FA.No.1683/2008 against CC.No.73/2008 District Consumer Forum, Kadapa.

Between:

Chukka Venkataswami, S/o.Chukka Subbaiah,

Aged: 28 years, Working as Teacher in DBN Palli Village,

Rajampet Mandal,

R/at D.No.4/67-D6,

Satyam School Street, Sivajinagar, Rajampet Town,

Kadapa District.

…Appellant/Complainant.

And

1.Life Insurance Corporation of India,

   Rep. by its Sr.Divisional Manager,

   Divisional Office, Kadapa City,

2.Life Insurance Corporation of India,

   Rep. by its Branch Manager, Kadapa City.

…Respondents/O.Ps.

Counsel for the Appellant                  : Mr.Manne Hari Babu.

Counsel for the Respondents            : Mr.G.Venugopal Rao.

FA.No.1684/2008 against CC.No.74/2008 District Consumer Forum, Kadapa.

Between:

Avula Venkata Lakshumma, W/o.Jayaramanaiah,

Aged: 35 years, Occ: Labourer,

Pallampalli Village, N.R.Puram Post,

Penagalur Mandal,

Kadapa District.

…Appellant/Complainant.

And

1.Life Insurance Corporation of India,

   Rep. by its Sr.Divisional Manager,

   Divisional Office, Kadapa City,

2.Life Insurance Corporation of India,

   Rep. by its Branch Manager, Kadapa City.

…Respondents/O.Ps.

Counsel for the Appellant                  : Mr.Manne Hari Babu.

Counsel for the Respondents            : Mr.G.Venugopal Rao.

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

SMT.M.SHREESHA, MEMBER,

AND

SRI K.SATYANAND, MEMBER.

THURSDAY, THE TWENTY SEVENTH DAY OF AUGUST,

TWO THOUSAND NINE.

Common Oral Order (Per Smt.M.Shreesha, Hon’ble Member )

******* 

1.         Aggrieved by the orders of the District Consumer Forum, Kadapa in CC.No.73/2008 and CC.No.74/2008 both dated 21.11.2008, the complainants preferred FA.No.1683/2008 and FA.No.1684/2008 respectively.  .

2.         The brief facts of the complaints are that complainants’ brother viz. Chukka Ramanaiah took Jeeven Mitra (triple cover endowment plan) with profits (with accident benefits) policies bearing Nos.653531525 and 653670749 each for Rs.2,00,000/- for 25 years commenced on 28.10.2004 and 25.02.2005 with annual premium of Rs.9,141/- for the first policy and half yearly premium of Rs.4,736/- for the second policy by nominating the complainants as his nominees.  Chukka Ramanaiah paid only one instalment of premium.  The life assured was murdered on 16.08.2005 and a case was registered as Cr.No.37/2005.  When the complainants approached the opposite parties to settle their claims, they issued letters both dt.26.12.2007 repudiating their claim on the ground that the assured  suppressed certain facts with respect to total risk cover, income earned by him, etc.  The complainants contended that there was no suppression of facts.  Hence, the complainants filed the present complaints claiming in each case Rs.6,00,000/- towards triple cover endowment benefit along with accrued bonus with interest at 12% per annum, Rs.50,000/- towards mental agony and costs of Rs 3,000/-.

3.         The opposite parties filed counters admitting the issuance of Jeevan Mitra policies (triple cover endowment plan with accident benefits) to the deceased Chukka Ramanaiah, wherein the complainants were shown as nominees.  The deceased Chukka Ramanaiah initially obtained policy No.653531525 from Kadapa Branch Office and another policy No.653670749 at Rajampet Branch Office for Rs.2,00,000/- each with triple cover endowment plan with accident benefits by making his brother Venkataswami and his sister A.V.Lakshumma as his nominees respectively. The opposite parties submitted that on investigation it was found that the life assured had no sufficient income to pay the premium.  The wife and children were not shown as nominees, when they are natural legal heirs.  But the brother and sister were nominated under the policies as nominees.  The signatures on the proposal forms were not tallied with the original signature of the life assured.  The life assured did not give correct information.  The claims are fraudulent claims  and hence, they were repudiated.  There was no deficiency in service on their part. 

4.         The District Forum based on the pleadings put forth by both parties and the documentary evidence i.e. Exs.A.1 to A.7 and B.1 to B.9 dismissed the complaints without costs.

5.         Aggrieved by the said order, the complainants preferred these appeals.

6.         The facts not in dispute are that the complainants were the brother and sister of Chukka Ramanaiah, who had taken Jeevan Mitra (triple cover endowment plan with accident benefit) bearing policies No.653531525 and 653670749 for Rs.2,00,000/-each with annual premium of Rs.9,141/- and half yearly premium of Rs.4,736/- respectively for a period of 25 years commencing from 28.10.2004 and 25.02.2005.  The life assured nominated the complainants as his nominees, which is clear from Ex.A.1 (same set of documents were marked as exhibits in both the cases).  It is not in dispute that the life assured was murdered on 16.08.2005 and an FIR was registered vide Ex.A.2.  Ex.A.3 is the Xerox copy of the death certificate of Chukka Ramanaiah certifying that he died on 16.8.2005.  Ex.A.6 is the repudiation letter dated 26.12.2007.  The main contention of the opposite parties for repudiating the claims is that the life assured had suppressed information with respect to the earlier policy and that the signatures of the life assured in the proposal forms were found to be forged and that the legal heirs are not the nominees and the brother and sister of the life assured have been nominated. It is the case of the complainants/appellants herein that the first proposal form was filled on 30.10.2004 and therefore the question of suppression of fact in proposal form dated 16.02.2005 cannot be taken into consideration.  The learned counsel for the respondents/opposite parties drew our attention to question No.9 in the proposal forms in which it is clearly stated that “please give details of your previous insurance (including policies surrendered/lapsed during last 3 years)”  It is the contention of the respondents/opposite parties that the earlier policy details have to be declared in the proposal forms. The repudiation is justified since the life assured did not declare the earlier policy taken as per question No.9 in the proposal form. Merely because there is a breach of condition in the second policy taken by way of suppression this very suppression must be a ‘material’ fact and we rely on the decision of the National Commission reported in Supreme Court & National Commission on Consumer Protection Law, Vol. III Page 176 between New India Assurance Co. Ltd. Vs. Jhankar Singh wherein it is stated as follows:

“NON-STANDARD CLAIMS

Following types of claim shall be considered as non-standard and shall be settled as indicated below after recording the reasons:

7.         The contention of the learned counsel for the respondents is that if the life assured had disclosed about the first policy in the proposal of the second policy, they would have sent him for medical examination.  We observe from the record that the life assured was indeed sent for medical examination under Ex.B.7 dated 25.02.2005.  Ex.B.7 clearly says that there was medical examination which was done by the panel doctor of the Insurance Company and the same has been signed by Dr.S.Bala Rau.  It was also countersigned by the life assured.  In the light of these contentions, we do not see any reason for the Insurance Company to repudiate the claim. 

8.         The second contention of the respondents/opposite parties is that the signatures were forged. We observe from the record that no steps have been taken by the opposite parties to send the said document to any hand writing experts for their opinion.  Therefore, we are of the considered view that they could not establish that the signatures were forged.  We are of the considered view that Appeal No.1683/2008 against CD.No.73/2008 which was filed for policy No 653531525 which commenced on 28.10.2004 can be allowed with all the benefits and Appeal No.1684/2008 against CD.No.74/2008 which was filed for policy No 653670749 which commenced on 25.02.2005 has to be allowed as a non-standard claim by awarding 75% of the policy amount with benefits. 

9.         In the result, these appeals are allowed directing the respondents to pay the entire claim amount with benefits in FA.No.1683/2008 and 75% of the claim amount with benefits for the second policy in FA.No.1684/2008 together with interest at 9% per annum from the date of repudiation till the date of realization with costs of Rs.3,000/-.  Time for compliance four weeks.                                

PRESIDENT   

MEMBER   

MEMBER

DT: 27.08.2009

Vvr.