Andhra Pradesh

Visakhapatnam-II

CC/140/2013

Smt. Dandupati Rajulamma - Complainant(s)

Versus

Metlife Insurance Company Limited - Opp.Party(s)

V. Someswara Rao

03 Jul 2015

ORDER

                  Reg. of the Complaint:12-06-2013                                                                                                                                     Date of Order:03-07-2015

BEFORE THE DISTRICT CONSUMERS FORUM-II

AT VISAKHAPATNAM

                   Present:

1.Sri H.ANANDA RAO, M.A., L.L.B.,

       President

2.Sri C.V.RAO, M.A., B.L.,

                                             Male Member

3.Smt.K.SAROJA, M.A., B.L.,

       Lady Member

                                            

 

FRIDAY, THE 03^RD DAY OF JULY, 2015

CONSUMER CASE NO.140/2013

 

BETWEEN:

Smt.Dandupati Rajulamma W/o late Tata Rao,

Hindu, aged 50 years, R/o D.No.2-19,

Rickshaw Colony, Thumpala, Anakapalli,

Visakhapatnam District.

…Complainant

AND:

1. Metlife Insurance Company Ltd., rep. by its

Branch Manager, near Sampath Vinayaka Temple,

•  
• The Senior Manager, Metlife Insruance Co., Ltd.,

Chairman Claims (committee) Bridge Seshamahal,

5, Vani Vilas Road, Basavanagudi, Bangalore,

Karnataka State.

…Opposite Parties

 

This case coming on 09-06-2015 for final hearing before us in the presence of   Sri V.SARVESWARA RAO, Advocate for the Complainant, and of                                     SRI SANAPALA KARUNA & SMT.SAILAJA, Advocates for the Opposite Parties, and having stood over till this date for consideration, this Forum made the following.

 

ORDER

 (As per the Honourable President on behalf of the Bench)                                                                              

 

1. The Complainant filed the present complaint against the Opposite Parties, directing them to pay an amount of Rs.5,00,000/- being the policy amount on account of death of her husband with subsequent interest @ 24% p.a., from 19-01-2011 till the date of realization, a compensation of Rs.2,00,000/- and costs of Rs.1,00,000/-.
2. The case of the complainant in brief is that her husband Dandupati Tata Rao had obtained Life Insurance Policy bearing No. 20488104 from OP-1 Met Life India Life Insurance Company Limited for Rs.5,00,000/- on 19-01-2011 and the insured died on 01-05-2012 i.e., natural death and immediately the relevant papers and original policy bond submitted to 1^st OP to pay the death claim but they repudiated the claim under reply dated 30-11-2012 on the ground that  non discloser of material facts. Hence, this complaint.
3. The case of the OP denying the material averments of the complaint admitted that D.Appa Rao has obtained Insurance Policy from OP-1 for Rs.5,00,000/- and he died on 1-5-2012.  However, justified repudiation of the claim on the ground that the insurance was obtained due to the non disclosure of material facts. It is also their case during the course of the investigation conducted, it was established that the Deceased Life Insured has mis-stated his age in the proposal form, there was a variation found in the age mentioned in the proposal form and his age as per voter ID list and Adhar Card DLA’s age was found to be 65 years, and as per the ration card, the DLA was 55 years at the time of his death. Hence there is a difference of age found in the voter ID card,  Adar Card etc., and concluded that there is a mismatch of 10 years in the age of DLA.
4. To prove the case on behalf of the complainant, she filed her evidence affidavit and got marked Exhibits A1 to A6. On the other hand, on behalf of the OPs, they filed their evidence affidavit and got marked Exhibits B1 to B8.
5. Exhibit A1 is the  Letter addressed by the Opposite Parties to the complainant dated 30-11-2012, Exhibit A2 is the Death Certificate of Thatarao, dated 09-05-2012, Exhibit A3 is the Ration Card of the complainant, Exhibit A4 is the Pan Card of the deceased Thatarao, Exhibit A5 is the Proper Person certificate and Exhibit A6 is the Policy Bond.
6. Exhibit B1 is the copy of the proposal form along with supportive documents, Exhibit B2 is the Metlife claim intimation, Exhibit B3 is the Investigation Report, Exhibit B4 is the Repudiation Letter by the OP, Exhibit B5 is the met life insurance copy, Exhibit B6 is the Met life Claim Intimation, Exhibit B7 is the proposal form along with supportive documents and Exhibit B8 is the Letter by OP.
7. Both Parties filed their respective written arguments.

8.       Heard oral arguments from both sides.

9.       Now the point for determination to be determined in this case is;

Whether there is any deficiency of service on the part of the OPs and the Complainant is entitled to any reliefs asked for?

10.     It is evident as seen from record, the deceased life assured submitted proposal form for obtaining Life Insurance policy wherein he mentioned his date of birth as 10-06-1962. The OP accepted the age and issued the subject policy. Admittedly the deceased is an illiterate. Though he is a signatory there is no dependable evidence from the side of OP that the contents of the proposal and the Annexures said to have been given by the life assured was read over and explained to him and that having understood the same, he put his signature in token of acceptance of the said contents. When the contents are in foreign language and also the proposed is only a signatory, it is bounden duty of the Insurance Company to establish that the men of the proposer accompanied the contents of the said proposal form and that he duly put his signature after knowing the details mentioned in the proposal form. The OP did not adduce or produce evidence in the said context and therefore, basing on the information mentioned in the proposal form, it is not desirable to believe that the deceased life assured suppressed his age and obtained the said policy fraudulently knowing fully well that it was false.

11.     It is held in Mithalal Nayak vs. Life insurance Corporation of India reported in 1962 SC 814 wherein it is held by the law of the land that it is not desirable to hold that the deceased life assured deliberately and fraudulently made false statement with regard to his age. It is common knowledge that the agents in order to improve the business of the Insurance company take active role in filling up the contents of the proposal form and obtain signature or thumb impression of purely educated persons and literates and therefore, no credence need to be given in the contention of the OP that the deceased life assured had given wrong declaration regarding his age at the time of submitting the proposal. Basing on Exhibit B3 and B7 that is the Investigation Report after verifying Voter Card, Aadhar Card, Pan Card, the OP contended that the deceased was shown his age at the time of issuance of policy but when the complainant submitted his documents, the complainant had investigated the claim and found his age as on the date of the death. Except the contents that the age, the other details of Exhibits B3 and B7 are not legible and readable and there is no dependable evidence from the side of the OP that it is true and genuine document. Merely because it is unauthorized as such Photostat copies with the original verified by the person who attested it, the same would not helpful for the OP to say that there is suppression of material fact regarding the age by the deceased life assured.

12.     It is common knowledge that when enumerators go to seek information for enrolling voters and also for preparing ration cards etc., only approximate age will be described by the inmates of the house and sometimes the enumerators mentioned approximate age of the inmates and therefore household card and voter IDs are not at all conclusive proof to decide the correct age of the deceased life assured and therefore, the documents relied upon by the OP in respect of the age of the deceased which no way helpful to the case of the OP. Thus, the contention of the OP that the deceased life assured suppressed his real age and obtained said policy fraudulently for wrongful gain etc., cannot be appreciated in his favour.  For all these reasons, the claim of the complainant deserves to be allowed.

13.     Now the question that comes up for consideration, at this stage of our discussion is, what is the rate of interest for which the Complainant is entitled.   The rate of interest claimed by the Complainant is 24% p.a.  This rate of interest claimed by the Complainant appears to be excessive, of course, it is a fact that the transaction covered by Ex.A6 is commercial in nature, but that does not and cannot mean to say that the Complainant is licensed to claim interest @ 24% p.a. from 19-01-2011.  But at the same time, it is imperative on our part to award a reasonable interest.   Having regard to all these facts and circumstances, we sincerely feel having considered the case on hand awarding of interest @ 9% p.a. would better serve the ends of justice.    Consequently, we proposed to fix the rate of interest @ 9% p.a. on Ex.A 1 i.e., Repudiation letter in question.   Accordingly interest is ordered.

14.     Whether the Complainant is entitled for compensation of Rs.2,00,000/- is to be considered.   It appears as seen from the evidence of Complainant that the Complainant was compelled to approach the Opposite Parties and therefore experienced a lot of physical strain besides mental agony and financial loss. It is an un-disputed fact that the Opposite Parties did not pay the sum assured to the complainant.   Naturally, that might have put the Complainant to suffer some mental agony besides physical stress and strain.   In this view of the matter, we sincerely feel that it is a fit case to award compensation.   But that does not and cannot mean to say that the Complainant claim for compensation is acceptable.    Having regard to all these facts and circumstances, we are of the considered opinion, award of compensation of 25,000/- would serve the ends of justice.   We therefore, proposed to award compensation of Rs.25,000 /-,  in the circumstances of the case on hand. Accordingly this point is answered.

15.     Before parting our discussion, it is incumbent and imperative on our   part to consider the costs of litigation.    The Complainants ought         not have to approach this Forum had his claim for payment of Rs.5,00,000/- or reliefs sought for have been honored by the Opposite           Parties within a reasonable time and in view of the matter, the Complainant’s claim for costs deserves to be allowed.   In our      considered and unanimous opinion awarding a sum of Rs.2,500/- as       costs would appropriate and reasonable.   Accordingly costs are           awarded.

16.     In the light of our discussion, referred supra, the complainant is entitled to receive the sum of Rs.5,00,000/-  with interest for the said sum @ 9% only from December, 2012, compensation of Rs.25,000/- and costs of Rs.2,500/-.

17.     In the result, this complaint is allowed in the part directing the opposite parties to pay an amount of Rs.5,00,000/- (Rupees Five Lakhs only) with subsequent interest @ 9% p.a, from December, 2012 till the date of realization, Rs.25,000/- (Rupees Twenty Five Thousand only) towards compensation and Rs.2,500/- (Rupees Two thousand and five hundred only) towards costs to the complainant. Time for compliance, one month from the date of this order.

Dictated to the Stenographer, transcribed by him, corrected and pronounced by us in the open Forum, on this the 03^rd day of July, 2015.      

 

Sd/-                                                     Sd/-                                     Sd/-                           

LADY MEMBER                            MALE MEMBER                        PRESIDENT  

    

APPENDIX OF EVIDENCE

  For the Complainant:-

Exhibits	Date	Description	Remarks
A1	30-11-2012	Letter addressed by the Opposite Parties to the complainant	Original
A2	09-05-2012	Death Certificate of Thata Rao	Original
A3		Ration Card of the complainant	Attested copy
A4		Pan Card  of the Thata Rao	Attested Copy
A5		Proper person Certificate	Photocopy
A6		Policy Bond	Original

 

For the Opposite Parties:-                                                       

Exhibits	Date	Description	Remarks
B1		Proposal form along with supportive documents	Photocopy
B2		Metlife claim intimation	Photocopy
B3		Investigation Report	Photocopy
B4		Repudiation Letter	Photocopy
B5		Metlife insurance bond	Photocopy
B6		Met life Claim Intimation,	Photocopy
B7		proposal form along with documents	Photocopy
B8		Letter by OP.	Photocopy

 

          Sd/-                                           Sd/-                                       Sd/-

LADY MEMBER                            MALE MEMBER                        PRESIDENT