Andhra Pradesh

StateCommission

FA/137/09

DR.P.GOPALAKRISHNAMURTHY - Complainant(s)

Versus

M/S TATA AIG LIFE INSURANCE COM.LTD. - Opp.Party(s)

M/S P.SADASIVA RAO

07 Feb 2012

ORDER

 
First Appeal No. FA/137/09
(Arisen out of Order Dated null in Case No. of District Hyderabad-II)
 
1. DR.P.GOPALAKRISHNAMURTHY
R/O H.NO.5-10-87, KISHANPURA, HANAMKONDA, WARANGAL.
WARANGAL
Andhra Pradesh
...........Appellant(s)
Versus
1. M/S TATA AIG LIFE INSURANCE COM.LTD.
THE SENIOR MANAGER-CLAIMS, SIMRAWCENTRE, 2ND FLOOR, PARSIPANCHAYAT, ANDHERI EAST,
MUMBAI
Andhra Pradesh
2. MS VIJAY INSURANCE SERVICE,BM
CORPORATE AGENTS FOR AIG LIFE INS.CO.LTD., H.NO.2-2-478, KISHANPURA, HANAMKONDA,
WARANGAL
ANDHRA PRADESH
...........Respondent(s)
 
BEFORE: 
 HONABLE MRS. M.SHREESHA PRESIDING MEMBER
 
PRESENT:
 
ORDER

A. P. STATE CONSUMER DISPUTES REDRESSAL COMMISSION : ATHYDERABAD

 

FA Warangal.

 

Between :

 

Dr. P. Gopalakrishnamurthy,

S/o Narasimha Rao,

Age : 58 years, Occ : Medical Practitioner

R/o H. No. 5-10-87, Kishanpura,

Hanamkonda,Warangal                                        

And

 

1.           The Senior Manager – Claims,

Tata AIG Life Insurance Company Limited

Simraw centre , 2ndParsipanchayat, Andheri ( East )

Mumbai.

 

2.           The Branch Manager,

Vijay Insurance Service,

Corporate Agents for

AIG Life Insurance Co. Ltd

H. No. 2-2-478, Kishanpura,

Hanamkonda,Warangal.

 

 

 

Counsel for the Appellant 

 

Counsel for the Respondents Mr.Md.

 

 

Coram                                  

 

And

                                             

 

Tuesday, the Seventh Day of February

Two Thousand Twelve

 

         

 

****

 

 

 

       Warangal. For convenience sake, the parties as arrayed in the complaint are referred to as under :

 

2.           The brief facts of the complaint 

The complainant obtained “ Maha Life gold policy” bearing No. C32032642 dt. 11.3.2004 for Rs. one lakh   Hyderabad    

 

3.          

              and that she was put on VALPROATE 1500 but it was not disclosed in the application dt. 11.3.2004. During the enquiry by the Claim investigator, the complainant disclosed that the insured was suffering from “ Myoclonic Epilepsy and was under treatment since 6-7 years and similar statements were also made by her mother and sister. NIMS medical record also supports the said disease for the last 7 years. The death Summary of the hospital clearly shows that the deceased has suppressed this material fact from OP 1 and thereby misrepresented and induced OP 1 to issue the policy. 

 

     

 

 

 

6.             

 

7.           

 

8.   Now the point for consideration is

 

There is no dispute that the                    The deceased     Hyderabad,      circumstances invariably it has to be believed that she took aid, help and advice from her father in the said context. . In this case there is ample evidence produced by both side that the deceased was suffering from Myoclonical Epilepsy for the past seven years from the date of the deceased and thus satisfied that on the date of Ex. B1 she was suffering from such an ailment and taking high power drug. Therefore the decision cited by the learned counsel for the appellant reported in New India Assurance Co. Ltd Vs.   30(NC) and 2011(1) CPR 106 between New India Assurance Co. Ltd Vs. Jagrut Nagarika and another.are not helpful for the complainant in this case. It is much more so when facts of the said decision are different from that of the facts on case on hand. The learned counsel for complainant/appellant also tried to distinguish the Epilepsy disease from Myoclonical Epilepsy but the same 

 

 

9.              

 

 

                                                                  

                                                                  

                                                                 

 

 

 

 

 

 

 

 

 

 

                                                                        

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
 
 
 
 
 
[HONABLE MRS. M.SHREESHA]
PRESIDING MEMBER

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