DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-I, LUCKNOW

CASE No.892 of 2008

       Smt. Pratibha Shukla, adult,

      W/o Late Prem Chandra Shukla,

       R/o 16, Vigyan Vihar,

       Triveni Nagar-3, Lucknow.

                                                                   ……Complainant

Versus

                1.  Life Insurance Corporation of India,

                    Divisional Office- “Jeevan Vikas”,

                   16/98, M.G. Marg, P.B. No.-170,

                   Kanpur- 208001.

               2. Life Insurance Corporation of India,

                   “Regional Office”,

                   Hazratganj, Lucknow-226001.

                   Through its Regional Manager.

               3. King George Medical College,

                   Department of Cardiology,

                   Through its Head of Department.

                                                                               .......Opp. Parties

Present:-

Sri Vijai Varma, President.

Smt. Anju Awasthy, Member.

JUDGMENT

This complaint has been filed by the Complainant against the OPs for payment of assured sum of Rs.6,00,000.00 with 18% interest, compensation of Rs.25,000.00 and the cost of litigation of Rs.10,000.00

          The case in brief of the Complainant is that the Complainant’s husband late Prem Chandra Shukla’s employer United India Insurance Co. had taken life insurance policy for Sri Prem Chandra Shukla in which the Complainant is a nominee. The Complainant’s husband expired on 06.01.2002 due to sudden heart attack. The Complainant’s husband was

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working with the United India Insurance Co. Ltd. and had taken a loan from United India Insurance Co. in the year 2000 and the United India Insurance Co. had taken an insurance cover “Jeevan Grah” on the life of the deceased husband of the Complainant on 22.07.2000 from OP No.1 for assured sum of Rs.2,00,000.00 (triple benefit). Under the conditions of the policy if the insured dies within the validity of the aforesaid policy then the OP No.1 and 2 were to pay triple benefit under the scheme. For procuring the insurance policy the doctors of LIC had carried out an exhaustive medical fitness test on the late husband of the Complainant and later declared him fit. The Complainant’s husband when he was posted at Lucknow suffered severe heart attack and he was admitted to KGMC, Lucknow but he died on 06.01.2002 due to heart failure. The Complainant pressed death claim of the Complainant by furnishing all the documents to the LIC but vide letter dated 11.11.2003 the OP No.1 and 2 repudiated the death claim of the Complainant’s husband on the ground that the Complainant’s late husband had made deliberate misstatement and withheld material information regarding his health status of chronic stable angina. The Complainant’s husband had never taken any treatment regarding the aforesaid disease nor did he suffer from any heart disease. In fact they came to know about the heart problem only when the deceased was admitted into KGMC on 05.01.2002. After the receipt of repudiation letter dated 11.11.2003 the Complainant as per instructions of OP No.1lodged her review petition before the Zonal Manager, LIC of India, North Zone, Kanpur. The Zonal Manager upheld the repudiation of OP No.1 and advised the Complainant to lodge claim with the office of ombudsman at Lucknow. The Complainant thereafter lodged claim with ombudsman at Lucknow but she did not get information from the insurance ombudsman regarding the settlement of the claim. In August, 2007 when the Complainant visited the office of the insurance

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ombudsman then she came to know that insurance ombudsman had rejected the claim of the Complainant on the ground that the insurance policy was assigned to United India Insurance Co. and it was not assigned to the Complainant, hence the Complainant had no right to claim. The Complainant was asked to submit the documents for reassignment so that the claim of the Complainant could be considered. Thereafter the Complainant obtained reassignment certificate in favour of the Complainant. Thereafter the Complainant requested the insurance ombudsman to settle the claim but in vain. The cause of action arose within the territorial jurisdiction of this Forum as the OP No.3 resides within the territorial jurisdiction of this Forum; besides the death took place at Lucknow and all the correspondence took place at Lucknow and the Complainant’s claim is still pending in insurance ombudsman at Lucknow and the Regional Office of LIC of India is also at Lucknow. Since the claim has not been allowed by the OP No.1 and 2, hence this complaint.

          The OP No.1 and 2 have filed the WS wherein they have mainly submitted that the claim is not allowed if the policy is taken on the basis of misstatement and concealment of material facts. The Complainant’s husband was medically examined in a routine manner and on the basis of the answers provided by the insured to the medical examiner. The policy could not have been reassigned by the United India Insurance Co. in favour of the Complainant. There is no cause of action for the complaint to be filed in this Forum as the insurance policy was issued by the city office of OP No.1 at Kanpur and the claim was repudiated by the Divisional Office of the Kanpur and the review was pressed in the Regional Office of the Kanpur and there is no Regional Office in Lucknow as is the contention of the Complainant. Since no cause of action has arisen in Lucknow, hence this Forum has no jurisdiction to entertain this complaint. The contract of insurance is based on utmost good faith and it is the duty of the proposer to provide

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correct information to the insurer. The medical examination of the proposer is based on information provided by the proposer only. The Complainant’s husband had died in KGMC, Lucknow on 06.01.2002 due to cardio respiratory arrest. The insured was ill for the last 6 months before filling the proposal form and doctors of Cardiology Department of CSJM wherein there is the mention of a chronic stable angina 2 years in d and [k of question number7. Since the Complainant’s husband had concealed these material facts while filling the proposal form, therefore there is breach of utmost good faith and hence the OPs have not committed any deficiency in service in repudiating the claim.

          The OP No.3 has filed the WS wherein it is submitted that the answering OP has not caused by mental tension and agony to the Complainant and that the complaint relates to deficiency in service on the part of OP No.1 who repudiated the insurance death claim of the Complainant’s husband, hence this case deserves to be dismissed against the answering OP No.3.

          Before going into the merits of the case it is essential to find out whether this complaint is barred by jurisdiction to file the complaint in this Forum or not?

          The OP No.1 and 2 have taken the stand that this case cannot be filed in this Forum as the cause of action has arisen only at Kanpur whereas the contention of the Complainant is that this Forum has the jurisdiction to deal with this case as the cause of action did arise at Lucknow. While scanning out the grounds for the cause of action to have arisen at Lucknow, we find that the Complainant has taken the stand that OP No.3 resides within the territorial jurisdiction of this Forum and that the death had occurred at Lucknow and that the correspondence took place at Lucknow and the office of the insurance ombudsman is also at Lucknow where the petition was filed by the Complainant. On the contrary, it is the stand

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of the OP No.1 and 2 that the insurance policy was taken at Kanpur. Besides death claim was rejected by the Divisional Office at Kanpur and that the Regional Office is also at Kanpur and not at Lucknow and it is on the basis of these grounds the jurisdiction of the Forum has been challenged.

          First of all, there is no cause of action against the OP No.3 and it appears that the OP No.3 has been arrayed just to invoke jurisdiction of this Forum at Lucknow. Actually the cause of action arises when the claim is repudiated by the Divisional Office i.e. OP No.1 which is situated in Kanpur. It is also interesting to note that the office of the Zonal Manager is also situated at Kanpur and while the Complainant talks about the Regional Office of Lucknow, it has been specifically stated by the OP No.1 and 2 that the Regional Office of the LIC is also situated at Kanpur and not at Lucknow. Again interestingly the jurisdiction on the basis of the office of the insurance ombudsman at Lucknow has been mentioned but it has not been made a party in this claim petition. It has been clearly held by the Hon’ble Supreme Court in Civil Appeal No.1560 of 2004 Sonic Surgical Vs National Insurance Co. Ltd. on 20.10.2009 that it is the office where the cause of action has arisen that should be made a party and not its branches which might be spreading in many parts of the country. Obviously, the cause of action has arisen only at Kanpur as not only the repudiating the office of the LIC is at Kanpur but also the reviewing authority was also at Kanpur. Therefore, there is no justification whatsoever for filing this complaint at Lucknow when the jurisdiction of this case falls within the jurisdiction of Kanpur only. Consequently, this Forum has no jurisdiction to dispose of this complaint, therefore this complaint deserves to be dismissed as this complaint is barred by jurisdiction.

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ORDER

          The complaint is dismissed. However, the Complainant can seek remedy before the appropriate Forum as per law.

          The parties to bear their own costs.

             (Anju Awasthy)                                      (Vijai Varma)

                    Member                                                 President

   Dated: 22    July, 2015