Between:

U.P.Maddileti Swamy, S/o V.Narayana,

R/o D.No.1-11, Gundla Singavaram Village – 518 122, Owk Mandal, Kurnool District.                                                     

…Complainant

                                       -Vs-

1. Life Insurance Corporation of India,Represented by its Branch Manager,  

   Banaganapalli Branch, H.N o.3-48,Near Mahaboob Talkies RoadBanaganapalli – 518 124,    Kurnool District.

2. Life Insurance Corporation of India, Divisional Manager,

   D.No.1-55, Post Box No. 10, Jeevan Prakash Building, College Road, Kadapa – 516 002.                              

...Opposite ParTies

This complaint is coming on this day for orders in the presence of Sri S.Siva Rama Krishna Prasad, Advocate for complainant and Sri.A.S.Ummer Javid Ali, Advocate for opposite parties 1 and 2 and upon perusing the material papers on record, the Forum made the following.

                                               ORDER

(As per Smt.S.Nazeerunnisa, Lady Member)

   C.C. No.65/2012

1.     This complaint is filed under section 12 of C. P. Act, 1986 praying:-

(a)        To direct the opposite parties to pay sum assured i.e., Rs.50,000/- with accrued bonus and other benefits arisen out of the policy bearing No.654191135;

(b)        To award the sum of Rs.50,000/- towards compensation causing mental agony to the complainant by the opposite party No.2;

(c)         To cost of the complainant;

(d)        To such other relief or reliefs as the Honourable Forum deems fit and proper in the circumstances of the case.             

2.    The case of the complainant in brief is as under:- The complainant is the son of Late Vapara Narayana.  Late Vapara Narayana insured his life with the opposite party No.1 under the policy bearing No.654191135 for a sum of Rs.50,000/-.   The yearly premium payable under the policy is Rs.3,935/-.  The period of the policy is 16 years.  On 24-10-2008 the insured died due to Cardiomiography.  The complainant submitted the claim to the opposite parties.  The opposite parties repudiated the claim on the ground that the insured suppressed the material facts regarding his age in the proposal form and that the insured was 50 years at the time of the proposal and the same was not disclosed by the insured and mentioned as 48 years in the proposal form.  The repudiation of the claim by the opposite parties is illegal.  On the date of proposal the age of life assured was 48 years.  There is a deficiency of service on the part of the opposite party in not honouring the claim of the complainant.  The opposite parties caused mental agony by falsely repudiating the claim of the complainant.    Hence the complaint.

3.     Opposite party No.2 filed written version and the same is adopted by opposite party No.1.  It is stated in the written version of opposite party No.2 that the complaint is not maintainable. It is admitted that opposite party No.1 issued policy in favour of Late Vapara Narayana for a sum of Rs.50,000/- basing on the facts mentioned in his proposal form with the date of commencement on 28-03-2006.  The policy was issued on the basis of age declared by him in the proposal form as 48 years.  The opposite parties repudiated the claim of the complainant on the ground that life assured suppressed the material fact as regards to his age.  On the date of proposal his age was 64 years he falsely declared his age as 48 years in the proposal form.   It is further stated that this opposite party is not aware about the death of Grandfather of complainant, who is nominee under the above policy.  The deceased or complainant had not made any representation for seeking change of nomination in the above said policy.  There is no deficiency of service on the part of opposite parties.  Hence the complaint is liable to be dismissed. 

4.     On behalf of the complainant Ex.A1 to A6 are marked and sworn affidavit of the complainant and third party affidavit of Smt.U.V.Mangamma is filed.  On behalf of the opposite parties Ex.B1 to Ex.B6 are marked and sworn affidavit of the opposite party No.2 is filed.

5.     Complainant and opposite parties are filed their written arguments.

6.     Now the points that arise for consideration are:

     i.                        Whether there is deficiency of service on the part of opposite parties?

    ii.                        Whether the complainant is entitled for the reliefs as prayed for?

  iii.                        To what relief?

7.      POINTS i and ii:-  Admittedly Late Vapara Narayana. Who is the father of the complainant obtained policy bearing No.654191135 in his name on 28-03-2006 under Ex.A1 = Ex.B6.  The sum assured under the policy was Rs.50,000/- along with other benefits.  Yearly premium payable under the policy was Rs.3,935/-.   The life assured died on 24-10-2008.  Ex.A2 is the Death Certificate issued by Executive Offices Panchayat Secretary, Banaganapalli, dated 06-10-2009.   Ex.A3 is the photo copy of Medical Attendance Certificate of Hospital Treatment dated 28-12-2008.  It is the case of the complainant that after the death of life assured, the complainant submitted claim to opposite parties.  The opposite parties repudiated the claim under Ex.B1 dated 27-07-2012 and Ex.A4 dated 06-08-2012, on the ground that the insured suppressed the material facts as regards to his age in the proposal form.  It is further case of the complainant that the life assured was submitted the Ration Card to opposite party to prove his age and that the approximate age was given by the Family Member of insured as 50 years and the agent of opposite parties Mr.B.Subramanyam also attested the same as 48 years.  The complainant filed Medical Attendance Certificate Ex.A3 dated 28-12-2008, where in the age of life assured is mentioned as 50 years.  It is also well known to the opposite parties after verification opposite parties issued the policy to deceased life assured.  To support his version he cited a decision in Revision Petition No.3123/2012, where in it was held that when Insurance Company accept the documents inrespect of age and issued policy now it does not fatal to the claim of the complainant.

8.     The learned counsel appearing for the complainant contended that the deceased obtained Insurance Policy form the opposite party in the year 2006. The deceased and his wife were illiterates so the L.I.C. Agent filled up the proposal form.  The deceased wanted to nominate his son U.P.Maddileti Swamy as nominee under the said policy.  The name of his son and his father name is same, so the L.I.C. Agent committed mistake and mentioned relationship between the nominee and insured is father in the Proposal Form Ex.B5.  At the time of taking policy the father of deceased was no more.  He was died in the year 1974.  But the death of deceased father was not registered.  The complainant filed non availability Certificate (Form No.10) along with third party affidavit attested by Notary stating that the event relating to the death of deceased father was not registered.  It is marked as Ex.A6.  The creation of the father of deceased as a nominee does not arise in the proposal form.  It is a mistake committed by its own agent.  The complainant filed Family Members Certificate dated 09-01-2009 issued by the Thasildar, Owk Mandal, Kurnool District stating that the complainant and his mother are the family members of the deceased.  The complainant also filed an affidavit of her mother Smt.U.V.Mangamma stating that she has no objection to receive the assured amount by his son as nominee under the said policy. 

9.     The learned counsel appearing for the opposite parties contended that while scrutinizing the claim of the complainant, as per house Hold Card Ex.B3 bearing No.WAP134700500356 available the age of life assured is 64 years, but in the Proposal Form the deceased life assured declared his age as 48 years.  The Proposal Form is marked as Ex.B5.  The maximum age limit under the said policy is 50 years only. So he was not eligible for insurance.  The House Hold Card supplied by the deceased to opposite party at the time of taking policy, which is marked as Ex.B2, where in the age of deceased life assured is shown as 50 years.  The deceased suppressed the material fact regarding his age at the time of taking policy.  So the complainant is not entitled for assured amount under the said policy. 

10.    The deceased submitted House Hold Card bearing No.WAP134700500356 dated 04-10-2006 (Ex.B2) issued by Grama Panchayat Secretary, at the time of proposal itself.  It is well known to the opposite parties inrespect of age of deceased.  The insurance company ought to have verified the particulars and documents furnished by the insured in the Proposal Form.  Merely because the insured stated in the proposal form that his age was at 48 years it cannot be said that he mentioned so with fraudulent intention.  The deceased and his wife were illiterates they do not know the technicalities of insurance policies.  The opposite parties accepted the Ex.B2, and well aware of the fact regarding his age, and issued policy in favour of the insured.  The opposite parties filed photo copy of same House Hold Card bearing No.WAP134700500356 (Ex.B3) where in, the age of deceased is shown as 64 years.  Except Ex.B3 there is no other material on record to show that the deceased was 64 years at the time of taking policy.  Ex.B3 cannot taken into consideration without any credible evidence to prove said fact. 

        As seen from Ex.B2 House Hold Card, Ex.B5 Proposal Form dated 31-03-2006 and Ex.A3 photo copy of Medical Attendance Certificate, it is clear that after due verification of the facts mentioned in Ex.B5, the opposite parties issued the policy to deceased life assured.  The L.I.C. Agent Mr.B.Subramanyam also attested the same as 48 years in (Ex.B5).  The doctor also mentioned the age of deceased as 50 years at the time of his death.  The opposite parties could not establish that life assured was 64 years and suppressed the said fact in the Proposal Form.  In Ex.B4 is the photo copy of Central Office Circular dated              28-06-2008.  As per the circular, the person can insured his life up to 50 years for an assured amount of Rs.50,000/-.  The repudiation of the claim by opposite parties is not just and proper.  The opposite parties kept pending the claim of the complainant beyond three years, it is not reasonable.  There is deficiency in service on the part of opposite parties.  The complainant who is nominee as already discuss under the policy is entitled for an assured amount of Rs.50,000/- along with other benefits. 

11.    In the result, the complaint is partly allowed directing the opposite parties jointly and severally to pay an assured amount of Rs.50,000/- along with other benefits under the policy and Rs.1,000/- as cost of the case.  Time for compliance is one month from the date of receipt of this order.

        Dictated to the stenographer, transcribed by her, corrected and pronounced by us in the open bench on this the 21^st day of March, 2013.

  Sd/-                                                                            Sd/-

LADY MEMBER                                                          PRESIDENT (FAC) 

                                   APPENDIX OF EVIDENCE

            Witnesses Examined

For the complainant : Nil                 For the opposite parties : Nill

List of exhibits marked for the complainant:-

Ex.A1                Photo copy of Policy bearing No.654191135.

Ex.A2                Photo copy of Death Certificate issued by Executive Officer,

Panchayat Secretary, Banaganapalli, dated 06-10-2009.

Ex.A3                Photo copy of Medical Attendance Certificate of Hospital

                Treatment dated 28-12-2008.

Ex.A4                Repudiation Letter dated 06-08-2012.

Ex.A5        Photo copy of Family Members Certificate dated 09-01-2009 issued by Thasildar, Owk Mandal, Kurnool District.

Ex.A6        Photo copy of Form No.10 (Non Availability Certificate

dated 08-03-2013 issued by Deputy Thasildar, Banaganapalli along with photo copy of Affidavit.

List of exhibits marked for the opposite parties:-

Ex.B1                Repudiation Letter dated 27-07-2012.

Ex.B2                House Hold Card.

Ex.B3        Photo copy of Family Details.

Ex.B4                Photo copy of Central Office Circular dated 28-06-2008.

Ex.B5                Proposal Forum.

Ex.B6                Policy bearing No.654191135.

 Sd/-                                                                                     Sd/-

LADY MEMBER                                                         PRESIDENT (FAC)

    // Certified free copy communicated under Rule 4 (10) of the A.P.S.C.D.R.C. Rules, 1987//

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