STATE CONSUMER DISPUTES REDRESSAL COMMISSION
BIHAR, PATNA
(Appeal No.19 of 2016)
S.B.I Life Insurance company Ltd
Central proceeding centre, 2nd
Floor, Kapas Bhavan, Plot No.3,
Sector-10, CBD Belapur,
Navi Mumbai and others Appellant.
VERSUS
Baijnath Tanti, S/O- Bisan Tanti and
Ashashree mentures corporate
Agen, SBI Life Insurance Company Ltd.
Bhikanpur Gumti Tampa-1,
Jegdeek, Bhagalpur and others Respondents.
BEFORE,
Hon’ble Mr. Justice S.K.Sinha, President,
Hon’ble Sri Upendra Jha, ADM(Rtd), Member and
Hon’ble Smt. Renu Sinha, member (F)
ORDER
25.05.2017
Upendra Jha Member(M).
This appeal is against the order dated 16.12.2015 passed by the District Forum, Bhagalpur in complaint case no. 13 of 2014 by which the appellants are directed to pay the respondent complainant sum of Rs. 3,00,000/- with 9% interest from the date of death i.e. 12 .03.2013. Rs. 5000/- as compensation and Rs. 1000/- by way of litigation cost within 30 days.
2. Brief facts of this case is that the brother of the complainant –Respondent Raju Kumar Tanti obtained two polices of Rs. 2,00,000/- on 03.05.2011 and Rs. 1,00,000/- on 2.06.2011 in which the complainant is the nominee. The life assured died on 12.03.2013.The nominee claimed the insurance amount with relevant documents which was repudiated by the appellants and the premium amount was returned to the complainant. The complainant filed a complaint before the District Forum. The opposite parties – appellants contested the case. The District forum passed the impugned order against which this appeal is preferred.
3. On being noticed, the respondent- complainant has filed written arguments, Heard the parties.
4. The District Forum finding deficiency in service on the part of the opposite parties- appellants for not paying the insurance amount to the nominee, has allowed the claimed amount and passed the impugned order.
5. The grounds taken is appeal is that the life assured had suppressed the materials facts at the time of revival of policies as such there is no deficiency in the part of appellants and rightly has repudiated the claim of the complainant. The District Forum has allowed the complaint on the basis of photocopies of medical records of the life assured which were produced by the appellants and original documents were not produced. Appellants have neither examined the doctor and the medical reports. However, the Forum allowed the complaint. Before revival of the lapsed policies, the life assured was suffering from pulmonary Tuberculosis . The Hon’ble Apex Court in the case of Satwant Kumar Sandhu Vs. New India Assurance company Ltd has held that non-examination of Doctors on oath does not invalidate the evidence. But the District Forum has not considered the points raised by the opposite parties – appellant regarding the evidence on oath by the Doctor. Thus, the order under appeal is not sustainable and it is fit to be set aside. The appeal be allowed.
6. The counsel for the respondent complainant submits that the onus of proving the pre-existing disease if any of the life assured lies on the insurance company and not on the claimant. The opposite parties have not produced the originals of documents of treatment Card. The opposite parties have filed simply photocopies. Doctor who treated the life assured has not been examined. The District forum considering all facts and materials produced by the opposite parties has allowed the claimed amount which is proper and justified. It needs not be interfered. The appeal has no merit. It is fit to be dismissed.
7. Having considered the grounds taken in appeal, submissions of the parties and on perusal of the order passed by the District forum, it appears that the district forum has analysed the matter in details and has considered the matter in right perspective. The opposite parties – appellants have not produced the original documents of the treatment card of the life assured prior to take the policy. Evidence on affidavit has not been taken of the doctor who treated the life assured as alleged by the appellants. The reason for repudiation has not been substantiated by the opposite parties – appellants. There is no evidence to prove the allegations which is essential under section 13 of (4) of the Consumer Protection Act 1986. We find the District Forum order proper and justified and there is no reason to take a different view in this matter. Hence the District Forum order is affirmed and the appeal stands dismissed.
S.K. Sinha Renu Sinha Upendra Jha
President Member(F) Member(M)
Mukund
