This C.C. is coming on before us for final hearing in the presence of Sri G.Bhaskar, Advocate for the complainant and of Sri G.Sita Rama Rao, Advocate for opposite party; upon perusing the material papers on record; upon hearing the arguments and having stood over for consideration this forum passed the following:
ORDER
(Per Sri R. Kiran Kumar, Member)
This complaint is filed u/s.12-A of Consumer Protection Act, 1986. The averments made in the complaint are that the father of the complainant by name Issarapu Prasad Rao, s/o.Prakasha Rao, who was a retired employee obtained a policy, opted for the “Reliance Super Invest Assure Plan” from the Bhadrachalam Branch Office, vide policy bearing No.14234028, by paying premium amount of Rs.3,00,000/-, for a sum assured of Rs.15,00,000/-, the date of commencement of plan from 31-3-2009. The complainant is the only daughter and the legal heir of the deceased, Prasad Rao. At the time of taking the policy, the said Prasad Rao mentioned the name of the complainant as his nominee. That on 3-4-2009 the policy holder, Prasad Rao died, immediately after his demise, in order to claim the policy amount, the complainant intimated the same to the opposite party by furnishing all relevant documents pertaining to the policy. But the opposite party failed to settle the claim, did not come forward to pay the policy amount and in this regard the complainant made many rounds around the office of opposite party. Having no other go, the complainant got issued a legal notice on 12-1-2010 to the opposite party demanding to pay the claim amount. The said notice was served to the opposite party, even after lapse of 3 months also, the opposite party did not come forward either to pay the amount or to give reply. It clearly shows the deficiency of service and negligent act on the part of opposite party. As such, the complainant approached the forum for redressal.
2. On behalf of the complainant, the following documents have been filed and marked as Exs.A.1 to A.4.
Ex.A.1 - Photocopy of insurance policy issued by the
opposite party, dt.31-3-2009
Ex.A.2 - Photocopy of proposal form
Ex.A.3 -Photocopy of death certificate of I.S.Prasada Rao,
issued by the Commissioner, Registrar of Births &
Deaths, Bhadrachalam Municipality.
Ex.A.4 - office copy of legal notice, dt.12-1-2010 along with
photocopy of postal receipt.
3. On receipt of the notice, the opposite party company appeared through their counsel and filed counter. In the counter, the opposite party submitted that the contract of insurance in the present matter was void abinitio, as the deceased/life assured had suppressed the material facts regarding his age at the time of availing the policy. The life assured has mentioned his date of birth as 17-1-1976 while filing the proposal form. However upon investigation, it was revealed that the actual date of birth of the deceased/life assured was 6-3-1939, which is mentioned in memorial service published by deceased life assured’s children, further the bank account number mentioned in the proposal form is not there in the bank’s record, the said information was vital for the issuance of the policy as the actual age of the deceased life assured was beyond the insurable age for availing Reliance Life Insurance policy and on this ground the opposite parties are entitled to rescind the contract as per section 45 of the Insurance Act, 1938. Further submitted that since one of the most important and basic principles of insurance is uberrimaefides i.e. utmost good faith and in the present case the deceased life assured had suppressed material facts about his age. Hence, the opposite party rightly repudiated the claim of the complainant on the ground of non- disclosure of material facts. The opposite party further submitted that as per the terms and conditions of the policy, since the deceased life assured had suppressed the material facts so all claim benefit shall cease and all monies that have been paid shall be forfeited to the opposite party company. However, the opposite party as good will gesture the fund balance amount of Rs.74,246.46 ps. was sent through cheque, vide cheque bearing No.216287, dt.30-11-2009 drawn on ICICI Bank in favour of the complainant and the same has been received by the complainant. The opposite parties further submitted that on 30-11-2009 the complainant was duly informed about the death claim repudiation based on the aforementioned reasons. As such this opposite party prayed that the complaint be dismissed with costs to meet the ends of justice.
4. To support their contention, the opposite party filed the following documents, which were marked as Exs.B.1 to B.4.
Ex.B.1 - Photocopy of proposal form
Ex.B.2 - Photocopy of Memorial service
Ex.B.3 - Photocopy of cheque bearing No.216287, dt.30-11-09
Ex.B.4 - Photocopy of repudiation letter, dt.30-11-2009
5. On behalf of the opposite party, written arguments filed.
6. Upon perusing the material papers on record, upon hearing the arguments, now the points that arose for consideration are,
- Whether the deceased/life assured had suppressed the material facts pertaining to his age in the proposal form, consequently the complainant is not entitled for the claim amount?
- To what relief?
Point No.1
7. In this case the father of the complainant by name, I.S.Prasad Rao during his lifetime had obtained “Reliance Super Invest Assure Plan” from the opposite party Bhadrachalam Branch Office, vide policy bearing No.14234028, by paying premium amount of Rs.3,00,000/-, for a sum assured of Rs.15,00,000/-, the date of commencement of plan from 31-3-2009. The life assured expired on 3-4-2009. After the demise of the life assured, the complainant submitted the claim form along with the relevant documents to the opposite party, but the opposite party made investigation. On investigation, the opposite party came to know that the deceased/life assured has intentionally suppressed the material facts about his age at the time of availing the policy, the assured has mentioned his date of birth as 17-1-1976 while filling up of the proposal form, during the course of investigation the opposite party came to know that the actual date of birth of deceased/life assured was 6-3-1939, which was mentioned in Memorial service published by deceased/life assured children, as in Ex.B.2. Further the opposite party came to know that the ban account mentioned in the proposal form is not there in the bank record.
8. From the material available on record we observed that the deceased/life assured suppressed his age at the time of availing policy and also in the first para of the complaint, the complainant admitted the deceased is a retired employee and also the complainant did not file any document to show the age of her father, which was objected by the opposite party.
9. The same was observed by the Hon’ble National Commission in II (2009) CPJ 38 (NC) PAGE 366 case in between LIC of India Vs. Yogendra Prasad Singh, Suppression of correct age – Claim repudiated – Complaint allowed by Forum – Order upheld in appeal – Hence revision – Son of deceased born on 1-5-1954, as per school records – Deceased father’s date of birth could not be 18-10-1950 – Document issued by school in due discharge of official duty, no affidavit required to prove the same – No occasion for lower Fora to disbelieve important piece of evidence – Material information withheld by not disclosing correct date of birth proved – Breach of principle of ubberrimafide – Repudiation of claim justified – Orders of lower Fora set aside.
10. From the above we observed that the opposite party company taken keen interest to safeguard their reputation in the market, the fund balance amount of Rs.74,246.46ps was sent to the complainant vide cheque bearing No. 216287, dt.30-11-2009 drawn on ICICI Bank and the same was received by the complainant and also repudiated the claim through letter, dt.30-11-2009. The insured is a retired employee, had the knowledge about his age and at the time of proposal he suppressed his date of birth and mentioned as 17-1-1976. Since the suppression of material fact, having knowledge of suppression of date of birth, the repudiation by opposite party was justified.
Point No.2
11. In the result, the complaint is dismissed. No costs.
Dictated to the steno, transcribed by her, corrected and pronounced by us in the open forum, on this 19th day of November, 2010.
PRESIDENT MEMBER MEMBER
DISTRIC CONSUEMRS FORUM, KHAMMAM
APPENDIX OF EVIDENCE
Witnesses examined for complainant: None
Witnesses examined for opposite party: None
Exhibits marked for Complainant:
Ex.A.1 - Photocopy of insurance policy issued by the
opposite party, dt.31-3-2009
Ex.A.2 - Photocopy of proposal form
Ex.A.3 -Photocopy of death certificate of I.S.Prasada Rao,
issued by the Commissioner, Registrar of Births &
Deaths, Bhadrachalam Municipality.
Ex.A.4 - office copy of legal notice, dt.12-1-2010 along with
photocopy of postal receipt.
Exhibits marked for opposite parties:
Ex.B.1 - Photocopy of proposal form
Ex.B.2 - Photocopy of Memorial service
Ex.B.3 - Photocopy of cheque bearing No.216287, dt.30-11-09
Ex.B.4 - Photocopy of repudiation letter, dt.30-11-2009
PRESIDENT MEMBER MEMBER
DISTRIC CONSUEMRS FORUM, KHAMMAM
