BEFORE THE MANDYA DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, MANDYA PRESENT: 1. SIDDEGOWDA, B.Sc., LLB., President, 2. A.P.MAHADEVAMMA, B.Sc., LLB., Member, ORDER Complaint No.MDF/C.C.No.48/2009 Order dated this the 25th day of September 2009 COMPLAINANT/S Mohamad Ibrahim S/o Late Hussain Khan, R/at Moolehatti, Old Post Office Road, Nagamangala Town, Mandya District. (By Sri.S.N.Nagaraj., Advocate) -Vs- OPPOSITE PARTY/S 1. The Managing Director, M/s Bajaj Allianz Life Insurance Co., Ltd., G.E.Plaza, Air Port Road, Yerwada, Pune 411006. 2. The Branch Manager, M/s Bajaj Allianz Life Insurance Co., Ltd., No.1128, 1st Floor, 1st Cross, Ashoka Road, Mandya. (EXPARTE) Date of complaint 13.05.2009 Date of service of notice to Opposite parties 05.08.2009 Date of order 25.09.2009 Total Period 1 Month 20 Days Result The complaint is allowed exparte, directing the Opposite parties to pay the insurance amount of Rs.1,50,000/- with interest at 9% p.a. from the date of complaint till payment. Sri.Siddegowda, President 1. This complaint is filed under section 12 of the Consumer Protection Act, 1986 against the Opposite parties Insurance Company to claim insurance amount of Rs.1,50,000/- with accrued benefits. 2. The case of the Complainant is that his wife Smt.Dilshad Banu had insured her life with the Opposite parties Insurance Company under Bajaj Allianz Capital Unit Gain for a sum of Rs.1,50,000/- for a period of 20 years and accepting the proposal, the Opposite party collected Rs.10,000/- from time to time as Annual Premium on 31.08.2007 and accepting the proposal and premium they issued insurance bond bearing Policy No.0065218724. They have also issued a letter of acceptance, but the insured Smt.Dilshad Banu died on 16.11.2007. Thereafter, the Complainant being a nominee filed death claim application on 27.12.2007 along with the insurance bond and other documents as required by the Opposite parties. After some time the Complainant has also addressed a letter to the Customer Care Desk, Grievance Redressal Company of the Opposite parties for payment of the amount. But all the efforts become vain. One Siraj Pash who is acting and canvassing the policies on behalf of the Opposite parties Insurance Company and as Agent of the Opposite parties, obtained the signatures of the Complainant to the number of blank forms giving false assurance to the Complainant that the amount to be paid early. Among the forms obtained by the Agent Siraj Pasha, one application had been sent to the Insurance Ombedsman on 30.04.2008 without the knowledge of the Complainant. The Complainant is an illiterate and believed the version of said Agent. The Complainant came to know the mischief of the Agent only on receiving the letter from Ombedsman with a direction to submit the application in Proforma. Since, the Complainant was not interested in taking action through Ombedsman sent a letter to the Opposite party requesting them to return all the documents. But they have not returned the documents. The Opposite party without assigning any cogent reasons has rejected the death claim. Though they are bound to pay the insurance amount of Rs.1,50,000/- to the Complainant. They have committed deficiency in service in not settling the claim. Therefore, the present complaint is filed. 3. The notice of the Complainant was served on the Opposite party, but the Opposite parties have remained exparte and they have not filed any version. Thereafter, the Complainant has filed affidavit and produced the documents Ex.C.1 to C.14. 4. We have heard the counsel for the Complainant and perused the records. 5. Now the points that arise for our considerations are:- 1. Whether the Opposite party has committed deficiency in service in not settling the claim of the insurance? 2. Whether the Complainant is entitled to the insurance amount? 6. Our findings and reasons are as here under:- 7. POINTS NO.1 & 2:- Ex.C.2 the receipt issued by the Opposite party and Ex.C.1 the letter of the Opposite party Company clearly established that the Opposite party has collected Rs.10,000/- as annual premium and issued receipt dated 31.08.2007 and accepting the proposal and premium, issued the insurance policy in favour of Dilshad Banu for Rs.1,50,000/- for 20 years and the date of commencement is 08.11.2007. It is established that the insured Dilshad Banu died on 16.11.2007 at Victory Hospital, Bangalore and the Complainant submitted death claim as per Ex.C.3 with necessary documents. As per the documents Ex.C.8 and C.9, the Opposite party has repudiated the claim and confirmed the same on 21.04.2008. According to the Complainant, the repudiation of the claim is without any basis. Even, the Complainant got issued legal notice Ex.C.14 and though served the Opposite party has not replied. It appears that the Complainant moved with the Customer Care Desk of the Opposite party Insurance Company and it was not fruitful and according to the Complainant, the Agent of the Opposite party obtained signature to the forms and came to know that the Agent has sent objection to Ombudsman, but the Complainant was not willing to file a petition before the Ombudsman and sought for return of the documents from the Opposite party so as to approach the Consumer Forum. The Opposite party sent letter refusing to return the documents on the ground they have received a complaint from the Ombudsman Office. 8. Now, in spite of service of notice to Opposite party, the Opposite parties have not filed any version disputing the insurance claim made by the Complainant. They have not pleaded on what basis and reasons they have repudiated the claim and the grounds of the repudiation are not established by adducing evidence by the Opposite party. The burden is on the Opposite parties to prove the grounds of repudiation. In the absence of proof of ground of repudiation, the nominee is entitled to the insurance claim in view of the terms of the insurance policy issued by the Opposite party Insurance Company. Under these circumstances, we hold that the Opposite party has committed deficiency in service in not settling to pay the insurance claim as per the terms of the policy. Therefore, the Complainant is entitled to the insurance amount of Rs.1,50,000/- with interest. 9. In the result, we proceed to pass the following order; ORDER The complaint is allowed exparte, directing the Opposite parties to pay the insurance amount of Rs.1,50,000/- with interest at 9% p.a. from the date of complaint till payment. (Dictated to the Stenographer, transcribed, corrected and then pronounced in the open Forum this the 25th day of September 2009). (PRESIDENT) (MEMBER)
