Tamil Nadu

StateCommission

A/79/2023

Premerica Life Insurance Ltd., - Complainant(s)

Versus

Mrs.Jeeva, W/o Late Vasudevan & Anr. - Opp.Party(s)

V Samuthiravihayan

31 Mar 2023

ORDER

IN THE TAMILNADU STATE CONSUMER DISPUTES REDRESSAL COMMISSION, CHENNAI - 3.

 

BEFORE    Hon’ble THIRU. JUSTICE  R. SUBBIAH               ::      PRESIDENT                       

                   Thiru.R VENKATESA PERUMAL                         ::      MEMBER

 

F.A. No.79/2023

 

(Against the Order made in C.C.No.18/2021 dated:13.06.2022 on the file of the

D.C.D.R.C., Krishnagiri)

 

TUESDAY, THE 31^ST DAY OF MARCH 2023

 

The Deputy Manager (Claims),

Pramerica Life Insurance Limited,

(Erstwhile known as DHFL Pramerica Life Insurance Co. Ltd.),

Having its registered office at:

4^th Floor, Building 9, Tower B,

Cyber City, DLF City Phase – III,

Gurgaon,

Haryana – 122 002.                                                  ..  Appellant / 2^nd Opposite party. 

-Versus-

1. Mrs. Jeeva,

W/o. Late Vasudevan,

No.3/55, Nanjappa Gounder Street,

Nallakathalhalli Village (Via) Kadathur,

Pappireddipatti Taluk,

Dharmapuri District.                                                 .. 1^st Respondent  / Complainant.  

 

2. The Branch Manager,

IndusInd Bank,

Seelanayakanapatti Branch,

Salem – 636 006.                                            ... 2^nd Respondent  / 1^st Opposite party. 

 

Counsel for the Appellant / 2^nd Opposite party            : M/s. V. Samuthiravijayan

Counsel for the 1^st Respondent  / Complainant           : M/s. A. Feroz Bathru Kadiri

Counsel for the 2^nd Respondent  / 1^st Opposite party  : M/s. R. Gopinath

 

This appeal coming before us on various dates and for final hearing today on 31.03.2023 and on hearing the arguments of both parties and on perusing the material records, this Commission made the following Order in the Open Court:-

 

ORDER (Open Court)

Thiru. R VENKATESA PERUMAL , MEMBER                       

1.     The 2^nd opposite party before the District Commission is the appellant herein.    

2.         For the sake of convenience and brevity, the parties are referred to here as they stood arrayed in the District Consumer Disputes Redressal Commission, Krishnagiri.

3.         The case of the respondent before the District commission is that the husband of the complainant was the customer of the 1^st opposite party.  He availed Home Loan on 31.07.2019 to the tune of Rs.8,00,000/- with the floating interest at the rate of 11.5% p.a. from the 1^st opposite party.  Again he availed an additional loan on 18.09.2019 for a sum of Rs.6,30,000/- with the floating interest at the rate of 11.25% p.a.  After availing the loan, the complainant’s husband periodically paid the EMI without any default.    The 1^st opposite party was having a tie up with the 2^nd opposite party insurance Co. Ltd. and acted as an agent as well as the master policy holder to insure the loan customers and take loan indemnification policies in case of any unforeseen happened to the customer of the 1^st opposite party.   Likewise, at the time of sanctioning the loan, the 1^st opposite party asked the complainant’s husband to have a loan indemnification policy with the DHFL Pramerica Group Credit Life Insurance Policy who is the 2^nd opposite party.  The complainant’s husband also accepted to take the said policy to safeguard his family.  But the opposite party did not conduct any medical check-up to the complainant’s husband but obtained signatures in the bank proposal form and fill up by ticking necessary columns and issued the policy for the complainant’s husband along with the loan application form and loan agreement booklet etc.  After availing the loan of Rs.9,60,054/-, the complainant’s husband paid the EMIs without any default.    While so on 26.06.2020, the complainant’s husband suffered an illness and died on the same day.  When the claim was made by the complainant, the 2^nd opposite party repudiated the claim on flimsy grounds stating that there is a suppression of the material facts.  It is the duty of the insurance company to subject the insured with their Local Panel Doctor and to conduct a Medical test before issuance of the policy.   But they have not done so. Hence finally, the complainant has filed the present complaint alleging deficiency in service claiming Rs.9,60,054/- being the sum assured, Rs.5,00,000/- towards compensation for mental agony, stress etc and the cost of proceedings.   

4.         Though notice has been served on the 2^nd opposite party, he did not appear before the District Commission.  Hence, the 2^nd opposite  party was set exparte and the complaint was allowed directing the 2^nd opposite party to pay a sum of Rs.9,62,054/- being the sum assured, Rs.2,00,000/- towards compensation for mental agony with interest at the rate of 9% p.. and  cost of Rs.10,000/- towards litigation expenses.

5.         Aggrieved over the said order, this appeal is preferred by the 2^nd opposite party for setting aside the order and for a chance to contest the case on merits.

6.         The Learned Counsel for the appellant would contend that the complainant’s husband was suffering diabetics but he has not disclosed the same in the proposal form.  Therefore it is a clear suppression of material facts.  Therefore, there is no deficiency in service on the part of the opposite party.   The opposite party is having a fair chance to succeed the complaint.   The non-appearance of the appellant / 2^nd opposite party is neither wilful nor wanton but due to the reasons beyond the control.  Thus, the appellant is having valid defence in this case. Thus, he prayed for an opportunity to contest the case on merits.

7.         We have heard the submissions on the side of appellant and perused the materials placed on record. 

8.         Having considered the submissions made by the learned counsel for appellant, we are of the considered opinion that there is some force in the arguments of the appellant/ 2^nd opposite party and therefore, a chance may be given to the 2^nd opposite party to agitate their right on merit.  Though there is a lethargic attitude on the part of the opposite party in appearing before the District Consumer Commission, in the interest of justice, we are inclined to allow this appeal on imposing a sum of Rs.3,000/-  as cost to the Legal Aid Account of the State Commission by way of Demand Draft drawn in favour of the Registrar, State Commission, Chennai, which condition was also complied with.   Hence, this appeal is allowed today by remanding back the complaint to the District Commission for fresh disposal according to law. 

            In the result, the appeal is allowed by setting aside the order of the District Commission, Krishnagiri in C.C. No.18/2021 dt.13.06.2022 and the matter is remanded back to the District Commission, Krishnagiri for fresh disposal according to law on merit.

The parties are directed to appear before the District Commission, Krishnagiri on 28.04.2023, for taking further instructions. On which date itself, the 2^nd opposite party shall file his Vakalath, Written version, proof affidavit and documents if any.  The District Commission is directed to dispose of the complaint, within three months from the date of appearance, according to law on merits.  

The amount deposited, by the appellant, shall remain in the custody of this commission, till the order passed in the original complaint.

 

 

   R  VENKATESAPERUMAL                                                                    R. SUBBIAH

                 MEMBER                                                                            PRESIDENT

 

KIR/TNSCDRC/Chennai/Orders/March/2023.