instituted on : 07.06.2017.
Decided on : 27.09.2018.
- Jitender Kumar s/o Late Azad Singh, Resident of Village Bedwa, P.O.Farmana Khas, Tehsil Meham,,District Rohtak.
- Sunil Kumar s/o Late Azad Singh, Resident of village Bedwa, P.O. Farmana Khas, Tehsil Meham, District Rohtak.
………..Complainant.
Vs.
- Life Insurance Corporation of India, Opposite Radio Station, Subhash Road, District Rohtak Through its branch Manager, Rohtak.
- Life Insurance Corporation of India, Divisional Office, 3,4,5 SCO Sector-1, Rohtak.
……….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.Sumit Ahlawat, Advocate for the complainant.
Sh.S.P.Gulati, Advocate for the opposite parties.
ORDER
NAGENDER SINGH KADIAN, PRESIDENT:
1. Brief facts of the case are that father of the complainant i.e. Azad Singh obtained a policy bearing No.179835918 with date of proposal as 02.08.2014, date of commencement 12.04.2018 and date of maturity is 23.07.2035. That the deceased life assured regularly paid half yearly instalments. It is averred that at the time of availing the policy, the life assured was healthy and was thoroughly examined by the doctor of the opposite parties. That father of the complainant had suddenly expired due to sudden heart attack. That agent of the respondent has also certified and submitted to the office of the opposite party that claim of the complainant is genuine and is payable. That the father of the complainant was healthy at the time of obtaining the insurance policy so alleging the concealment does not arise. That the act of opposite party is completely against the law and principal of natural justice. It is therefore, prayed that the complainant is entitled for the relief of Rs.300000/- alongwith interest, compensation and litigation expenses as explained in relief clause.
2. Notice of the complaint was issued to the opposite parties. Opposite parties in their written reply has submitted that the respondent has issued a policy bearing No.179835918 on the life of Sh. Azad Singh s/o Sh. Ram Singh for sum assured of Rs.3 lakh with date of commencement from 28.07.2014 with nomination in the name of Sunil and Jitender Kumar subject to terms and conditions printed on the policy bond. That life assured was not in a good health at the time of taking insurance. The competent authority has repudiated all liability under the above policy on account of deceased having withheld correct information regarding his health at the time of affecting the assurance. That as per form no.3787 leave records from employer, life assured had availed medical leave for 90 days from 01.01.2014 to 31.03.2014 which is prior to date of FPR. That as per record of hospital life assured had difficulty in walking and seeing fine objects. The life assured was not in good state of health at the time of taking the policy. As such claim has rightly been repudiated by the opposite party. Opposite party 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, documents Ex.C1 to Ex.C9 and the evidence of complainant was closed by the order dated 19.06.2018 of this Forum. On the other hand ld. Counsel for the opposite party has tendered affidavit Ex.R1, documents Ex.R2 to Ex.R5 and has closed his evidence.
5. We have heard ld. counsel for the parties and have gone through the written arguments placed on record by the complainant as well as material aspects of the case carefully.
6. The perusal of the documents itself shows that the respondent officials had paid an amount of Rs.1 lac against policy No.1747852017 of deceased LA Azad Singh. This policy was issued by the respondent officials. One more policy No.179835918 was also issued by the respondents on 02.08.2014 and regarding this policy the claim of the complainants was repudiated on the ground that the deceased LA availed medical leave for 90 days from 01.01.204 to 31.03.2014. The deceased LA suppressed the material facts from the opposite party. So the claim of the complainant was repudiated on this ground alone.
7. Perusal of the documents Ex.R5 i.e. the repudiation letter itself shows that the deceased LA was suffering from ailment in his Eye and he suffered some difficulty in walking and seeing. The doctors advised him 3 months medical rest. The deceased died due to heart attack. This fact was also admitted by the respondents. Ld. counsel for the complainant has also placed reliance upon the law of Hon’ble National Commission in Revision Petition No.1782 of 2018 titled as Life Insurance Corporation of India Vs. Reena Nanda.
8. On the other hand respondent has also argued that the deceased LA had not disclosed proper information in his claim form and has placed reliance upon the law of Hon’ble National Commission in Revision Petition No.1316 of 2008 titled as Kapil Rai Singhani Vs. Life Insurance Corporation of India. The perusal of this case itself shows that in this case titled Kapil Rai(Supra) the deceased LA was suffering from cancer and he died due to this ailment. But the facts of the present case are different. In the present case the deceased died due to heart attack and he was examined by the penal doctor of the opposite party at the time of issuance of policy.
9. The perusal of the documents itself shows that he had not suffered any critical illness but he suffered only eye-infection and he obtained medical rest. Moreover an amount of Rs.1 lac had already been released against the policy No.174785217. As such the respondents have wrongly repudiated the claim against the policy No.179835918 and the complainants are entitled for the claim under the policy. As per statement given by ld. counsel for the complainant at the time of arguments, two sons of deceased namely Jitender and Sunil and wife of Azad Singh namely Roshani are L.Rs of deceased and he has no objection to give the claim to the L.Rs.
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 Rs.300000/-(Rupees three lacs only) alongwith interest @ 9% p.a. from the date of filing the present complaint i.e. 07.06.2017 till its actual realization, other benefits under the policy, if any and 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 L.Rs. of the complainant i.e. Jitender Kumar s/o Late Azad Singh, Sunil Kumar s/o Azad Singh and Roshni wife of late Azad Singh in equal share.
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:
27.09.2018. ................................................
Nagender Singh Kadian, President
..........................................
Ved Pal Hooda, Member.
…………………………..
Saroj Bala Bohra, Member.
