Andhra Pradesh

Visakhapatnam-II

CC/456/2011

Tagarampudi Prasad - Complainant(s)

Versus

M/s MetLife Insurance Company Limited - Opp.Party(s)

R. Asha Latha

10 Feb 2015

ORDER

Reg.of the Complaint:24-11-2011

                                                                                                                                    Date of Order:10-02-2015 BEFORE THE DISTRICT CONSUMERS FORUM-II

AT VISAKHAPATNAM

                   Present:

1.Sri H.ANANDHA RAO, M.A., L.L.B.,

       President

2.Sri C.V.N. RAO, M.A., B.L.,

                                             Male Member

3.Smt.K.SAROJA, M.A., B.L.,

       Lady Member

                                            

 

TUESDAY, THE 10^TH DAY OF FEBRUARY, 2015

CONSUMER CASE NO.456/2011

 

BETWEEN:

 

SRI TAGARAMUPUDI PRASAD  S/O LATE ATCHIBABU,

HINDU, AGED 23 YEARS, R/AT D.NO.14-118, NEAR LADIES HOSTEL,

GUNDALA VEEDHI, ANAKAPALLE, VISAKHAPATNAM.

                                                                                             …COMPLAINANT

A N D:

1.M/S METLIFE INSURANCE COMPANY LTD.,

REP. BY ITS GENERAL MANAGER (CLAIMS),

REGISTERED OFFICE AT BRIGADE SESSHAMAHAL,

5 VANI VILAS ROAD, BASAVANAGUDI, BANGALORE-560 004.

 

2.M/S METLIFE INSURANCE COMPANY LTD.,

REPRESENTED BY ITS BRANCH MANAGER(CLAIMS),

DWARAKANAGAR, VISAKHAPATNAM.

                                                                                      …OPPOSITE PARTIES

 

This case coming on 27-01-2015 for final hearing before this Forum in the presence of Smt. R.Asha Latha, Advocate for the Complainant and of  Sri SANAPALA KARUNA, Advocate for the Opposite Parties, and having stood over till this day for consideration, the Forum made the following:

 

O  R  D  E  R

(As per the Honourable President on behalf of the Bench)

1.       The Complainant filed the present complaint against the Opposite Parties, directing them to pay an amount of Rs.3,20,000/- with interest @24% p.a., from December, 2010 and Rs.50,000/- towards compensation and Rs.5,000/- towards costs.

2.       The case of the compliant in brief is that he is the grandson of late Tagarampudi Satyavathi w/o late Chinnodu, who has taken a policy under Plan Met Easy Plus vide Policy No.20301383 dated 30-03-2010 with effect from 23-03-2010 from the OPs and paid an amount of Rs.32,000/- towards first installment premium and the premium due date is 23^rd March of every Year for a sum Assured/Face Amount under the Policy is Rs.3,20,000/- while so on 30-11-2010 her grandmother i.e., insured died in a motor accident and a case was registered in Crime No.177/2010 of Anakapalle Rural P.S., thereupon, her death was intimated along with a Claim Form but the OPs by their letter dated 31-03-2011 repudiated their claim with false grounds that the age of the deceased was wrongly given as 49 years in the application whereas the deceased age was 60 years. Then immediately, he approached the OPs requesting for settlement of the claim by reviewing the case but they issued a cheque for Rs.9,461/- only without giving any reasons for sending the cheque. Then, immediately he got issued a notice date 13-05-2011 but there was no reply. Hence, this complaint.

3.       The case of the OP, denying the material averments of the complaint admitted that they issued a policy to the insured for Rs.3,20,000/- and at that time, she gave her age in the proposal form dated 9-3-2010 as 49 years copy of the ration card dated 26-08-2006 was produced by DLI mentioned her age as 46 years. The declaration after read over the contents of the agreement signed therein. After receiving death intimation i.e., claim form, an investigation was conducted and it reveals that DLI had misrepresented her age at the time of application and they came to know that her age was 60 years in the FIR. As per the provision of the policy, the maximum age entered is 50 years and if the DLI had disclosed her true and correct age, the OP would not have issued the instant policy to her. Therefore, they rightly repudiated the claim of the claimant on the ground of suppression of material facts by the complainant at the time of filling of the proposal form. After receipt of notice, they sent a suitable reply. There is no deficiency of service on their part. For these reasons, the compliant is liable to be dismissed.

4.       To prove the case on behalf of the complainant, he filed his evidence affidavit and got marked Exhibits A1 to A11. On the other hand, on behalf of the OPs, they filed their respective evidence affidavits and got marked Exhibits B1 to B6.     

5.       Exhibit A1 is the First Premium Receipt dated 30-03-2010, Exhibit A2 is the Policy Certificate dated 23-03-2010, Exhibit A3 is the Notarized Affidavit, dated 09-12-2009, Exhibit A4 is the FIR, dated 14-11-2010, Exhibit A5 is the inquest report, dated 14-11-2010, Exhibit A6 is the P.M. Certificate, dated 14-11-2010, Exhibit A7 is the Repudiation Letter dated 31-03-2011, Exhibit A8 is the letter addressed by complainant to the 2^nd OP, dated 19-04-2011, Exhibit A9 is the Registered Laywer’s Notice, dated 13-05-2011, Exhibit A10 is the Nominee Certificate, dated 19-03-2011, Exhibit A11 is the Death Certificate, dated 30-12-2010

6.       Exhibit B1 is the copy of the proposal form and copy of the policy document dated 31-03-2010, Exhibit B2 is the Death Claim Statement dated 14-03-2011, Exhibit B3 is the FIR dated 14-11-2010, Exhibit B4 is the letter from OPs dated, 31-03-2011, Exhibit B5 is letter from the OPs the 29-04-2011, Exhibit B6 is the Lawyer’s Notice dated 13-05-2011 and Reply Notice dated 24-10-2011.

7.       Both parties filed their respective written arguments.

8.       Heard oral arguments from both sides.

9.       Now the point for determination to be determined in this case is;

Whether there is any deficiency of service on the part of the OPs and the Complainant is entitled to any reliefs asked for?

10.     As seen from pleadings on record, it is an admitted fact that the deceased policy holder had taken a policy under Plan Met Easy Plus vide Policy No.20301383 dated 30-03-2010 for annual premium of Rs.32,000/- from the OPs  and on 13-11-2010, she died in a motor accident and a case was registered in Crime No.177/2010 U/s 304 IPC by Anakapalli Rural Police and at that time, Police registered FIR and conducted inquest and PM over the dead body of the deceased. The point in controversy is in respect of the age of the Insured-Deceased. According to the complainant, at the time of obtaining policy, the deceased insured was below 50 years. On the other hand, according to OP though the insured was more than 50 years, she obtained the policy by suppressing her age which is not contemplated under the aforesaid insurance policy. Now, it is to be seen what is the evidence on record, let in by both sides.

11.     To prove, at the time of issuance of policy in favour of the insured, he is not at all even 49 years and by suppressing the deceased insured obtained policy, the burden of proof is heavily lies on OPs. To prove the same, they relied upon Exhibit B1 to B3. Exhibit B1 is the copy of the proposal form and copy of the policy document dated 31-03-2010, Exhibit B2 is the Death Claim Statement dated 14-03-2011, Exhibit B3 is the FIR dated 14-11-2010. Exhibit B1 shows the age of the insured deceased is noted as 49 years. Exhibits B2 shows the age of the deceased insured at the time of obtaining the policy is 49 years and the term of policy is for 25 years. According to the OP, the deceased life insured (DLI) represented her age in the proposal form dated 19-03-2010 as 49 years by producing ration card dated 26-08-2006 but admittedly, the said copy of the ration card is not filed by OPs. However, to show that the DLI was aged more than 50 years, at the time of Exhibit B2, there is no recorded evidence let in by the OPs. In the absence of prove, it cannot be said that the deceased gave wrong declaration that she was aged more than 50 years at the time of obtaining Exhibit B1. The death claim statement also reveals that the DLI was below 50 years at the time of obtaining the policy.

12.     Exhibit B3 F.I.R. and A6 P.M. Certificate shows age of DLI as 58 and 60 tears respectively. The Police statements are not the authenticated documents. Admittedly, none of these statements appears to have been signed either by the complainant or any legal heirs of the insured deceased. Therefore, basing on the police record, the age of DLI can not be determined. No substantive proof by a competent person is filed to show that the DLI is more than 50 years. As per the provisions of the policy, the maximum age of the insured is 50 years and Exhibit B1 and B2 clearly go to show that the DLI had disclosed her true and correct age before obtaining the policy vide Exhibit B1. On a careful perusal of the Exhibit B1 and B2 we are of the considered opinion, the OPs failed to substantiate their contention. It appears as seen from record, OPs approved the policy after satisfying with the information given by the Applicant-DLI and after receiving the policy premium amount of Rs.32,000/- but now to avoid the payment of the claim amount due under the above policy, the OPs are                    taking the aforesaid pleas as an afterthought. The record shows that the complainant immediately after the death of the deceased approached the OPs by issuing notice but for the reason best known to the OPs, they repudiated the claim of the complainant.  All these acts of the OP clearly, comes under the purview of deficiency of service. For all the reasons, we hold that the complainant is entitled not only the insured amount but also interest, compensation and costs.

13.     Now the question that comes up for consideration, at this stage of our discussion is, what is the rate of interest for which the Complainant is entitled.   The rate of interest claimed by the Complainant is 24% p.a.  This rate of interest claimed by the Complainant appear to be excessive, of course, it is a fact that the transaction covered by Ex.A2 is commercial in nature, but that does not and cannot mean to say that the Complainant is a licensed to claim interest @ 24% p.a. on Ex.A 2.  But at the same time, it is imperative on our part to award a reasonable interest.   Having regard to all these facts and circumstances, we sincerely feel having considered the case on hand awarding of interest @ 9% p.a. would better serve the ends of justice.    Consequently, we proposed to fix at rate in question @ 9% p.a. on Ex.A 9 i.e., Legal Notice in question.   Accordingly interest is ordered.

14.     Whether the Complainant is entitled for compensation of Rs.50,000/- is to be considered.   It appears as seen from the evidence of Complainant that the Complainant was compelled to approach the Opposite Parties and therefore experienced a lot of physical strain besides mental agony and financial loss. It is an un-disputed fact that the Opposite Parties did not refund the advance amount paid by the Complainant.   Naturally, that might have put the Complainant to suffer some mental agony besides physical stress and strain.   In this view of the matter, we sincerely feel that it is a fit case to award compensation.   But that does not and cannot mean to say that the Complainant claim for compensation is acceptable.    Having regard to all these facts and circumstances, we are of the considered opinion, award of compensation of 30,000/- would serve the ends of justice.   We therefore, proposed to award compensation of Rs.30,000 /-,  in the circumstances of the case on hand. Accordingly this point is answered.

15.     Before parting our discussion, it is incumbent and imperative on our part to consider the costs of litigation.    The Complainants ought not have to approach this Forum had his claim for refund of the advance amount of Rs.3,20,000/- or reliefs sought for have been honored by the Opposite Parties within a reasonable time and in view of the matter, the Complainant’s claim for costs deserves to be allowed.   In our considered and unanimous opinion awarding a sum of Rs.2,500/- as costs would appropriate and reasonable.   Accordingly costs are awarded.

16.     In the light of our discussion, referred supra, the complainant is entitled to receive the sum of Rs.3,20,000/- together with subsequent interest @9% p.a., from 13-05-2011 till the date of realization, a compensation of Rs.30,000/- and also costs of Rs.2,500/-.

17.     In the result, the complaint is allowed in part, directing the OPs 1 and 2 to pay the insured sum of Rs.3,20,000/- (Rupees Three Lakhs Twenty thousand only) with subsequent interest @ 9% p.a., from the date of issuance of legal notice i.e., 13-05-2011 till the date of realization and compensation of Rs.30,000/- (Rupees Thirty Thousand only) and costs of Rs.2,500/- (Rupees Two Thousand and five Hundred only) to the Complainant. Time for compliance, one month from the date of this order.

Dictated to the Stenographer, transcribed by him, corrected and pronounced by us in the open Forum, on this the 10^th day of February, 2015.

  Sd/-                                                  Sd/-                                      Sd/-

LADY MEMBER                       MALE MEMBER                       PRESIDENT        

 

APPENDIX OF EVIDENCE

  For the Complainant:-

Exhibits	Date	Description	Remarks
A 1	30-03-2010	First Premium Receipt	Photostat copy
A2	23-03-2010	Policy Certificate	Photostat copy
A3	09-12-2009	Notarized affidavit	Photostat copy
A4	14-11-2010	FIR	Photostat copy
A5	14-11-2010	Inquest report	Photostat copy
A6	14-11-2010	P.M.Certificate	Photostat copy
A7	31-03-2011	Repudiation Letter	Original
A8	19-04-2011	Letter addressed by the complinant	Office copy
A9	13-05-2011	Registered lawyer’s Notice	Office copy
A10	19-03-2011	Nominee Certificate	Office copy
A11	30-12-2010	Death Certificate	Photostat copy

For the Opposite Parties:-  

Exhibits	Date	Description	Remarks
B1	31-03-2010	Proposal form and policy document	Photocopy
B2	14-03-2011	Death Claim Statement	Photocopy
B3	14-11-2010	FIR	Photocopy
B4	31-03-2011	Letter from OPs	Photocopy
B5	29-04-2011	Letter from OPs	Photocopy
B6	24-10-2011	Lawyer’s Notice dated 13-05-2011 and Reply Notice dated 24-10-2011	Photocopy

 

  Sd/-                                                  Sd/-                                      Sd/-

LADY MEMBER                       MALE MEMBER                       PRESIDENT