1.      Heard Mr. Harsh Kaushik, Advocate for the appellants.

2.      Above appeal has been filed against the order of Andhra Pradesh State Consumer Disputes Redressal Commission, Vijayawada, dated 12.06.2023, whereby the State Commission partly allowed the complaint filed by the complainant (respondent No.1 herein). 

3.      Ms. Shaik Mumtaj (respondent No.1) filed Consumer Complaint No.36 of 2019 with the State Commission, for directing the appellants to (i) pay the insurance amount of Rs.20 lakhs; (ii) award amount of Rs.15,40,000/- (interest @ 12% p.a. on Rs.20 lakhs from 31.11.2012 till 31.03.2019); (iii) award amount of Rs.5 lakhs towards mental agony and suffering; (iv) award interest @ 12% p.a. from the date of complaint till realization; (v) award amount of Rs.25000/- towards costs; and (vi) pass such other order or orders the Hon’ble Commission may deem just and proper.

4.      Husband of the complainant (Shaik Mokther) purchased Pulsar 150 DTS BS-III motorcycle from opposite party No.3 (respondent No.2). The vehicle was registered on 17.02.2012 vide registration No.AP-31-BU-3347. Opposite Party No.3 had obtained Group Insurance Policy from opposite parties- 1 & 2 for the benefits of its customers. Opposite party No.3 also took Rs.4720/- from him for adding his name in Group Insurance Policy and deposited the premium and the papers of Shaik Mumtaj with opposite party No.2. On 13.02.2012, opposite party No.2 (appellants) issued life insurance certificate to shaik Mokther Basha for a sum assured of Rs.20 lakhs, valid from 13.02.2012 to 12.02.2013. Unfortunately, the life assured died on 27.04.2012 due to sun stroke. On 31.08.2012 the complainant submitted claim form with the insurance company through opposite party No.3. The insurance company, vide letter dated 15.05.2013 repudiated the claim on the ground that the life assured had not disclosed about the previous policies obtained by him. Alleging deficiency in service on the part of the insurance company, the complainant filed Consumer Complaint No.36 of 2019 with the State Commission.

5.      Opposite Parties 1 & 2 (appellants) filed the written version denying the allegations made in the complaint. However, it was accepted that master policy of Group Insurance Policy was issued to opposite party No.3 and the insurance certificate was issued in the name of the deceased. The claim was repudiated as the life assured supressed the material fact with regard to the previous insurance policies. Had he declared about the previous policies in the proposal form, the opposite parties would not have issued the policy. The complainant did not produce any evidence to prove that the life assured died due to sun stroke. There are also two versions about the place of death. As per newspaper articles, the life assured died on the road near bus stand and as per version of the complainant he died at home. It was stated that the complaint was barred by limitation as the cause of action accrued on 15.05.2013 when the claim of the complainant was repudiated and the complaint was filed in June, 2019 after expiry of more than six years. The opposite parties repudiated the claim as per terms & conditions of the policy. Therefore, there is no deficiency in service on the part of the opposite parties and the complaint is liable to be dismissed. Opposite party No.3 (respondent 2) did not appear despite service of notice. 

6.      The State Commission, vide impugned order dated 12.06.2023 partly allowed the complaint and directed opposite parties 1 & 2 (insurance company) jointly and severally to pay Rs.20 with interest @ 9% p.a. from the date of the complaint till the date of realization and cost of Rs.25000/- as litigation cost. However, the State Commission dismissed the complaint against opposite party No.3 (respondent No.2). Hence opposite party Nos.1 & 2 (insurance company) have filed the instant appeal.

7.      We have considered the arguments of the counsel for the parties and examined the record. The appellants repudiated the claim of the complainant on two grounds (I) the life assured supressed the material fact regarding previous life insurance policies and (II) there two versions regarding place of death of the life assured. Regarding suppression of material fact, it is admitted by the appellants that respondent No.2 (dealer) had obtained a master policy of group insurance policy for the benefit of its customers. In such cases, the master policy is obtained by the dealer for the benefit of its customers and the proposal form is also filled by the dealer. The customer, who wants to avail the benefit of group insurance policy, can avail the same by paying requisite premium amount and no proposal form is required to be filled by the customer as the master policy has already been obtained by the dealer. This is also established from the fact that the appellant has not filed the copy of the proposal form either before the State Commission or before this Commission. Had there been any requirement of filling the proposal form by the life assured, the appellants (insurance company) would have certainly filed the copy of the same to prove that they had sought information about the previous life insurance policies and the life assured has supressed this material information from the insurance company. It is also admitted case of the parties that the life assured had filled a membership and declaration of good health form. The life assured provided all information as sought for the membership and declaration of good health form. Since in the group insurance policy there is no provision of filling the proposal form, the insurance company cannot take the ground that the life assured had supressed any material information. Therefore, repudiation of claim on the ground of suppression of material fact is not justified. Counsel for the appellants relied on the judgments in Reliance Life Insurance Co. Ltd. & Anr. Vs. Rekhaben Nareshbhai Rathod (2019) 6 SCC 175  and Janta Machine Tools vs. Oriental Insurance Co. Ltd. Judgment of Supreme Court in Reliance Life Insurance Co. (supra) is not applicable as case relates to the life insurance wherein life assured had given false information in the proposal form about the previous insurance policy. The present case relates to the group insurance. The judgment of this Commission in Janta Machine Tools (supra) is distinguishable on law point as in that case this Commission relegated the case to the Civil Court and dismissed the complaint as not maintainable. Counsel for the appellants also raised the issue of limitation and relied on the judgment of this Commission in Tehri Hydro Development Corporation Ltd. vs. New India Assurance Co. Ltd. in OP/332/2002 MANU/CF/0402/2002. The complainant claimed that that she came to know about repudiation of claim in January, 2019. The appellants have not produced any evidence to show that they have dispatched/served the copy of the repudiation letter before January, 2019. Therefore, the aforesaid judgment is not helpful to the appellants.

ORDER

In view of aforesaid discussions, the appeal is dismissed.