Tamil Nadu

South Chennai

334/2010

C.Gandhimathi - Complainant(s)

Versus

M/s. Bajaj Allianz Life Insurance & others - Opp.Party(s)

Auxilia Peter

01 Mar 2018

ORDER

                                                                                                                           Date of Filing  : 17.08.2010

                                                                                                                            Date of Order : 01.03.2018

DISTRICT CONSUMER DISPTUES REDRESSAL FORUM, CHENNA (SOUTH)

2^ND Floor, Frazer Bridge Road, V.O.C. Nagar, Park Town, Chennai-3

PRESENT: THIRU. M. MONY, B.Sc., L.L.B, M.L,                    : PRESIDENT

                 TMT. K. AMALA, M.A. L.L.B.                                 :  MEMBER-I

          DR. T.PAUL RAJASEKARAN, M.A ,D.Min.PGDHRDI, AIII,BCS  : MEMBER II                              

CC. NO.334 /2010

THURSDAY THE 1^ST  DAY OF MARCH 2018

                                              

C. Gandhimathi,

W/o. D. Chellappa,

No.3A, Miles Stone Appartments,

14, Sri Ram Nagar, South Street,

Chennai – 18.                                                     .. Complainant

                                      ..Vs..

 

1. M/s. Bajaj Allaianz Life Co. Ltd.,

Rep. by its Managing Director,

GE.Plaza Airport,

Yerwada, Pune 411 006.

 

2. M/s. Team Line Care Company India

Company Limited,

Rep. by its Managing Director,

54-1, Hasthampatti Main Road,

Adjacent Barathi Super Market,

Upstairs Shivashri Complex,

Sale 636 007.

 

3. The Octopus,

Rep. by its Managing Director,

No.9, Murrays Gate Road,

Alwarpet, Chennai 600 018.             ..  Opposite parties.

 

 

Counsel for complainant         :  M/s. Auzilia Peter    

Counsel for opposite party-1  :  M/s. E.Veda Bagath Singh

Counsel for opposite party-2  :  M/s. S.K.Sambuvarayan

For opposite party-3               :  Exparte.      

ORDER

THIRU. M. MONY, PRESIDENT

       This complaint has been filed by the complainant against the opposite parties under section  12 of the Consumer Protection Act 1986 seeking direction to pay a sum of Rs.1,00,000/- towards life insurance policy with interest and also to pay a sum of Rs.3,00,000/- towards compensation for mental agony and to pay cost of the complaint.

1. The averments of the complaint in brief are as follows:

          The complainant submit that  the complainant’s husband D. Chellappa availed a Life policy bearing No.23504593 dated 9.7.2006 for an assured sum of Rs.1,00,000/-.   Further the complainant state that the complainant’s husband failed to pay the premium within the specified time.   Thereafter on intimation by the opposite parties  insurance company  the complainant’s husband paid a sum of Rs.20,000/- on 13.8.2008 and  the policy was also duly revived on 25.9.2008.   The complainant approached the opposite parties for due payment of the policy amount.  Since the opposite parties refused to entertain the complainant claim.  The complainant issued legal notice dated 14.6.2010. The 2^nd opposite party had received the notice and not send any reply.    As such the act of the opposite parties amounts to deficiency in service which caused mental agony and hardship to the complainant.  Hence this complaint is filed.   

2. The brief averments in the written version filed by the  1^st opposite party is as follows:

The  1^st  opposite party deny each and every allegations except those that are specifically admitted herein.  The 1^st opposite party state that the complainant’s husband is a policy holder with the 1^st opposite party and that he had failed to pay the premium within the time specified and the same was elapsed.  After intimation he paid a sum of Rs.20,000/- on 13.8.2008.  But on renewal of the policy he did not disclose his medical status.   The complainant’s husband died on 15.7.2009 due to various medical illnesses and he took treatment prior to 5.9.2008 and the allegation that illness was diagnosed only on 5.9.2008 is utterly false.   Further the complainant did not state how her husband was died and this itself would amply establish that she has not approached this forum with clean hand.    The opposite party also state that  the company had covered the risk for the above said policy on the basis of the facts mentioned in the proposal form.  However on receipt of the death claim intimation for the above said policy various investigation and various medical certificates confirm that the deceased / life assured had history of regular consultation / treatment  for cancer on 5.9.2008.   The deceased /life assured did not disclose the above medical history in declaration of good health submitted for reviving policy dated 25.9.2008.   Therefore the claim has been repudiated due to non-disclosure of material facts by declaring revival dated 25.9.2006.   Hence there is no deficiency in service on the part of the opposite  parties and the complaint is liable to be dismissed.

3. The brief averments in the written version filed by the  2^nd  opposite party is as follows:

The  2^nd   opposite party deny each and every allegations except those that are specifically admitted herein.  The 2^nd  opposite party state that the  entire allegations contained in the complaint are matter of records and this opposite party is not aware of the same and the complainant  is put to strict proof of the same.   There is no specific allegation made against the opposite party and hence this opposite party is adopting the written version filed on behalf o the 1^st opposite party.  Hence there is no deficiency in service on the part of the 2nd opposite  party and the complaint is liable to be dismissed.

4.    Inspite of service of notice the 3^rd opposite party called absent and set exparte. 

5.   In order to prove the averments of the complaint, the complainant has filed proof affidavit as his evidence and documents Ex.A1 to Ex.A7 marked.  Proof affidavit of the opposite parties 1 & 2  filed and no documents marked on the side of the 1^st and 2^nd  opposite parties.

6.      The points for consideration is :

1. Whether the complainant is entitled to a sum of Rs.1,00,000/- towards life insurance policy with interest as prayed for ?

2. Whether the complainant is entitled to a sum of Rs.3,00,000/- towards compensation for mental agony with cost as prayed for ?

7.      POINTS  1 & 2:

        The opposite parties filed their respective written version and has not turned up to file due proof affidavit to prove the averments in the written version.  The complainant filed proof affidavit and written arguments.   Perused the records (viz) complaint, written version, proof affidavit of complainant  and documents.   The complainant pleaded in the complaint and contended that the complainant’s husband D. Chellappa availed a Life policy bearing No.23504593 dated 9.7.2006 for an assured sum of Rs.1,00,000/-.   Further the complainant contended that due to oversight the complainant’s husband failed to pay the premium within the specified time.   Thereafter on intimation by the opposite parties  insurance company  the complainant’s husband paid a sum of Rs.20,000/- on 13.8.2008 and another sum of Rs.5000/- on 2.3.2009 as per Ex.A1 & Ex.A2 towards the premium and late fee etc.  and  the policy was also duly revived on 25.9.2008 and due receipt issued by the opposite party on 19.5.2009 as per Ex.A3.  Meanwhile the complainant approached the opposite parties for due payment of the policy amount.   Since the opposite parties refused to entertain the complainant’s claim  the complainant was constrained to issue legal notice dated 14.6.2010 as per Ex.A5.  Further the contention of the complainant is that admittedly the policy issued by the opposite parties on 9.7.2006 it was duly renewed at request of the opposite parties and the renewal is accepted by the opposite parties.   The repudiation of claim on the basis of suppression of illness during the course of revival of the policy cannot be accepted as per law.  The complainant is claiming an assured amount of Rs.1,00,000/- with interest and compensation of Rs.3,00,000/-.

8.    The opposite parties  after filing written version has not turned up to file any proof affidavit to prove the contentions raised in the written version.   The contention raised by the opposite parties for the renewal of claim is that the receipt of death claim intimation for the above said policy is highly belated.  But no documents produced before this forum.   Equally on the investigation by the opposite parties the deceased Chellappa under gone various medical certificates confirmed that he died on 5.9.2008 due to cancer; which factor has been disclosed at the time of reviving the policy dated 25.9.2008.   But the opposite parties has not substantiated the said fact with proper document.   After issuing the revival policy in such a manner.   Considering the facts and circumstances of the case this forum is of the considered view that the  opposite parties  are jointly and severally liable to pay  a sum of Rs.1,00,000/- with interest at the rate of 9% p.a. from the date of this complaint (i.e.) 17.8.2010 to till the date of this order (i.e) 1.3.2018 and also shall pay compensation of Rs.25,000/-  for mental agony with cost of Rs.5,000/- to the complainant and the points are answered accordingly.

In the result the complaint is allowed in part.  The  opposite parties 1 to 3 are jointly and severally liable to pay a sum of Rs.1,00,000/- (Rupees one lakh only) with interest at the rate of 9% p.a. from the date of this complaint (i.e.) 17.8.2010 to till the date of this order (i.e) 1.3.2018 and also shall pay compensation of Rs.25,000/- (Rupees Twenty five thousand only)  for mental agony with cost of Rs.5,000/-  (Rupees Five thousand only) to the complainant.

The above  amounts shall be payable  within six weeks from the date of receipt of the copy of this order, failing which, the said amounts shall carry interest at the rate of 9% p.a to till the date of payment.       

Dictated  by the President to the Assistant, taken down, transcribed and computerized by her, corrected by the President and pronounced by us in the open Forum on this the 1^st  day of March 2018. 

 

MEMBER –I                       MEMBER-II                              PRESIDENT.

COMPLAINANT SIDE DOCUMENTS:

Ex.A1- 13.8.2008 - Copy of receipt issued by the 3^rd opp. party.

Ex.A2- 2.3.2009  - Copy of receipt issued by the 3^rd opp. party.

Ex.A3- 19.5.2009 - Copy of policy deposit renewal premium receipt.

Ex.A4- 28.3.2010 - Copy of letter from the 1^st opposite party.

Ex.A5- 14.6.2010- Copy of legal notice.

Ex.A6-             - Copy of return cover of 3^rd opp. party.

Ex.A7-             - Copy of Ack. Card.

 

 

OPPOSITE  PARTIES SIDE DOCUMENTS:  .. Nil..

 

MEMBER –I                       MEMBER-II                              PRESIDENT.