F.A.No.813/2005   against  C.D.No.24/2003 ,  DISTRICT CONSUMER FORUM, Krishna ,Machilipatnam. .

Between:

Goriparthi Lakshmi Suvarchala Devi,

W/o.late Narasimha Sastry,

Hindu, aged 39 years,

C/o.Purnachandra Rao,

21/123, Englishpalem,

Machilipatnam.                                                                                 .... Appellant/

                                                                                                                  Complainant

      And

The Divisional Manager,

Life Insurance Corporation of India,

Divisional Office, Jeevan Prakash,

Kennedy road, Machilipatnam.                                                          ...   Respondent/

                                                                                                                     Opp.party

Counsel for the appellant          :       Mr.M.Srinivas

Counsel for the  respondent      :        Mr.K.R.Koteswara Rao

  CORAM:HON’BLE JUSTICE SRI D.APPA RAO, PRESIDENT,

                            SMT.M.SHREESHA, HON’BLE   MEMBER

                                                                   AND

                           SRI G.BHOOPATHI REDDY, HON’BLE MEMBER.

                    FRIDAY, THE  FIFTTEENTH   DAY OF FEBRUARY,

          TWO THOUSAND EIGHT.

ORAL ORDER: (Per Sri G.Bhoopathi Reddy, Hon’ble Member)

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         This is an appeal filed by the appellant/complainant under Section 15 of Consumer Protection Act, 1986 to  modify the order  passed by District Forum Krishna, Machilipatnam in C.D.No.24/2003 dt.23.12.2004 .

      The appellant herein is the complainant before the District Forum.  She filed  a complaint under Section 12 of the Consumer Protection Act ,1986  to direct the opp.party to  pay the policy amount of Rs.25,000/-  each against the policy nos.  673589980 and 673590199 with interest at 12% p.a. from the date of death , compensation of Rs.20,000/-  and costs.

The case of the complainant is as follows:

 The complainant’s husband during his life time obtained two life  insurance policies bearing nos.673589980 and 673590199  for Rs.25,000/- each commencing from 15.11.1999  and the complainant is the nominee under the said policies.     The life assured died on 2.10.2000  while the policies were in force.  .The complainant submitted her claims  along with required documents to the opp.party.  The opp.party repudiated the claims of the complainant  stating that the life assured withheld the material information with regard to his health.   The complainant preferred an appeal to the  Zonal Manager of the opp.party .    The Zonal  Manager of the opp.party corporation sent a  letter dt.30.5.2001   stating that the claim of the complainant will be referred to Mahcilipatnam Divisional  office for settlement. The complainant issued registered legal notice to the opp.party demanding   for redressal of her grievance for  settlement of the policies . The opp.party  sent a letter dt.22.11.2001  stating that the they have received communication from Zonal office  that the decision of repudiating both claims by Divisional office was up held.   Hence the complainant approached the District Forum to direct the opp.party to  pay the policy amount of Rs.25,000/-  each against the policy nos.  673589980 and 673590199 with interest at 12% p.a. from the date of death , compensation of Rs.20,000/-  and costs.

      The opp.party  filed counter denying  the allegations  made in the complaint and contending that the life assured suppressed all the facts regarding his pre existing diseases  The complainant  has not submitted the information regarding the death of her husband in time.   Hence the  opp.party is not liable to pay the claim amounts.   There is no deficiency in service on its part.  . It prayed for dismissal of the complaint. 

     In support of the complainant’s claim she filed  evidence affidavit and    documents Exs.A1 to A5.  The District Forum based on the evidence adduced  and pleadings  held  that there was deficiency in service on the part of the opp.party  and directed  it  to  pay Rs.25,000/-  against the policies bearing nos. 673589980 and 673590199  with interest at 9% p.a. from the date of complaint i.e. 13.3.2003 till realisation and  Rs.1000/- towards costs.    

     Aggrieved by the said order  the complainant preferred this appeal  contending   that the order of the District Forum is contrary to law and weight of evidence.  The District Forum ought to have decreed to pay Rs.25,000/- principle sum assured on each policy and also the consequential benefits which accrued on each policy as per terms and conditions of policies.. Since  the appellant has taken  Jeevan Mitra Tripple cover policies  covered under table no.133,  the complainant is entitled for three times the  maturity value of the sum assured in case of death before  the maturity  and the said fact was not considered by the District Forum. She prayed to allow the appeal by directing the opp.party to pay sum assured of Rs.25,000/- on each policy nos. 673589980 and 673590199 and other consequential benefits which are accrued as per terms and conditions of the policies.

     The point for determination is  whether  the appellant is entitled for Jeevan Mitra Triple cover policies     and entitled for three times to the maturity value of the sum assured ?

      There is no dispute with regard to the  complainant has obtained  two Jeevan Mitra Tripple cover policies,  each policy for an amount of Rs.25,000/- . During the validity of policies after the demise of life assured the complainant has submitted claims before the insurance company claiming policy amounts.  The opposite party repudiated the claims on the ground that the life assured  withheld the material information  with regard to  his health.  The  District Forum has   partly allowed the complaint directing the insurance company to pay  Rs.25,000/- against  two policies   along with interest at  9% p.a. and Rs.1000/- towards costs.   The appellant contended that    after  death of her husband she has submitted  claims  before the insurance company claiming insurance policy amounts along with consequential benefits , the District Forum has not  awarded   consequential benefits hence the order of the  Dist Forum be modified .   Submission made by the appellant is concerned the relevant document is Ex.A1  legal notice dt.15.10.2001  issued  to the opposite party  prior to  filing of the complaint.  . We have perused Ex.A1 .   In the said notice the complainant has taken a plea   to pay the insurance  claim amount only .   Apart from this in the complaint also  it is prayed to direct the opp.party to pay  the  amounts under two policies with simple interest , Rs.20,000/- towards mental agony and costs.    There was no specific   mention in the complaint for a direction to pay     the Jeevan Mitra Tipple Cover Policy benefits.  The appellant is now seeking  to modify the order by granting  consequential benefits  under the policies   which was not asked  earlier in the complaint.   The District Forum elaborately discussed and given finding .  There are no reasonable grounds to interfere with the order passed by the District Forum. 

     In the result appeal is dismissed.  Order of the District Forum is confirmed . In the circumstances no costs.  Time  for compliance six weeks.

                                    PRESIDENT      LADY MEMBER    MALE MEMBER 

                                                                     Dt.14.2.2008

Pm*