Orissa

Cuttak

CC/127/2015

Rosalin Nayak - Complainant(s)

Versus

Senior Branch Manager,Life Insurance Corporation of India - Opp.Party(s)

A K Samal

29 Nov 2022

ORDER

IN THE COURT OF THE DIST. CONSUMER DISPUTES REDRESSAL COMMISSION,CUTTACK.

C.C.No.127/2015

 

Rosalin Nayak,

Sister of Late Soubhagini Nayak,

At:Gajipur,PO:Chanchol,Danpur,Dist:Kendrapapra,

At present: Plot No.736/1233, Koradakanta,

PO:Budheswari,  P.O:Mancheswar,

Bhubaneswar,Dist:Khorda.                                       ... Complainant.

 

                                   Vrs.

1.      Life Insurance Corporation of India,

District Branch Office,Jeevan Jyoti,

Link Road,Cuttack-753012,Dist:Cuttack,

Through its Senior Branch Manager.

 

.

2.      Life Insurance Corporation of India,

Cuttack Divisional Office, Nuapatana, P.O.Box No.36,

Cuttack-753001,Dist:Cuttack,

trough its Senior Divisional Manager.                                           ... Opp. Parties.

 

 

Present:  Sri Debasish Nayak,President.

      Sri Sibananda Mohanty,Member.

 

Date of filing:      21.11.2015

Date of Order:    29.11.2022

 

For the complainant:          Mr. A.Samal,Advocate.

For the O.Ps :           Mr. S.Swain,Adv. & Associates.

 

 

Sri Debasish Nayak,President.                            

                                               

          Case of the complainant as made out from the complaint petition in short is that her sister Soubhagini Nayak  had obtained one LIC Policy bearing No.588617919 from the O.Ps on 17.12.2009 wherein the sum assured was of Rs.3,00,000/-.  While the said policy was inforce, the insured Soubhagini Nayak died on 23.1.2010 due to hypertension at the PHC of Nankar in the district of Kendrapada.  The complainant being the sister of the deceased Soubhagini Nayak andthe nominee in the said policy, had claimed for the insured amount before O.P No.1.  She had deposited the relevant documents also.  But the O.Ps had repudiated her claim on 3.3.14 alleging therein that the deceased life assured had not disclosed about her illness at the time of proposal for the said policy that she was a known case of Anaemia(bloodlessness).  Inspite of several efforts when the complainant failed to get back the assured amount of Rs.3,00,000/- from the O.Ps, the complainant has filed this case claiming the assured amount of Rs.3,00,000/- from the O.Ps together with interest thereon @ 12% per annum with effect from 23.1.2010 till the total amount is quantified.  She has further claimed from the O.Ps a sum of Rs.50,000/- towards compensation for her mental agony and harassment and further a sum of Rs.10,000/- towards her litigation expenses.  She has also prayed for any other reliefs as deemed fit and proper.

          The complainant has filed copies of the policy of her deceased sister Soubhagini Nayak together with the premium receipts, copy of the death certificate of Soubhagini Nayak and her copies of correspondences with the O.Ps.

2.       The O.Ps have contested this case and have filed their written version jointly.  According to them, the case of the complainant is not maintainable which is liable to be dismissed with cost.  The case of the complainant is barred by law of limitation, bad for mis-joinder and non-joinder of necessary parties.  They also allege about the suppression of the material facts by the deceased Soubhagini Nayak that she had severe Anaemia.  They have relied upon the out door tickets of Nankar PHC(N) of dt.1.12.2009,19.12.2009,5.1.2010 and 19.1.2010.  According to them, the deceased Soubhagini Nayak was under regular treatment for Anaemia and hypertension prior to commencement of the policy.  It is alleged by the O.Ps that by suppressing the said facts there was a clear-cut violation of the terms and conditions of the policy.  In this context they have relied upon a decision of our Hon’ble Apex Court in the case of Mithoolal Naik Vrs. LIC of India reported in AIR 1962(SC) 814 wherein their lordships have held that the policy holder was guilty of suppression of material facts relating to his health and the Company is entitled to avoid the contract further, the appellant was not entitled even to a refund of the money paid as premium as one of the terms of the policy was that all monies paid belonged to the company if the policy was vitiated by fraudulent suppression of material facts.  Thus, according to the O.Ps they had not practised unfair trade nor they were deficient in their service by repudiating the claim of the complainant. 

They have also filed copies of several documents in order to establish their stand.

3.         Keeping in mind the averments of the complaint petition and the contents of written version, this Commission thinks it proper to settle the following issues in order to arrive at a proper conclusion here in this case.

i.          Whether the case of the complainant is maintainable ?

ii.         Whether there was any deficiency in service on the part of the O.Ps & if there was practice of any unfair trade by the O.Ps ?

iii.        Whether the complainant is entitled to the reliefs as claimed?

Issue no.ii.

Out of the three issues, issue no.ii being the pertinent one is taken up first to be considered here in this case.

On perusal of copies of the available documents in this case, it is noticed that admittedly the deceased Soubhagini Nayak had obtained a policy from the O.Ps which was inforce when she died and the present complainant is the sister of the said deceased Soubhagini Nayak and also the nominee in the said policy of the said deceased.  When the complainant being the nominee had applied for the assured money from the O.Ps in respect of the death of her sister Soubhagini Nayak, it is noticed that the O.Ps had sent a letter dt.3.3.14 to the complainant that the deceased assured Soubhagini Nayak had mentioned in her policy proposal that her state of health was good and she had no ailments like blood pressure etc.  The O.Ps have collected medical documents from the Public Health Centre of Nankar whose copies they have filed together with their written version.  Those when perused, it is noticed that, the assured deceased Soubhagini Nayak was being treated regularly there at Nankar PHC for Anaemia and hypertension.  Thus while weighing the evidence as available from either sides in this case, it is noticed that the balance of convenience leans in favour of the O.Ps since because infact the deceased assured Soubhagini Nayak had suppressed her previous illness like Anaemia and hypertension while entering into the policy and filling up the proposal form with the O.Ps.  In this connection the O.Ps have rightly relied upon the pertinent decision of the Hon’ble Apex Court in the case of of Mithoolal Naik Vrs. LIC of India as reported in AIR 1962(SC) 814.  Thus, this Commission finds no deficiency in service on the part of the O.Ps when they had repudiated the claim of the complainant as there was suppression of material facts which hadinfact  violated the terms and conditions of the LIC policy as obtained by the deceased assured Soubhagini Nayak.  Accordingly, there is also no notice of unfair trade practice.  Hence, this issue goes in favour of the O.Ps.

            Issues no.i& iii.

From the discussions as made above, it can never be said here that the case as filed by the complainant is maintainable and the complainant is entitled to any of the reliefs as claimed by her.  Hence it is so ordered;

ORDER

Case is dismissed on contest against the O.Ps and as regards to the facts and circumstances of the case without any cost.

Order pronounced in the open court on the 29^th day of   November,2022 under the seal and signature of this Commission.             

                                                                                                                                Sri DebasishNayak

                                                                                                                                            President

                    

                                                                                                                                                                   Sri SibanandaMohanty

                                                                                                                                                Member