Karnataka

Bidar

CC/55/2016

Smt. Sunita w/o Shivshankar N Halbarge - Complainant(s)

Versus

Life Insurance Corporation Bidar - Opp.Party(s)

Sri. D.Basawaraj Adv.

30 May 2017

ORDER

::BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM,

AT BIDAR::

 

 

                                                                                                                 C.C.No. 55/2016

 

                                                                                                    Date of filing :04/08/2016

 

                                                                                               Date of disposal : 30/05/2017

 

 

P R E S E N T:-               (1) Shri. Jagannath Prasad Udgata,

                                                                                         B.A., LL.B.,

                                                                                                       President.

    

                                   (2) Shri. Shankrappa (Halipurgi),

                                                                                    B.A.LL.B.,

                                                                                                Member.

                                 

                                                                                                                                            

COMPLAINANT/S:             Smt. Sunita, W/o Shivshankar N. Halbarge,

                                            Age: Major, Occ: House hold, R/o Mudhol (B),

                                                Tq. Aurad (B),Dist.Bidar.

             

 

                                          (By Shri. D. Baswaraj , Advocate)

 

 

                                                      VERSUS

 

OPPONENT/S   :-               1.  The Branch Manager,

                                                    Life Insurance Corporation, Branch, Bidar.

                                                Near Railway Station, Bidar.

 

                                             2.   The Divisional Manager ( L & HPF),

                                                   Divisional Office, Jeevan Prakash,

                                                    Near Mahathma Gandhi Stadium,

                                                    Raichur-584101.

 

                                          3.   Prakash Kushnoore,

                                                    Age: Major, Occ: LIC Agent at Bidar.

                                 

 

                                         ( O.P.No. 1& 2-By Shri. Vijay Udgir, Advocate )  

                                            ( O.P.NO. 3-Exparte )

                                              

::   J UD G M E N T  : :

 

By Shri. Jagannath Prasad Udgata, President.

 

                    This is a complaint filed by the above said complainant U/s.12 of the C.P.Act., 1986, against the O.Ps. The sum total of her allegations are as follows:-

 

2.         The complainant is daughter of the deceased (DLA) Subhadrabai.  Deceased Subhadrabai in her life time had obtained LIC policies namely Janaraksha Plan, LIC policies bearing nos. 666100591, for sum assured Rs. 1,00,000/-,  666100592 for sum assured Rs. 1,00,000/-, 666100614 for sum assured 1,00,000/- & 666103803 for sum assured 1,00,000/-.  Out of the above said four policies the claim amount already paid to the complainant pertaining to the policy no. 666100591 and  for claim pertaining to policy no. 666103803 separate case has been filed.  The DLA has obtained the  policy (s) through the LIC agent namely Sri.Prakash Kushnoore and the DLA Subhadrabai has made  her daughter namely Sunita w/o Shivshankar the nominee.  The complainant avers that, after her mother’s death due to heart attack the complainant has approached the O.Ps for claiming the sum assured amount but, the O.Ps have repudiated her claim on the ground that the DLA had suppressed the existence of the earlier policy before obtaining the policies.   Hence the complainant approached this Forum.

 

3.               In spite of service of Court’s notice the O.P.No.3 has not appeared before the Forum hence placed exparte.  The O.P.No.1 and 2 have appeared before this Forum  and have filed written version.  The O.P.no.1 claims in the written version that the complaint filed by the complainant is not tenable either on factual or on legal grounds.  The O.Ps admitted that deceased Subhadrabai has taken three policy(s) bearing nos. 666100591, 666100592 and 666100614 respectively for sums of Rs. 1,00,000/- Dt. 28/09/2013 and another policy No. 666103803, dt. 27/12/2013 through an agent Prakash Kushnoor.  Tthe same are obtained by submitting non-standard age proof and suppressing the material facts.  The life assured knows that, if the previous policies were mentioned she was not eligible for risk under the present policies also taking under consideration that she was not eligible for four lakhs for under writing, basing on non-standard age proof.  Hence life assured has deliberately made misstatement and with held material information from the O.P. regarding her other policies  already held for risk coverage.  The contents of para no.1 of the complaint are denied bythe O.P. about the deceased engaged in agriculture and the role and identity of the agent in explaining the proposer due to lack of knowledge.

 

4.                 In reply to contents of para no.2 of the complaint it is stated that, out of three policies one was satisfied as she was eligible.  When a person proposes for more than one policy the terms and conditions differ, namely she is required/bound to submit her standard age income proof, medical report, etc as per the norms/rules, but in the  the proposals the following defects are found.  On the other hand the proposals are submitted with suppression of the material fact of other two proposals made earlier which was mandatory.  The proposal Form vide question no.7 clearly  raised a demand for information.  The question no.7 of the proposal form was “ Is your life now being proposed for another assurance or an application for revival of a policy on your life or any other proposal under consideration in any office of the corporation or to any other insurer”?  The DLA had answered in negative.  The question was very clear as to enquire about any other proposal under consideration in any office of the corporation, for which proposer should have given a simple answer as “Yes “.  If the proposal was submitted with real facts the company would have held up  other two policies in official notes.   The complainant’s  policy(s) were obtained by submitting the non standard age proof .  The proposals were accepted on ut-most good faith with a hope and co-operation from proposer that, she should submit the real/true facts.  The L.I.C. of India Corporation is a Government institution governed by the Government of India, it’s by the people, for the people, to the people of India, it’s for their benefit, it’s their money, there is no any personal interest or enmity in repudiating the policies by the officials.  They act as per the guidelines given to them by Government of India.  Hence there is no  deficiency on the part of the O.Ps in repudiating the claim hence, the complaint may be dismissed.

 

 5.         Considering the rival contentions of the parties, the following points arise for our consideration:-

 

 

1. Does the complainant prove that, there has been a deficiency of service in the part of the Opponent?

 

2. What order ?

 

 

6.           Our answers to the points stated above are as follows:-

 

               1.   In the affirmative.

               2. As per the final order, for the following:

                                                                                

:: REASONS ::

 

7. Point no.1:-    We observe from the documents ( copies) submitted by the complainant vide Ex.P.5 to P.15 that, she has submitted all necessary documents required for settlement of her claim, in spite of which vide Ex.P.4, the O.P. Corporation has repudiated her claim in respect of policy no. 666100592 and 666100614, while settling the claim in respect of policy no. 666100591.  The O.P. Corporation claims that, while obtaining policies subsequent to that of 666100591, the deceased life assured had not disclosed about the previous policy and had suppressed material facts.  The O.P. Corporation alleges, had  the proposer disclosed the policy taken earlier they would have insisted on age proof, income proof and so on.  We have given our anxious considerations to this contention of the O.P. Corporation and conclude that, the defence taken is perfunctory, self serving improper, incompetent and irrelevant.  It is seen from Ex.P.1 to P.3 that, all the three policies were issued on the same day i.e. 28/09/2013 simultaneously.  The agent is the same and the issuing office of policy is  common.  It is therefore obvious that, the proposals were also filled up and submitted on a single/particular day by the proposer.  At  the time of filling up the proposal forms(s), she had no other policy standing in her name and hence her answer in negative to the queries in question no.7 is truthful.  No material facts were ever with held by her and hence the O.P. Corporation would not be competent to allege as such, more so, when it has already settled the claim in respect of another policy obtained on the ;same day.  Receiving the three proposals at a stretch, it was open for the corporation to take all precautionary measures before ;issuing the policies. Now after issuance of the policy(s) it is not open to raise an objection on the aspect of utmost good faith (ubbiramae fidei) and by repudiation the O.P. has committed deficiency of service and we answer the point No.1 in affirmative and proceed to pass the following:-

 

:: ORDER ::

 

  

1.  The Opponent Corporation is hereby directed to pay the full proceeds of policies no. 666100592 and 666100614 to the complainant along with 12% interest p.a. calculated from the date of raising the claim till the date o realisation.

 

2. The  Opponent Corporation are further directed to pay a sum of Rs. 10,000/- as compensation towards sufferings and mental agonies under gone by the complainant, together with litigation expenses of Rs.5,000/-
3. The case against O.P.no.3 is dismissed, he being a mere agent and facilitator.

              d)  Four weeks time granted to comply this order.

 

( Typed to our dictation then corrected, signed by us and then pronounced in the open Forum on this 30^th day of  May-2017 )

 

 

   Sri. Shankrappa H.                                             Sri. Jagannath Prasad                                  

Member.                                                                President.                                                                                            

 

 

Documents produced by the complainant

1. Ex.P.1-  Copy of Insurance Policy Bond issued by O.P.
2. Ex.P.2-  Copy of Insurance Policy Bond issued by O.P.
3. Ex.P.3-  Copy of Insurance Policy Bond issued by O.P.
4. Ex.P.4- Copy of letter addresed to Smt. Sunita by Sr.Divisional Manager,LIC.
5. Ex.P.5- Copy of Death certificate.
6. Ex.P.6- Copy of letter addressed to  Br.Manager,LIC by complainant.
7. Ex.P.7-Copy of NEFT Mandate Form.
8. Ex.P.8-Copy of declaration form.
9. Ex.P.9- Copy of Claimant’s Statement. 
10. Ex.P.10- Copy of Medical Attendants certificate.
11. Ex.P.11- Copy of Certificate of Hospital treatment
12. Ex.P.12- Copy of Certificate of identity and burial or cremation.
13. Ex.P.13- Copy of e-stamp( affidavit )
14. Ex.P.14 –Copy of Election I.D. of Neelkanth.

 

 

 Documents produced by the Opponent/s

 

                -Nil-

 

Sri. Shankrappa H.,                                             Sri. Jagannath Prasad,                                  

       Member.                                                                      President.

 

           

mv.