BEFORE THE DISTRICT FORUM:KURNOOL
Present: Sri.K.V.H. Prasad, B.A., LL.B President
And
Smt. C.Preethi, M.A.LL.B., Lady Member
Wednesday the 13th day of August, 2008
C.C. No.181/07
Between:
Smt. Somala Saraswathi, W/o. Late. S. Naga Gurunath,
D.No.34/131, Kummari Street, Near Chatribagh Masque, Kurnool Post and District. Complainant
Versus
- Life Insurance Corporation of India, By its Branch Manager,
Kurnool.
2. Life Insurance Corporation of India, By its Divisional Manager,
Jeevan Prakash, College, Kadapa. Opposite Parties
This complaint is coming on this day for orders in the presence of Sri.S.Siva Rama Krishna Prasad, Advocate, for the complainant, and Sri.I.Anantha Rama Sastry, Advocate for opposite parties and upon perusing the material papers on record, the Forum made the following.
ORDER
(As per Smt.C.Preethi , Lady Member)
C.C.No.181/07
1. This consumer complaint of the complainant is filed U/s 11 and 12 of C.P.Act 1986 seeking a direction on opposite parties to pay policy amount under policy bearing No.653735453 and 653735515 with 18% interest, cost of the complaint , Rs.50,000/- towards mental agony and any other relief or reliefs which the complainant is entitled . in the circumstances of the case.
2. The case of the complainant is that the complainant’s husband Gurunath @ Gurumurthy has taken policies bearing Nos65373543 and 653735515 from opposite party No.2 and paid premiums regularly till his death. The policy holder died due to heavy consumptions of alcohol cumulative effect of cardiac arrest in a lodge at Nandikotkur town. The manager of the lodge without knowing the facts gave a complaint that the deceased committed suicide by consuming pesticide poison . But no traces of poisons were found in autopsy . Thereafter, the agent of opposite parties obtained signatures of the complainant in printed forms and taken away the original policy bond under the guise of settlement of policies. But, the complainant received a letter dated 10-1-2007 stating that her claim for policy amount has been repudiated on the ground that the deceased committed suicide within one year from the date of risk and the policy had become null and avoid. The complainant submits that the policies were issued on 28-8-2004 and the deceased died on 22-9-2005 which is more than one year . Hence, the complainant is entitled for assured amount under the policy. Thus the opposite party No. 2 are deficient in service to the complainant in repudiating the claim under the above two policies and the complainant is resorted to the forum for reliefs.
3. In support of her case the complainant relied on the following documents viz., (1) repudiation letter dated 10-1-2007 of opposite party
No.2 to complainant , (2) second premium receipt dated 11/04 for policy
No.653735575 and (3) second premium receipt for bearing No. 653735453 besides to the sworn affidavit of the complainant in reiteration of her complaint averments and the above documents are marked as Ex.A1 to A3 for its appreciation in this case and replies to the interrogatories exchanged.
4.. In pursuance to the notice of this forum as to this case of the complainant the opposite parties appeared through their standing counsel and contested the case. The opposite party No . 2 filed written version denying the complaint averments.
4. The written version of opposite parties submits that the compliant of the complainant is not maintainable either in law or on facts but admits the policy bearing No.653735453for Rs. 1 lakh and another policy bearing No.653735515 for Rs.1,05,000/- was issued with dated back commencement of 28-8-2004 by opposite parties and the policy were in force on the date of death of policy holder. The policy holder committed suicide as per the report of Manager of the lodge . This is also evident from Dr. B. Lakshmi Narayana Assistant Professor of forensic medicine of Kurnool Medical College who reserved his opinion about the cause of death of policy holder. The policy holder in the proposal form answered negatively to the questions in question No.11 (A to J) . The policy holder also suppressed the fact of his habit of drinking of alcohol and the proposals submitted by the policy holder were sent to higher officials of the opposite parties for their decision. The date of acceptance of risk under the above two policies and the one year suicide clause operates with effect from those dates. The policy holder died on 22-9-2005, the date of death was within one year from the date of commencement of risk and nothing is payable to the complainant as per suicide claim. On the other hand the deceased policy holder have died due to over drinking of alcohol and the same was suppressed by the policy holder in answers to question No.11 (A to J) and thus deprived the opposite parties to conduct the special examination on the deceased policy holder to arrive on the risk involved in accepting the proposal. The claim of the complainant has been repudiated lawfully and no where the signatures alleged to be signed by the complainant were used and the date of acceptance of risk of both the policies was on 18-11-2004 and date of death of policy holder is 22-9-2005 . Thus the death of policy holder was within one year from the date of acceptance of risk i.e., 10 months and 4 days. Hence, the opposite parties are not liable to pay the policy amount to the complainant as per suicide clause and seeks for the dismissal of complaint with costs.
5. In support of their case the opposite parties relied on the following documents viz., (1) policy bond bearing No.65333735453 , (2) proposal form in 6 papers, (3) proposal review slip in 2 papers ,(4) policy bond No.653735515 , (5) proposal form for Ex.B4 in 5 papers, (6) proposal review slip for Ex.B5 and ( 7) attested Xerox of forensic laboratory report, besides to the sworn affidavit of opposite party No .2 in reiteration of his written version averments and the above documents are marked as Ex.B1 to B7 for its appreciation in this case and replies to the interrogatories exchanged.
6.. Hence, the point for consideration is to what relief the complainant is entitled alleging deficiency of service.
7. It is the case of the complainant that she is the wife and nominee of Gurumurthy @ Gurunath , who has taken life insurance polices bearing No. 653735453 and 653735515 vide Ex.B1 and B4 and regularly paid premiums till his death. On 22-9-2005 the policy holder due to heavy consumption of alcohol died in a lodge and the manager of the lodge complained the policy holder committed suicide. The complainant thereafter submitted a claim and the opposite party No.2 repudiated vide Ex.A1 stating that the deceased policy holder committed suicide as per police records within one year from the date of risk and nothing is payable under the policy.
8. Hence, the only point for consideration is whether the policy holder committed suicide within one year from the date of risk or ?. The policy bonds issued to the deceased are in Ex.B1 and B4. The Ex.B1 is the New Bima Kiran Policy issued by opposite party No.2 . The opposite parties contents that the policy in Ex.B1 was issued on 29-11-2004 with dated back commencement, hence the issual date should be treated as date of commence of risk, but no material filed to substantiate this by the opposite parties . Where as in the Ex.B1 in the column policy No .and date of commencement , it is clearly mentioned commencement of policy as 28-8-2004 and policy No.653735453, hence, it cannot be said that the policy commences from the date of issual. In the Ex.B2 proposal for obtaining in Ex.B1 the policy holder signed on 26 August 2004, ie. two days before to the commencement of policy i.e 28-8-2008. Hence from the above what appears is that the proposal for obtaining policy in Ex.B1 was submitted in August but the policy was issued on 29-11-2004 . Hence, there appears lethargic conduct on part of opposite parties in issuing policy belatedly but mentioned the date of commencement correctly. Therefore, it is clear that the policy in Ex.B1 commenced from 28-8-2004 only.
9. The other policy in Ex.B4 is a Jeevan Mithra Policy issued by opposite party No. 2. Regarding this policy also the opposite parties alleged that the Ex.B2 was also issued with dated back commencement and the policy was issued on 4-12-2004 and the issual date may be treated as commencement date. But to substantiate it no material is placed on record. While such is so in the Ex.B4 in the date of commencement column, the date of commencement in mentioned as 28-8-2004, hence it is clear from the above that this policy in Ex.B4 also commenced from 28-8-2008 itself. The proposal inEx.B5 submitted by the policy holder for obtaining policy in Ex.B4 was signed on 26-8-2004 ie. two days prior to the commencement of policy i.e., 28-8-2008. Hence, what appears is that the proposal for obtaining policy bond in Ex.B4 was submitted in August, 2004, but the policy was issued belatedly on 4-12-2004 .
10. Thus, the above material clearly indicates that both policies in Ex.B1 and B4 commenced from 28-8-2008 itself and not on the date of their issual as alleged by the opposite parties.
11. In this case the policy holder committed suicide on 22-9-2005, as per Cl.6 of conditions and prevelages on back side of the policy bond, indicates that this policy shall be void if the life assured commits suicide at any time on or after the date on which the risk under the policy was commenced, but before to the expiry of one year from the date of this policy no claim will be considered. But in this case the policies in Ex.B1 and B4 commenced from 28-8-2004 and the policy holder died on 22-9-2005, i.e, after the expiry of year from the date of commencement of policy.
12. To sum up the above discussions, as the policy holder death after expiry of one year from the date of commencement of policy , the complainant as nominee under the above two policies is certainly remaining entitled to the assured amount under the above two policies along with costs of Rs.1,000/- . As no cause of action is made out against opposite party No.1 case against opposite party No.1 is dismissed.
13. In the result, case against opposite party No.1 is dismissed and allowed against opposite party No.2 directing him to pay to the complainant the assured amount under policies bearing No.653735453 & 653735515 with 9% interest from he date of filling of this complaint i.e, 21-11-2007 along with costs of Rs.1,000/- within one month from the date of receipt of this order. In default the opposite party No.2 shall pay the supra award amount with 12% interest from the date of default till realization.
Dictated to the stenographer, transcribed by her, corrected and pronounced by us in the open bench on this the 13th day of August, 2008.
MEMBER PRESIDENT
APPENDIX OF EVIDENCE
Witnesses Examined
For the complainant :Nil For the opposite parties :Nil
List of exhibits marked for the complainant:-
Ex.A1. Repudiation letter, dated 10-1-2007 of opposite party No.2
to complainant.
Ex.A2. Second premium receipt, dated 11/04 for policy No.
653735515.
Ex.A3. Second premium receipt for policy No.653735453.
List of exhibits marked for the opposite parties:
Ex.B1. Policy bond No.653735453.
Ex.B2. Proposal form for Ex. B1 (No in 6 papers)
Ex.B3. Proposal review slip (No in 2 papers)
Ex.B4. Policy bond No.6537355175.
Ex.B5. Proposal form for Ex.B4 (No in 5 papers)
Ex.B6. Proposal review slip for Ex.B5.
Ex.B7. Attested Xerox copy of forensic science lab report.
MEMBER PRESIDENT
// Certified free copy communicated under Rule 4 (10) of the
A.P.S.C.D.R.C. Rules, 1987//
Copy to:-
Complainant and Opposite party.
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