FA No.1332/2008 against CC.No.109/2007 District Consumer Forum-I, Visakhapatnam.

Between:

1.Bajaj

   Rep. by its Branch Manager,

   CBM Compound,

   Visakhapatnam.

2.Bajaj

   Rep. by its Divisional Manager,

   Divisional Office at Macmet Building,

   10B, Lee Road),

   Calcutta – 700 020.

…Appellants/And

Prasadi S/

Occ: Sheep Business,

R/o.D.No.4-160, Thummapala Village,

Anakapalle Visakhapatnam District.

…Respondent/Complainant.

Counsel for the Appellants        :     

Counsel for the Respondent      :     

QUORUM: THE HON’BLE MR.JUSTICE D.APPA RAO, PRESIDENT,

AND

SMT.M.SHREESHA

FRIDAY, THE TWENTY FOURTH DAY OF OCTOBER,

TWO THOUSAND EIGHT.

Oral Order (Per

*******

1.         Having heard the learned counsel for the appellants  we are of the opinion that this appeal could be disposed of at the stage of admission.

2.         This is an appeal preferred by the opposite parties Insurance Company against the order of the District Consumer Forum-I,

3.         The case of the complainant in brief is that his father late   While so, on 28.09.2003 the insured   Immediately, he was shifted to King George Hospital at Visakhapatnam, where he died on 30.09.2003.  The matter was informed to the police and a case in Crime No.37/2003 was registered.  Thereafter, the complainant submitted claim form enclosing the death certificate, FIR, post mortem certificate, etc.  However, the same was repudiated.  Therefore, he filed the complaint claiming the above mentioned amounts.

4.         The appellants Insurance Company resisted the complaint.  It alleged that the claim was repudiated on the ground that the deceased was aged 70 to 75 years and he was an illiterate.  Contrary to that, the proposal form bears his signature and his age was shown as 56 years. He was ailing for three months prior to his death.  His death was taken within forty days from taking the policy.  He has suppressed the material fact in regard to his age and health and other facts, and therefore, it prayed that the complaint be dismissed.

5.         In support of his case, the complainant filed his affidavit evidence and Exs.A.1 to A.6, while the opposite parties filed affidavit and Exs.B.1 to B.4.

6.         The District Forum after considering the evidence placed on record opined that there is a valid policy and the death was due to head injury, evidenced under Ex.A.3 post mortem certificate. The appellants could not prove that the deceased was aged more than 70 years or that he was ailing.  Therefore, directed the appellants to pay the amount covered under the policy together with compensation of Rs.12

7.         Aggrieved by the said decision, the Insurance Company preferred this appeal contending that the insured had played fraud by giving incorrect information as to his age and education and earning capacity.  Therefore, prayed that the appeal be allowed by dismissing the complaint.

8.         It is not in dispute that the appellants issued insurance policy valid from 12.08.2003 to 11.08.2004 in   It was a personal accident insurance policy.  It is also not in dispute that on 30.09.2003, he died in the King George Hospital at Visakhapatnam, evidenced under Ex.A.3 post mortem certificate.  In fact the complainant’s brother had given report, evidenced under Ex.A.1 FIR alleging that his brother had sustained head injury basing on which the crime No.37/2003 was registered.  The complainant made claim by furnishing all these documents in 2003.  Under Ex.B.2, which consists of two letters dated 17.12.2003 and   The repudiation is by virtue of the investigation said to have been made by a surveyor appointed by the Insurance Company, who submitted his report.  A perusal of Ex.B.4 shows that he did not obtain date of birth certificate from any competent authority.  Equally he did not obtain any certificate to show that the insured was illiterate.  All this was gathered from the   The statements that said to have been recorded by him were not signed by any of the persons.  It is all hearsay.  It is not known as to how the said statements would determine the age of the deceased or that he was an illiterate.  There is absolutely no proof that particulars furnished by him were incorrect.  It is a dubious report pressed into service to repudiate a just claim.  Obviously, the Insurance Company has been searching some ground or the other for repudiating the claim made by the complainant taking advantage that the complainant is a villager and might not be able to pursue the remedies.  It is not as though the Insurance Company did not want to pay any amount.  The letter dated 17.12.2003 is to the effect that “the policy mentioned above shall be cancelled with effect from 25.12.2003 and pro-rata refund of premium for unexpired period shall be sent to you shortly”.  They would not have paid even       

9.         The learned counsel for the appellants contended that the complaint was barred by limitation on the ground that it was not filed within a period of two years.  However, the fact remains that the investigator himself submitted his investigation report on 31.07.2004.  It shows that the Insurance Company itself has kept the matter without settling the claim.  Belatedly on 20.06.2004 a surveyor was deputed, though the death was on 30.09.2003.  The survey report has not been served on the appellant.  The complainant had issued a notice to the Insurance Company questioning the repudiation.  He filed the complaint in December, 2006.  We do not see how the limitation comes into effect.  These pleas are all taken to drag on the proceedings as long as possible.  We do not see any   Absolutely there are no merits in the appeal. 

10.       In the result, the appeal is dismissed at the stage of admission.  No costs.      

PRESIDENT              LADY MEMBER        

                                                              Dt