BEFORE THE DISTRICT FORUM (UNDER CONSUMER PROTECTION ACT, 1986), MEDAK AT SANGAREDDY
Present: Sri Mekala Narsimha Reddy, M.A.,LL.B.,
P.G.D.C.P.L. Male Member
Smt. Meena Ramanathan, B.Com.,
Lady Member
Monday, the 19th day of July, 2010
CC. No. 6 of 2010
Between:
Smt. R. Lakshmi W/o Late R. Rama Krishna,
Age: 48 years, Occ: Housewife,
R/o D.No. 8-4-393/7, New Premnagar,
Erragadda, Hyderabad. ….. Complainant
And
1. Life Insurance company of India,
Represented by its Branch Manager,
D.No. 8-1-60, Hyderabad Road,
Near Bus Stand, Siddipet,
Medak District.
- P. Narsimhulu, L.I.C. Agent,
D.No. 17-1/1, L.I.C. Colony,
Sri. Nagar Colony, Siddipet,
Medak District. .... Opposite parties
This case came up for final hearing before us on 14.07.2010 in the presence of Sri. C. Janardhan, Advocate for complainant, Sri M. Prabhakar Gupta, Advocate for opposite party No. 1 and opposite party No. 2 is being called absent, upon hearing the arguments of both sides, on perusing the record and having stood over for consideration till this day, this forum delivered the following
O R D E R
(Per Sri. M. Narsimha Reddy, Male Member)
This complaint is filed Under Section 12 of The Consumer Protection Act, 1986 to directions to the opposite parties No. 1 & 2 to pay the policy amount Rs. 10,00,000/- (Rupees Ten Lakhs Only) with interest of 12% p.a. from 30.05.2008 to till the date of payment, with the brief averments as follows
1. In the month of August-2007, the opppoiste party No. 2, being the authorized agent of the opposite party No. 1. Approached husband of the complainant with a request to obtain money back policy for a sum of Rs. 10,00,000/- for a term of 20 years for which he expressed his willingness. Thereafter, opposite party No. 2 brought policy proposal forms and got filled up the contents of the same, collected a sum of Rs.32,316/-towards initial premium and deposited the said amount with the opposite party No. 1 vide Miscellaneous receipt dated 31.10.2007 for Rs. 316 proposal Deposit receipt dated 31.10.2007 for a sum of Rs.16,000/- and proposal deposit dated 31.10.2007 for a sum of Rs.16,000/- along with the proposal form and the required documents, that husband of the complainant had requested the opposite party No. 2 to furnish the policy bond for which he stated that it will take some time for issuing the policy bond, that the husband of the complainant did not receive any communication whatsoever either of opposite party Nos. 1 and 2, that due to misfortune husband of the complainant died on 30.05.2008, that complainant informed the same to the opposite party No. 2 through phone call and requested to obtain claim forms the opposite party No. 1, for which the opposite party No. 2 promised complainant that he will obtain claim form and requested complainant to obtain the death certificate from the municipal authorities, that the complainant obtained death certificate from the Greater Hyderabad Municipal Corporation on 08.07.2008 and informed the opposite party No. 2 on 10.07.2008 about her obtaining the death certificate, for which opposite party No. 2 replied that he will bring the claim form and collect the same, that to her utter shock and surprise, complainant received letter dated 18.07.2008 from opposite party No. 1 enclosing a cheque for a sum of Rs. 31,880/- in the name of deceased husband of the complainant and informing about the cancellation of proposals, that the complainant got a issued the legal notice on 21.10.2008 calling upon opposite party No. 1 and 2 to pay the policy amount Rs.10,00,000/- along with interest 12% to complainant, which were received by them and the opposite party No. 1 sent reply with evasive replies, and that after collecting the premium amount, the husband of the complainant did not receive any communication whatsoever from either the opposite party N. 1 or for that matter from the opposite party No. 2 . The opposite party No. 2 did not send any reply, refuting the allegations.
It complainant further states that having received the money and proposal form along with required documents on 31.10.2007 and also undergoing medical examinations, cancellation of Insurance policy after long delay of 8 months, that too after receiving the death information, amounts to deficiency in service and is an unfair trade practice. Hence, the opposite party No. 1 being the insurance corporation and opposite party No. 2 being its authorized agent are jointly and severally liable to pay the policy amount of Rs. 10,00,000/- to complainant. Hence the complaint.
2. The opposite party No. 1 resisted by the claim of the complainant by filing a counter to the following effect:
The opposite party No. 1 filed a counter admitting about the payment of the initial premium, submission of the proposals by the deceased for a policy for a sum of Rs. 8,00,000/- but not Rs.10,00,000/-, the amount of Rs. 32,000/- is lying in the deposit of suspense account, the age of the proponent is 50 years as per the age proof i.e., copy of the school certificate, the proponent was required to submit special medical report such as ECG, Heamogram, BST, Lipidogram, RUA, Chest X Ray, Elisa for HIV pertaining to him, which are preliminary for assessment of risk for age 50, and the said proposal number 11600 was forwarded by the branch office to its Divisional office, Secunderabad, which was received by the Divisional office on 29.12.2007, and that on 31.12.2007 without commitment, the Divisional office call for fresh ECG on his life and the submitted age proof document to be strictly verified and attested by the Branch Manager of Siddipet Branch office and also called the original document submitted in proof of his declared age and that the proposal was under consideration stage and was not accepted, that the proposal was received back at the siddipeta branch office on 01.02.2008 and the branch office informed the life assured vide letter dated: 06.02.2008, 15.03.2008 and 20.06.2008 to submit fresh ECG relating to him obtained from a different diagnostic centre and also age proof document, by informing clearly that no risk would be covered till the proposal is completed, no record is produced by the proponent to suggest that he had either contacted the opposite party No. 1 nor adduced any document evidencing the submission of the preliminary requirements called for consideration of the proposal, that deceased / proponent despite having knowledge of the requirements to be submitted, had not submitted the requirements which were very much material or assessment of risk under the said proposal and as the proposal could not be underwritten and that there is no valid and binding contract, the opposite party did not receive any death intimation from the complainant, the opposite party No. 1 took up action on 09.07.2008 to cancel the stale proposal i.e., proposal is communicated and as such there is no contractual liability and that since the proponent did not show any willingness to comply with the requirements, it is clearly that he had dropped the proposal for insurance and as such there is no deficiency of service on the part of the opposite party No. 1, it had replied to the legal notice on 29.10.2008. Hence, Complaint case is liable to be dismissed.
3. Evidence affidavit of complainant and opposite party No. 1 are filed. Exs. A1 to A15 are marked on behalf of the complainant. Exs. B1 to B6 are marked on behalf of the opposite party No. 1. Written arguments are complainant filed. The opposite party No. 2 filed a memo for stating that the counter treated as a written argument and oral arguments deemed to be heard. Perused the record.
1) Point for consideration whether the complaint is entitles for claim of repudiation proved against the opposite parties.
2). Whether the policy was accepted as policy proposal?
Point:
3. The undisputed facts of the case are that, the proponent / deceased submitted proposal on 31.10.2007 duly filled in and certified by the panel doctor the effect that the proponent was of good heath, through opposite party No. 2 who is the authorized agent of the opposite party No. 1 and paid Rs.32,000/- towards initial deposit towards initial deposit towards proposal No. 11600, dated : 27.12.2007.
The opposite party No. 1 contended that since the policy is for Rs. 8,00,000/- and the age of the proponent is 50 years at the time of proposal, it required further special medical reports such as ECG, Haemogram, BST, Lipidogram, RUA, Chest X ray, Elisa for HIV pertaining to him, vide letters dated 06.02.2008, 15.03.2008 and 20.06.2008 and the proponent did not respond to the above letters nor submitted any reports. The complainant is disputing the above letters. In view of the denial of receipt of the above letters, it is for the opposite party No. 2 to establish the fact that the said letters were communicated to the proponent / deceased. Except producing copies of the letters marked as Exs. A3 to A6, the opposite party No. 1 did not produce any postal receipts or acknowledgments to show that the said letters were in fact dispatched from their offence and reached the proponent / deceased at any point of time. Hence, the contention of the opposite party No. 1 that the proponent was informed to submit special medical reports vide their letters 06.02.2008, 15.03.2008 and 20.06.2008 is rejected.
Through the opposite party No. 1 contends that it informed the proponent as to required to fulfil the requirements, but no material is plased on record atleast to show that the alleged letters were dispatched from the office of opposite party No. 1. The opposite party No. 1 kept the insurance premium with it for long stretch of time for the reasons best known. The opposite party failed to place any material to show that the proposal can be kept pending for certain period without acceptance. The even the letter dated 18.07.2008 does not contain the reason for refusal of the premium. For its own laches, the opposite party No. 1 cannot de-fasten its liability. The opposite party No. 1 even failed to prove that the alleged letters sent by it requiring the proponent to fulfil tests were acknowledged by the proponent. Admittedly, the proponent died on 30.05.2008 and the proposal is cancelled on 18.07.2008 which shows doubt about the alleged intimation by opposite party No. 1 to the proponent. A perusal of the Ex.A5 document shows that it was addressed to the dead person. Admittedly, the opposite party No. 1 has knowledge about the death of the proponent as on 18.07.2008. It is for the opposite party No. 1 to prove that the alleged letters were dispatched from its office, with the available record in its possession, which is not done in the case.
The opposite party No. 1 cannot escape from its liability with fictitious records. It seems only to evade payment of claim, the opposite party No. 1 has resorted to cancellation of proposal after abnormal period. Nothing is placed before this forum to show that the opposite party No. 1 can retain the premium for certain period.
Admittedly, initial deposit premium was paid on 31.10.2007 along with the proposal forms, and after a period of nearly seven months, the proponent died on 30.05.2008. Except taking the plea of addressing letters to the proponent, which were not acknowledged, the opposite party No. 1 is not coming forward with any other legally acceptable ground for keeping the policy pending till the time of his death. Had it for the reasons best known, the opposite party no. 2 remained exparte. Opposite party No. 2 who is the statutory and authorized agent of the opposite party No. 1 did not issue the reply nor did he contest the claim of the complainant by denying their pleas putforth in the complaint. Under the above circumstances, we are of the opinion that there is a deficiency in service on the part of the opposite party Nos. 1 & 2.
5. In the result the complaint is allowed, directing the opposite parties No. 1 and 2 to pay Rs.8,00,000/- towards the sum assured of the proposed policy together with interest @ 6% p.a. from the date of complaint till realization with costs of Rs.1,000/-. The order shall be comply within one month from the date of receipt of the order.
Typed to dictation, corrected and pronounced by us in the open forum this 19th day of July, 2010.
Sd/- Sd/-
MALE MEMBER LADY MEMBER
Copy to
- The Complainant
- The Opposite parties
- Spare copy copy delivered to the Complainant/
Opposite parties On _________
Dis.No. /2010, dt.
