Orissa

Cuttak

CC/33/2022

Saralabala Dash - Complainant(s)

Versus

Manasger,Bharati Axa Life Insurance Co Ltd - Opp.Party(s)

S Swain & associates

03 Nov 2022

ORDER

IN THE COURT OF THE DIST. CONSUMER DISPUTES REDRESSAL COMMISSION,CUTTACK.

                                    C.C.No.33/2022

 

Saralabala Dash,

W/O:Purna Chandra Dash,

At:Plot No.811, Mahanadi Vihar,PO:Nayabazar,

Cuttack Sadar,Dist:Cuttack,Pin-753004.                                    ... Complainant.

 

                                                Vrs.

1.        Bharati AXA Life Insurance Company Ltd.

Represented through its Manager Customer Care,

Spectrum Tower,3^rd Floor,Malad Link Road,

Malad(West),Mumbai-400064,Maharashtra.

 

2.       Bharati AXA Life Insurance Company Ltd.,

Represented through its Branch Manager,

Link Road,At/PO:Madhupatna-753009,Dist:Cuttack.            ... Opp. Parties.

 

 

Present:               Sri Debasish Nayak,President.

                                Sri Sibananda Mohanty,Member.

 

Date of filing:      07.03.2020

Date of Order:   03.11.2022

 

For the complainant:          Mr. Sidhartha Swain,Adv. & Associates.

For the O.Ps  :                                   None.

 

Sri Debasish Nayak,President.                                                              

            Case of the complainant bereft unnecessary details as made out from the complaint petition in short is that she is the nominee/beneficiary for the policy undertaken by her deceased son Chandan Dash from the O.Ps vide policy no.50-9772481.  The said policy was for 24 years and the sum assured was of Rs.3,00,714/- with the premiums payable @ Rs.24,539.98p for 12 years.  Chandan Dash had died on 13.7.21 due to Cardiac Respiratory Failure.  Subsequently the complainant being the mother and nominee/beneficiary had made her claim for the insurance amount since because the insurance as undertaken by her son was in force then.  The O.Ps repudiated her claim on the plea of suppression of the material facts that her son was suffering from Cancer of Buccal Mucaso as diagnosed in the month of February,2018 and that he had undergone Chemotherapy and Radiotherapy for the same.  The letter of repudiation as sent by the O.Ps dt.30.10.21 was received by the complainant on 8.11.21.  According to the complainant, the death of her son  was due to Cardiac Respiratory Failure which has no nexus with Cancer.  The complainant had made her representation again to the O.Ps and ultimately when nothing fruitful had yielded, she had to approach this Commission claiming the sum assured amount of Rs.3,00,714/-from the O.Ps, alongwith interest thereon @ 12% per annum from the date of repudiation till the total amount is quantified.  She had further claimed compensation towards her mental agony to the tune of Rs.50,000/- from the O.Ps alongwith cost of her litigation to the tune of Rs.20,000/-.

            She has filed copies of certain documents in order to prove her case.

2.         Having not contested this case, both the O.Ps were set exparte vide order dt.27.6.22.

3.         The points for determination are as follows:

i.          Whether the case of the complainant is maintainable ?

            ii.         Whether there was any deficiency in service on the part of the O.Ps ?

            iii.        Whether the complainant is entitled to the reliefs as claimed ?

 

            Admittedly, the complainant is the mother of the deceased Chandan Dash who had expired on 13.7.21.  The said deceased Chandan Dash had obtained one “Bharati AXA Life Monthly Advantage Individual-Non Linked-Par product” policy from the Opposite parties which was in force on the date the deceased Chandan Dash had expired.  The O.Ps through their repudiation letter to the complainant had mentioned that the case of the insured deceased Chandan Dash was a re-occurent of Cancer of Buccal Mucaso that which was diagnosed in the month of February,2018 and for which he had undergone Chemotherapy and Radiotherapy.  Thus, it is made out that the O.Ps disbelieve the cause of the death of the deceased Chandan Dash to be of Cardiac Respiratory Failure.  Having not contested this case and by not filing any scrap of document in order to convince and apprise this Commission, the plea of the O.Ps as taken by them through their repudiation letter and communicated to the complainant; do not suffice.  And when the claim of the complainant was repudiated disbelieving the cause of the death of her son to be of Cardiac Respiratory Failure without any basis or evidence by the O.Ps it goes to show that the O.Ps had committed deficiency in their service infact.  Accordingly, this point goes in favour of the complainant.

Points no.i & iii.

            From the discussions as made above, the case of the complainant is maintainable and the complainant is entitled to the reliefs as claimed.  Hence, it is so ordered;

                                                            ORDER

            The case is allowed exparte against both the O.Ps of this case who are found to be jointly and severally liable.  The O.Ps are thus directed to settle the claim as made by the complainant to the tune of Rs.3,00,714/- alongwith interest thereon @ 12% per annum with effect from 30.10.21 till the total amount is quantified.  The O.Ps are further directed to pay a compensation of Rs.50,000/- to the complainant towards her mental agony and harassment and also to pay the cost of the litigation of the complainant to the tune of Rs.20,000/-.

Order pronounced in the open court on the 3^rd  day of   November,2022 under the seal and signature of this Commission.           

                                                                                                                                Sri Debasish Nayak

                                                                                                                                            President

                       

                                                                                                                                                          Sri Sibananda Mohanty

                                                                                                                                          Member