Karnataka

Chitradurga

CC/55/2017

Honnur Ali P.H. - Complainant(s)

Versus

Manager Life Insurance Corporation - Opp.Party(s)

G.R. Suresh.

27 Mar 2018

ORDER

COMPLAINT FILED ON:05/06/2017

DISPOSED      ON:24/05/2018

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, CHITRADURGA.

 

CC.NO: 55/2017

 

DATED:  24^th MAY 2018

PRESENT: - SRI. T.N. SREENIVASAIAH  : PRESIDENT                                   B.A., LL.B.,

                   SRI.N. THIPPESWAMY        : MEMBER

                          B.A., LL.B., PGD., CLP   

 

……COMPLAINANT/S	Sri. Honnur Ali P.H, S/o P.H. Honnur Sab, Age: 25 Years, Pennammanahalli Village, Thimmalapura Post, Molakalmuru Taluk, Chitradurga.   (Rep by Sri. G.R. Suresh, Advocate)
V/S
…..OPPOSITE PARTIES	1. Life Insurance Corporation of India, Claims Department, Divisional Office, Jeevana Prakasha, 100 Feet Road, Gopalagowda Extension, Shimoga.   2. The Branch Manager, LIC of India, Claims Department, Branch Office, Challakere.   3. Sri Shivamurthi, LIC Agent, C/o LIC Agency Code No.0033062L, Challakere LIC Office.   (Rep by Sri.L. Madhusudhan, Advocate for OP No.1 and 2 and Sri.Y.Thippeswamy, Advocate for OP No.3)

ORDER

SRI. T.N. SREENIVASAIAH:   PRESIDENT

The above complaint has been filed by the complainant u/Sec.12 of the C.P Act, 1986 for the relief to direct the OPs to pay       Rs.2,00,000/-, the sum assured under the policy with interest and Rs.20,000/- towards mental agony and pain and such others reliefs.

2.      The brief facts of the case of the above complainant are that, his father by name P.H. Honnur Sab has obtained new endowment policy bearing No.0033062L from OP No.3, who is an agent through OP No.1 for a sum assured amount of Rs.2,00,000/- for a period from 19.03.2014 to 19.03.2033 at yearly premium of Rs.11,305/-.  The father of the complainant has paid premium amount to OP No.1 through OP No.3 for three years.   The said P.H. Honnur Sab, the father of the complainant died on 11.04.2016, the same has been intimated to the OP No.1 through OP No.3 by the complainant and approached the OP No.1 so many times for settlement of the claim under the policy.  But, the OP No.1 has repudiated to settle the claim on the ground that, the father of the complainant has completed the age of 60 years at the time of obtaining the policy and the new endowment policy is applicable only to below the age of 55 years.  The contention taken by the OP is that, the complainant has produced the certificate issued by the Head Master, Government Lower Primary School, Venkatapura, Molakalmuru showing that, the date of birth of the said P.H. Honnur Sab is 01.06.1964.  The cause of action for this complaint arose when the complainant issued the legal notice to the OPs on 08.05.2017 and the same has been served to the OPs.  After service of the notice, they have not settled the claim, which is a deficiency in service and hence, prayed for allow the complaint.  

    3.  After issuance of notice to the OPs, OP No.1 and 2 appeared through Sri. L. Madhusudhan, Advocate and filed version stating that, the complaint filed by the complainant is not maintainable either in law or on facts and the same is liable to be dismissed in limine.  Further it is admitted that, one Sri. Shivamurthy D.R is the agent of our Challakere branch with agency Code No.33062L canvassed and procured a proposal for insurance from late P.H. Honnur Sab.  At the time of submitting the proposal for insurance, the deceased had submitted his age proof by way of school certificate issued by the Head Master, Government Lower Primary School, Venkatapura, Molakalmuru with Admission No.14/69-70 wherein his date of birth is mentioned as 01.06.1964 and the age was 50 years.  Further it is submitted that, the above said Honnur Sab is having three children with their age as 31, 29 and 27 years.  The OP No.1 and 2 considered the proposal based on the age proof submitted by the deceased is accurate and issued policy No.668826990 for a sum assured of Rs.2,00,000/- with date of risk 19.03.2015.  At para 3 of the complaint that, the death intimation under the above policy from nominee i.e., the complainant who is the son of policy holder, informing the death of the life assured with date of death as 11.04.2016 mentioning the cause of death as subsequent developments of ill health due to accident which has taken place on 13.12.2014 for which Police case is not registered.  As the death is within 3 years from the proposal and section 45 of the Insurance Act was applicable.  During the investigation came to know that, the age of the life assured was knowingly mentioned as 50 years even when he was of 61 years.  The School Authorities have confirmed that, the school certificate submitted by the deceased Honnur Sab was fake.  The School Authorities have given a letter dated 04.12.2017 confirming that, on verification of the admission register, there is no entry in the name of Honnur Sab S/o Raja Sab and the R.No.14/1969-70 was not issued by them.  OP No.1 and 2 have the Voter ID Card No.KT/7/087037 of the deceased, as per the same, the age of the deceased life assured was 61 years as on the date of proposal for the above policy.  Further it is submitted that, if the age is exceeds 55 years, this plan cannot be given as per NB Circular Ref: CO/PD/43 dated 01.01.2014.  In the proposal, the deceased nominated his son Sri. Honnur Ali P.H mentioning his age as 25 years.  The nominee Honnur Ali P.H is having life insurance policy No.657054438 wherein it was mentioned that his date of birth as 01.06.1983.  According to this date of birth the nominee under the complaint policy is 31 years and not 25 years.  OP No.1 taken a main contention that, at the time of obtaining the policy, the age of the deceased P.H. Honnur Sab was 61 years and not 50 years and on the basis of fake certificate issued by the School Authority, the complainant has filed this complaint seeking remedy so, it is not maintainable under law and prays for dismissal of the complaint. 

4.  OP No.3 appeared through Sri.Y.Thippeswamy, Advocate and filed version stating that, the father of the complainant has obtained new endowment policy through him on 19.03.2014 and the said policy is a yearly premium paid policy of Rs.11,305/- for a sum of Rs.2,00,000/-.  The said P.H. Honnur Sab has paid three installments at Rs.11,305/- p.a to the OP No.1 through him.  The said P.H. Honnur Sab was died on 11.04.2016.  The further allegations made by the complainant under his complaint that, the OP No.3 has bring the certificate from the Government Lower Primary School, Venkatapura, Molkalmuru is not correct.  Further denied that, the complainant has issued any legal notice to him and the complainant has not demanded to claim under the policy from OP No.1 and the complainant is not entitled for any claim under the policy obtained by the deceased P.H. Honnur Sab and there is no deficiency in service on the part of OP No.3 and prayed for dismissal of the complaint.

5.      The complainant himself has examined as PW-1 by filing affidavit evidence and the documents Ex.A-1 to A-9 were got marked and closed his side. On behalf of OP No.1 and 2, one Sri.B. Shamanna, A.O of the LIC, Branch Office, Chitradurga has examined as DW-1 by filing the affidavit evidence and Ex.B-1 to B-13 documents have been got marked and closed their side.  OP No.3 has not filed any affidavit and never produced any documents to disprove the case of the complainant.      

6.      Arguments of both sides heard.

7.      Now the points that arise for our consideration for decision of above complaints are that;

 

1. Whether the complainant proves that, OP No.1 has failed to settle the claim under the new endowment policy and committed deficiency in service and entitled for the reliefs as prayed for in the above complaint?

              (2) What order?

          8.      Our findings on the above points are as follows:-

          Point No.1:- Partly in Affirmative.

          Point No.2:- As per final order.

 

REASONS

9.      It is not in dispute that, the father of the complainant by name P.H. Honnur Sab has obtained the new endowment policy No.668826990 from the OP No.1 by paying yearly premium amount of Rs.11,305/-.  At the time of obtaining the policy, the said P.H. Honnur Sab has produced the Certificate issued by the Head Master, Government Lower Primary School, Venkatapura, Molkalmuru with Admission No.14/69-70 wherein his date of birth is mentioned as 01.06.1964 and the age was 50 years.  After payment of three installments, the said P.H. Honnur Sab was died on 11.04.2016.  Thereafter, the complainant has claimed the policy amount from the OP insurance company.  OP No.1 and 2 have filed their objections stating that, at the time of obtaining the policy, the said P.H. Honnur Sab has suppressed the real facts stating that, his age is 50 years.  But, the correct age of life assured was 61 years at the time of obtaining the policy as per the ID produced by the OPs 1 and 2.  They have accepted the policy of deceased P.H. Honnur Sab through OP No.3.  At the time of accepting the policy, the OP No.1 and 2 never raised any objections as to whether the age of the life assured is 50 years or 61 years.  After the death of life assured, the OP No.1 and 2 have raised this objection.  The main contention of the OP No.1 and 2 is that, the certificate produced by the deceased P.H. Honnur Sab at the time obtaining the policy is a fake certificate but, the certificate issued by the School Authority on 04.03.2014 has been accepted by the insurance authority at the time of issuing the policy and now they have raised this objection.  Now the OPs have no right to object the same.  When the OPs have admitted and issued the policy, the question of repudiation in compensating the claim under the policy does not arise.  The Ex.B-5 produced by the OPs obtained by the Head Master, Government Lower Primary School, Venkatapura stating that, P.H. Honnur Sab was not a student of their School and the admission number as mentioned in the Ex.A-1 is no way concerned to the deceased P.H. Honnur Sab, the same has been obtained by the OP No.1 on 04.01.2017.  The certificate was accepted by the OP No.1, the same was issued by the School Authority on 04.03.2014.  OP No.1 and 2 have simply keep quite from the date of issuance of the policy till today.  Now after the death of life assured, have raised this objection stating that, the certificate issued by the School Authority is a fake certificate, the same cannot be considered at this stage.  When once the policy is accepted, the question of repudiation is not sustainable at this stage. 

10.    We have gone through the entire documents and affidavits filed by the complainant and the OPs.  According to the complainant, his father has obtained new endowment insurance policy from the OP No.1 under policy No.668826990 for a sum assured amount of Rs.2,00,000/- on yearly premium amount of Rs.11,305/- commencing from 19.03.2014.  At the time of obtaining the policy, the father of the complainant has produced the certificate obtained from the concerned authority as per Ex.B-2 i.e., the date of birth of deceased P.H. Honnur Sab on 01.06.1964, by that time, the OP No.1 and 2 have accepted the certificate issued by the concerned authority and issued policy in favour of deceased P.H. Honnur Sab.  After obtaining the policy from the father of the complainant, they have received three instalments.  The father of the complainant died on 11.04.2016.  After the death of above said P.H. Honnur Sab, the complainant has filed the requisition before the OP No.1 and 2 for settlement of the claim, by that time, the OP No.1 and 2 have taken a contention that, the certificate produced by the father of complainant at the time of obtaining the policy is a fake certificate.  After a lapse of three years, the OP No. 1 and 2 have raised this objection.  If the deceased P.H. Honnur Sab was died after the maturity of the policy issued by OP No.1 and 2 they will not raise this objection because, the OPs have keep quite nearly for three years from the date of issue of the policy.  Now they raised this objection after the death of policy holder, the same is not sustainable under law.  As per the exhibits produced by the complainant, the father of the complainant has obtained the policy from OP No.1 and 2 and paid the premium continuously without fail and hence, they are liable to pay the insurance amount.  Complaint as against OP No.3 is liable to be dismissed as he is only an agent working on commission basis.  Hence, the complainant is entitled for the insurance amount of his father.   Accordingly, this Point No.1 is held as partly affirmative to the complainant.          

            11.     Point No.2:- As discussed on the above point and for the reasons stated therein we pass the following:-

ORDER

            The complaint filed by the complainant U/s 12 of CP Act 1986 is hereby partly allowed.

            It is ordered that the OP No.1 and 2 are hereby directed to pay a sum of Rs.2,00,000/- to the complainant, the sum assured amount under the new endowment policy plan obtained by the deceased father of the complainant along with interest @ 9% p.a from the date of complaint till realization.

            It is further ordered that, the OP No.1 and 2 are hereby directed to pay Rs.10,000/- towards mental agony and Rs.5,000/- towards cost of the proceedings to the complainant. 

            The complaint filed as against OP No.3 is hereby dismissed.

            It is further ordered that, the OPs are hereby directed to comply the above order within 30 days from the date of this order.

 (This order is made with the consent of Member after the correction of the draft on 24/05/2018 and it is pronounced in the open Court after our signatures)         

 

                                     

 MEMBER                                                   PRESIDENT

 

-:ANNEXURES:-

Witnesses examined on behalf of Complainant:

PW-1:  Complainant by way of affidavit evidence.

Witnesses examined on behalf of OP:

DW-1:  Sri.B. Shamanna, A.O of the LIC, Branch Office, Chitradurga by way of affidavit evidence. 

 

Documents marked on behalf of Complainant:

01	Ex-A-1:-	Legal notice dated 08.05.2017
02	Ex.A-2:-	Policy Bond
03	Ex-A-3:-	Letter dated 01.02.2017 by the OP to complainant
04	Ex-A-4:-	Death Certificate
05	Ex-A-5:-	Election ID
06	Ex-A-6:-	Ration Card
07	Ex-A-7:-	2 Postal acknowledgements
08	Ex-A-8:-	Postal Acknowledgement and postal receipt
09	Ex-A-9:-	2 Postal receipts

 

Documents marked on behalf of OPs:

01	Ex-B-1:-	Proposal Form
02	Ex-B-2:-	Certified copy of age proof
03	Ex.B-3:-	Voter ID
04	Ex.B-4:-	Policy bond
05	Ex.B-5:-	Letter issued by H.M, HPS, Venkatapura
06	Ex.B-6:-	Policy bond
07	Ex.B-7:-	Proposal Form
08	Ex.B-8:-	Form No.3260 and 5096
09	Ex.B-9:-	FDL No.2759/04-05
10	Ex.B-10:-	Ration Card
11	Ex.B-11:-	Voter ID
12	Ex.B-12:-	Letter of Sanjeevini Hospital to Sub-Inspector of Police, Rayadurga
13	Ex.B-13:-	Charge Sheet

 

 

 

MEMBER                                                            PRESIDENT

Rhr**