Kerala

StateCommission

A/10/447

PRASANNA SUDHA - Complainant(s)

Versus

M/S BAJAJ ALLIANCE INSURANCE INDIA LTD - Opp.Party(s)

VISWAMBARAN

19 Apr 2011

ORDER

 
First Appeal No. A/10/447
(Arisen out of Order Dated 08/06/2010 in Case No. cc136/07 of District Kozhikode)
 
1. PRASANNA SUDHA
ANUGRAHA PO,CHEVALUR,CALICUT
KOZHIKKODE
KERALA
...........Appellant(s)
Versus
1. M/S BAJAJ ALLIANCE INSURANCE INDIA LTD
C.E.PLAZA AIRPORT ROAD,YERAVADA
PUNE
MAHARASHTRA
2. THE BRANCH MANAGER
CHEROOTY ROAD,CALICUT
KOZHIKKODE
KERALA
...........Respondent(s)
 
BEFORE: 
  SMT.VALSALA SARNGADHARAN PRESIDING MEMBER
 
PRESENT:
 
ORDER

     KERALA STATE CONSUMER DISPUTES REDRESSAL COMMISSION VAZHUTHACAUD THIRUVANANTHAPURAM

                                                                                                             

APPEAL NOS.447/10 & 468/10

 

                   COMMON JUDGMENT DATED 12.4.2011

 

PRESENT

 

SMT.VALSALA SARANGADHARAN               --  MEMBER

 

SRI.M.V. VISWANATHAN                                -- JUDICIAL MEMBER

 

SHRI.M.K. ABDULLA SONA                                      --  MEMBER

 

 

APPEAL NO.447/10

 

Prasanna Sudha,

W/o Late P.Suresh Babu,

Augraha, P.O.Chelavoor,                         -- APPELLANT

Calicut, Calicut Dist.

 

(By Adv:Sri.E.V.Viswambaran)

 

          Vs.

 

1.      M/s Bajaj Allianz Life Insurance Co. Ltd.,

C.E.Plaza, Airport Road, Yerawada,

Pune – 411 006.

                                                                   -- RESPONDENTS

2.      The Branch Manager,

M/s Bajaj Allianz Life Insurance Co. Ltd.,

CheroottyRoad, Calicut.

 

(By Adv:Sri.Siju Rajan)

 

 

 

 

                                                                                                                         

APPEAL NO.468/10

                                

          The Branch Manager,

M/s Bajaj Allianz Life Insurance Co. Ltd.,

CheroottyRoad, Calicut.

Repd. By Saiju Philip,

Regional Manager,                                    -- APPELLANT

M/s Bajaj Allianz Life Insurance Co. Ltd.,

Kailas Plaza, 3rd floor, Pattom, TVPM-4.

 

(By Adv:Sri.Siju Rajan)

 

          Vs.

1.      Prasanna Sudha,

W/o Late P.Suresh Babu,

Augraha, P.O.Chelavoor,                        

Calicut, Calicut Dist.

 

(By Adv:Sri.E.V.Viswambaran)

                                                                   -- RESPONDENTS

2.      M/s Bajaj Allianz Life Insurance Co. Ltd.,

C.E.Plaza, Airport Road, Yerawada,

Pune – 411 006.

 

COMMON JUDGMENT

 

SMT.VALSALA SARANGADHARAN-MEMBER

 

          These appeals are preferred against the order dated 8.6.10 of CDRF, Kozhikode in CC.136/07 whereby the Forum below directed the opposite parties to pay a sum of Rs.1,50,000/- along with a compensation of Rs.5,000/- and costs of Rs.500/- to the complainant.  The appellant in Appeal No.447/10 is the complainant who has sought for getting the amount  covered under Child gain Scheme  and the appellant in A.468/10 is the second opposite party who has sought for setting aside the impugned order passed by the Forum below directing them to pay the above said amounts to the complainant.

          2.      The case of the complainant’s is that   her husband had a joined in 2 policies with the opposite parties vide Unit Gain Single Premium Scheme with the assured sum of Rs.1,50,000/- and another policy dated 28.8.05 with the assured sum of Rs.1,00,000/-.  The necessary premiums were also paid.   On 31.12.05  her husband died due to Coronary Artery Trombosis.  After his death, the complainant submitted necessary documents with claim form for getting the amounts covered under the 2 policies.  But, the opposite parties denied the claim alleging that there is non disclosure of material facts in the proposal.  Hence, the complaint was filed alleging deficiency in service on the part of the opposite parties in repudiating the insurance claim preferred by the complainant, as the widow of the life assured.

          3.      The opposite parties filed joint version and contended that the insured had paid single premium only for the second policy namely the Child Gain Scheme.  They further contended that the life assured suppressed the fact that he had treated for Polytrauma just before 8 months of joining the policy.  It is submitted that in the first policy taken by the insured namely   Unit Gain Single Premium Scheme, the opposite party had received a sum of Rs.30,000/- by way of premium and they refunded the policy amount collected from the insured along with  account value to the complainant.  For the second policy namely Child gain Scheme, the insured had remitted only one premium and to that policy the policy holder has to make yearly payments and have to pay at least 3 yearly premiums for getting the benefits.  In this case, the complainant’s husband paid only one premium and that too without disclosing the material facts regarding the treatment he had undergone for Polytrauma.  Thus, the opposite parties were justified in their action in repudiating the insurance claim.    Pleading that there was no deficiency in service on their part and they prayed for the dismissal of the complaint.

          4.      We heard the learned counsel for both sides. The counsel for the appellant/complainant in A.447/10 argued for the position that the finding of the Forum below to the effect that in the Child Gain Scheme the policy holder has to make yearly payment was based on the contention raised in the version and it is without verifying the policy conditions and there is no condition in the policy to the effect that the policy holder has to pay at least 3 yearly premiums.  He submitted that there was no suppression of material facts by the life assured while submitting the proposal form.  Thus, he prayed for allowing the appeal filed by him.

          5.      On the other hand, the learned counsel for the appellant in A.468/10 ie; second opposite party before the Forum below has submitted that the life assured had undergone treatment for Polytrauma and the policy was obtained fraudulently by suppressing the fact that he had undergone Polytrauma  8 months before taking the policy.  The insurance claim preferred by the complainant was repudiated on the ground that the life assured did not disclose the material facts and thus they justified the repudiation of the claim.  As per the policy condition, the first opposite party had refunded the policy amount collected from the policy holder along with account value by way of cheque.  Hence there is no deficiency in service on their part and prayed for  setting aside the impugned order passed by the Forum below in directing the opposite party to pay the assured sum of Rs.1,50,000/- with compensation and costs.

          6.      On hearing the learned counsel for both sides and on perusing the records, we find that admittedly the beneficiary of the Child Gain Policy is the minor daughter of late R.P.Suresh Babu, who had taken the insurance policy.  On the death of the insured, the sum assured must go to the minor daughter, the beneficiary.  But, the complaint is preferred by the wife of the insured, and the mother of the beneficiary.  It is to be noted that the complaint is preferred not for the minor but in the individual capacity of Ms.Prasanna Sudha.  The minor beneficiary is a necessary party to the complaint in CC.136.07.  The said complaint filed without impleading the minor is bad for non-jointer of necessary parties.  But, the forum below failed to give an opportunity to the complainant for impleading the necessary parties.  The complainant being the mother and natural guardian can very well maintain the complaint by impleading the minor.  The complainant can only represent the minor in her capacity as the mother and natural guardian.  So, we are of the opinion that the complaint is to be remitted back to the Forum below for curing the said defects of non-joinder of necessary parties.  More over, the concerned policy and policy conditions were not produced before the Forum below.  The parties have also failed to produce the policy with terms and conditions at the appellate stage also.   For a just and proper consideration of the issues, the policy with condition is necessary.

          7.      In the circumstances, the impugned order dated 8.6.10 passed by the CDRF, Kozhikode in CC.136/07 is set aside and the matter is remanded to the Forum below for fresh consideration after permitting the complainant to implead the necessary parties.  The Forum is also directed to give opportunity to both parties to adduce evidence in support of their contentions if they so desire and dispose of the matter on merits.

         

          The matter will stand posted before the Forum below on 31.5.11. 

          The office is directed to forward the copy of this order along with LCR to the Forum urgently.

 

VALSALA SARANGADHARAN--  MEMBER

 

 

 

M.V. VISWANATHAN  -- JUDICIAL MEMBER

 

 

 

M.K. ABDULLA SONA --  MEMBER

          

 

 
 
[ SMT.VALSALA SARNGADHARAN]
PRESIDING MEMBER

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