Per Mr.B.S.Wasekar, Hon’ble President
1) The present complaint has been filed by the complainant u/s 12 of the Consumer Protection Act, 1986. According to the complainant, her husband deceased Pramod Madan Mhatre alongwith complainant applied for loan to the O.P.No.1/ Bank on 30 July, 2010 for purchase of flat No.A-1,302 at Plot No.34, Sector 12, Kamothe, Taluka Panvel, District Raigad. After scrutinizing the application and documents, the O.P.No.1/Bank sanctioned the housing loan to purchase the flat in the joint name of complainant and her husband. The O.P.No.1/Bank induced the complainant and her husband to take insurance policy from O.P.No.2 for collateral security to the housing loan advanced to the complainant and her husband. It was the master policy for group suraksha policy bearing master policy No.0128591934 under loan account No.9/1099. The sum of Rs.6,25,000/- was secured for single mode premium of Rs.26,063/- It was in the name of Pramod, the husband of the complainant. The complainant was mentioned as nominee in that policy. The O.P.No.1/Bank also compelled the complainant to take policy for the amount of Rs.6,00,000/- in the name of complainant to secure the said housing loan for single premium of Rs.13,200/-. During the pendency of the above said housing loan, the husband of the complainant died on 16th February, 2011 due to heart attack.
2) The complainant filed application on 15th March, 2011 and requested the O.P.No.2 to release the amount of Rs.6,25,000/- under insurance benefit for repayment of housing loan. The original policy document was submitted to the O.P.No.2. The O.P.No.1/Bank was also informed. The O.P.No.1 also agreed to follow the said application for release of the insured amount. The O.P.No.2 vide e-mail dated 9th November, 2011 called upon the complainant to produce certain documents and the same were produced by the complainant. The O.P.No.2 avoided their liability to pay the amount and sent letter dated 8th June, 2011 repudiating the claim. The O.P.No.2 had given the reasons that deceased had history of Ischemic Heart Disease since last six to seven years. The complainant strongly objected the reasons given by the O.P.No.2. Her husband was healthy and was not suffering from any heart disease. The complainant requested the O.P.No.1 for reconstruction of the claim in the name of her husband. Insurance policy was taken at the inducement of O.P.No.1. Therefore, the O.P.No.1 is liable to reconstruct the outstanding amount after adjusting the amount under policy. As the opponents failed to pay the insurance benefit and reconstruct the housing loan, the complainant has filed this complaint to direct the O.P.No.2 to pay amount of Rs.6,25,000/- under policy and to direct the O.P.No.1 to adjust the said amount and reconstruct the outstanding housing loan statement. She has also prayed for compensation of Rs.3,50,000/- towards loss of interest, inconvenience, hardship and harassment. She has also prayed for expenses Rs.50,000/-.
3) The O.P.No.1 appeared and filed written statement. The O.P.No.1 has denied all the averments in the complaint. In para 6 of the written statement, the O.P.No.1 has admitted that after scrutinizing the documents produced by the husband of the complainant, housing loan was sanctioned to purchase the flat in the joint name. As per the policy of O.P.No.1, the complainant and her husband were introduced to O.P.No.2 to take policy for collateral security equivalent to the loan amount under master policy for group suraksha policy bearing master policy No.0128591934 under Loan Account No.9/1099 for the sum of Rs.6,25,000/- for single mode premium of Rs.26,063/-. It is denied that O.P.No.1 compelled the complainant and her husband to take policy for Rs.6,00,000/-. It is submitted that master policy No.0128591934 was issued for Rs.6,00,000/- for single premium of Rs.13,200/-. All other allegations are denied by the O.P.No.1
4) The O.P.No.2 remained absent though duly served. Therefore, the O.P.No.2 was proceeded to ex-parte.
5) After hearing the complainant and after going through the record, following points arise for our consideration
POINTS
Sr. No. | Points | Findings |
1) | Whether there was insurance policy in the name of Pramod Mhatre, husband of the complainant and secured the housing loan amount of Rs.6,25,000/-? | Yes |
2) | Whether the repudiation of claim by the O.P.No.2 was proper and legal ? | No |
3) | Whether the complainant is entitled for insurance benefit of Rs.6,25,000/- ? | Yes |
4) | Whether the complainant is entitled for adjustment of loan amount of Rs.6,25,000/- ? | Yes |
5) | What Order ? | As per final order |
REASONS
6) As to Point No.1 to 4:- According to the complainant, she alongwith her husband requested the O.P.No.1/Bank for housing loan and same was sanctioned. They had insured loan under group suraksha policy under master policy no.0128591934 in Loan Account No.9/1009 for the amount of Rs.6,25,000/- in the name of her husband Pramod. She has produced the copy of the said policy on record. It shows that amount of Rs.6,25,000/- was secured under group suraksha policy in the name of Pramod, husband of the Complainant. This fact is not denied by the O.P.No.2. In the written statement, the O.P.No.1 has denied all the averments of the complaint. But in para 6 of the written statement, the O.P.No.1 has admitted that as per policy of O.P.No.1, the complainant and her husband were introduced to O.P.No.2 to take group suraksha policy for the amount of Rs.6,25,000/- on single mode premium of Rs.26,063/-. It is admitted that the said policy was issued in the name of Pramod. Thus, there is sufficient evidence on record to accept the averment of the complainant about group suraksha policy for the amount of Rs.6,25,000/-. The said policy is on record. It is not denied by the O.P.No.2. On the other hand, the complainant has produced letter from the O.P.No.2 dated 8th June, 2011 repudiating the claim of the complainant on the ground of history of Ischemic Heart Disease since six to seven years. Thus, the defence of O.P.No.2 is of previous history of IHD and non disclosure of it at the time of taking policy. In order to prove this defence, it was necessary for the O.P.No.2 to produce the proposal form and declaration of deceased Pramod. In the ordinary course, these documents are with the O.P.No.2. It is not clear as to whether the O.P.No.2 has obtained proposal form and declaration from the deceased Pramod. It is group suraksha policy. While taking defence, it was necessary for the O.P.No.2 to obtain declaration form from the insured. There is nothing on record to show that there was declaration obtained from the deceased and he has suppressed his disease. The complainant has specifically stated in her complaint as well as in her affidavit of evidence that her husband was not suffering from any heart disease. These averments and evidence is not denied by the O.P.No.2. Therefore, the defence of O.P.No.2 can not be accepted.
7) The learned advocate for the complainant has submitted that there was no pre existing ailment. Therefore, there was no question of suppressing it. He has placed reliance on the judgment of our State Commission in the case of Haresh Jathlal Shah –Versus- The United India Insurance Company Limited & Anr., reported in 2012(5) ALL MR (JOURNAL) 18. The facts before us are identical. In this case, there is no denial of policy. There is no evidence on record to show the suppressing of previous ailment. Therefore, the defence taken by the O.P.No.2 can not be accepted. The O.P.No.2 has received the premium of Rs.26,063/- and issued policy. Therefore, the O.P.No.2 is liable to pay the secured sum of Rs.6,25,000/-.
8) The O.P.No.1 has admitted in the written statement that the complainant and her husband were introduced to O.P.No.2 to take policy for collateral security under master policy for group suraksha policy. The complainant has informed the death of her husband. She is the nominee under policy. She is also joint borrower. Therefore, it was necessary for the O.P.No.1 to take follow up with O.P.No.2. The O.P.No.2 has wrongly repudiated the claim. Due to such repudiation, the complainant is paying interest on the amount of Rs.6,25,000/-. Due to wrong repudiation by O.P.No.2, the complainant is burdened with interest. Therefore, the O.P.No.2 is liable to pay amount of Rs.6,25,000/- with interest and the O.P.No.1 is liable to adjust it in the housing loan advanced to the complainant and her husband. The complainant has produced recent housing loan statement. It shows that earlier Loan Account No. was 9/1099. It was converted to new Loan Account No.06461200000054. The husband of the complainant died on 16th February, 2011. It was informed to the O.P.No.2 vide letter dated 4th March, 2011. Therefore, the O.P.No.2 is liable to pay amount with interest from 4th March, 2011 to the O.P.No.1 for adjustment of it in the old Loan Account No.9/1099 and new Account No. 06461200000054.
9) According to the complainant, the O.P.No.1 has wrongly deducted the premium of Rs.14,300/- every month. Terms and conditions for sanctioning the loan are not before the Forum. Therefore, it can not be decided whether the deduction of Rs.14,300/- per month is wrong. As discussed above, the complainant is entitled for adjustment of insured amount of Rs.6,25,000/-. The O.P.No.1 will reconstruct the account after adjustment of amount of Rs.6,25,000/-. Besides this, the complainant also claimed compensation of Rs.3,50,000/- towards interest, hardship and mental agony. As discussed above, the O.P.No.2 is liable to pay the amount with interest therefore, it is not necessary to pass further order about the interest. Inspite of requests by the complainant, the O.P.No.2 has wrongly repudiated the claim thereby the complainant suffered hardship and mental agony. Therefore, the O.P.No.2 is liable to pay compensation to the complainant for hardship and mental agony. We think compensation of Rs.10,000/- will suffice the purpose. The complainant is also entitled for the cost of this proceeding. We think cost of Rs.5,000/- will be the reasonable cost.
10) Thus, the complainant is entitled for adjustment of loan amount of Rs.6,25,000/- with interest. She is also entitled for compensation of Rs.10,000/- and cost of Rs.5,000/-. Hence, we proceed to pass the following order.
O R D E R
1) Complaint is allowed.
2) The O.P.No.2 shall pay Rs.6,25,000/- (Rs.Six Lakh Twenty Five Thousand Only) with interest at the rate of 10% per annum from 4th March, 2011 till its realization to O.P.No.1 and the O.P.No.1 shall adjust it in the old Loan Account No.9/1099 & New Loan Account No.06461200000054 of the complainant.
3) After adjustment of the above amount, the O.P.No.1 shall reconstruct the loan account and give the statement to the complainant for further payment.
4) The O.P.No.2 shall pay compensation of Rs.10,000/- (Rs.Ten Thousand Only) and cost of this proceeding Rs.5,000/- (Rs.FiveThousand Only) to the complainant within one month.
5) Copies of this order be sent to the parties free of cost.
Pronounced
Dated 11th September, 2013
