BEFORE THE DISTRICT CONSUMER FORUM : WARANGAL
Present: Sri D. Chiranjeevi Babu,
President.
Sri N.J. Mohan Rao,
Member
And
Smt. V.J. Praveena,
Member.
Monday, the 02nd day of June, 2008.
CONSUMER COMPLAINT NO. 16/2007
Between:
1. Maloth Mangamma, W/o late Janardhan,
Age: 35 years, Occ: Household,
R/o Kodthimatu thanda
H/o Mangalvaripet (V), of
Khanapur (M), Warangal District.
2. Maloth Jyothi, D/o late Janardhan,
Age: 10 yrs, Occ: Student.
3. Maloth Ramu, S/o late Janardhan,
Age: 5 years, Occ: Student,
4. Maloth Laxman, S/ late Janardhan,
Age: 5 yrs, Occ: Student.
(The complainants Nos.2 to 4 are being minors,
Rep. by their natural guardian mother Maloth Mangamma
i.e., complainant No.1.)
… Complainants
AND
1. The Senior Divisional Manager,
LIC of India,
Divisional Office, Balasamudram,
Hanamkonda,
Warangal District.
2. The Branch Manager,
LIC of India,
Narsampet,
Warangal District.
… Opposite Parties
Counsel for the Complainants : Sri. T. Sarangapani, Advocate
Counsel for the Opposite Parties: Sri J.J. Ratnam, Advocate.
This complaint coming for final hearing before this Forum, the Forum pronounced the following Order.
ORDER
Per Smt.V.J. Praveena, Member
This is a complaint filed by the complainants against the opposite parties under section 12 of Consumer Protection Act, 1986 for a direction to pay Rs.1,00,000/- towards policy amount and Rs.1,00,000/- towards damages.
The brief averments contained in the complaint filed by the complainant are as follows:
The complainant No.1 is the wife and complainant Nos.2 to 5 are the legal heirs of Maloth Janardhan (herein after referred to as the deceased). The deceased during his life time obtained two life insurance policies bearing Nos.687081061 and 686718510 and paid the premiums to the Opposite parties. The husband of the complainant NO.1 died on 11-4-2005 due to Jaundice. After the death of the deceased the complainant No.1 submitted all the required documents to Opposite party NO.2. The opposite party No.2 paid Rs.32,880/- of policy bearing No.686718510 and refused to pay the amount of policy bearing NO.6867081061. The opposite party No.1 issued a letter to the complainant No.1 on 31-3-2006 stating that policy has become null and void on account of suppression of material information by the life assured at the time of effecting assurance vide letter reference No.MKTG/claims/449, dt.31-3-2006. Vexed with the attitude of the opposite parties, the complainant got issued legal notice to Opposite parties. Opposite party No.2 gave rely that the complainant has suppressed the material facts and obtained the policy thus policy became null and void. As such the complainant field this complaint before this Forum for redressal of his grievance.
Opposite parties filed the Written Version contending in brief as follows:
It is true that the husband of the complainant M.Janardhan had taken two life insurance policies from Opposite party No.2. Opposite party no.2 paid claim under policy No.686718510 to the complainant as life assured was maintaining good health at the time of taking policy from Opposite party NO.2. The life assured Sri Janardhan had suppressed his ill health i.e, suffering from cancer before taking the policy No.687081061, thus the policy become void and opposite parties are not liable to pay any amount under the policy. Hence, the complaint filed by the complainant may be dismissed.
The complainant in support of his claim filed his Affidavit in the form of chief examination and also marked Exs.A-1 to A-9. On behalf of opposite parties V. Bhaskar filed his Affidavit in the form of chief examination and also marked Exs.B-1 to B-4.
Now the point for consideration:
1) Whether there is any deficiency of service on the part of opposite parties?
2) To what relief?
The deceased during his life time obtained two policies from opposite party No.2. After the death of the deceased, the complainant No.1 submitted the required documents for settling the claim. The opposite party No.2 paid Rs.32,880/- towards policy bearing No.686718510 and repudiated to pay another policy bearing NO.687081061 due to suppression of material facts as the deceased was suffering with cancer earlier to taking policy bearing NO.687081061. As such the complainant filed this complaint before this Forum.
The opposite parties did not place any piece of paper to establish that the deceased was taken treatment at Cancer Hospital, Hyderabad. The concerned doctor who issued the said Exs.B-3 and B-4 – Medical Certificates shows that the complaint with duration Mild Fever since 3 months, loss of appetite, heaviness in abdomen, severe anaemia, no melina, hematosis . The above symptoms since 10 days back then developed anorexia and as per Ex.B-4 the doctor gave same certificate shows that the patient is suffering from fever since one month and have CML treatment at Cancer Hospital, Hyderabad and 2 days back he got Dysnocea.
As per Exs.B-3 and B-4 it is true that the deceased was suffering with fever and Dysncea and he treated at Cancer Hospital, but the person who treated the deceased and who has given Exs.B-3 and B-4 to the opposite parties he has not given any Affidavit before this Forum. If really the doctor gave Affidavit before this Forum on behalf of Opposite parties certainly the Forum can believe the version of the opposite parties that the deceased was treated in Cancer Hospital and he was getting fever and Dysncea prior of the taking the insurance policy. But in this case when the doctor has not given any Affidavit on behalf of opposite parties , we reject the Exs.B-3 and B-4. Nodoubt the deceased as per Ex.B-3 and B-4 suffering from Cancer and he has suppressed the material fact and obtained the policy from opposite parties, but without Affidavit of the concerned doctor, we dis-believe the version of the opposite parties.
As there is no evidence to show that the deceased was suffering from preexisting disease, taking the policy with concealment of the said disease from the opposite parties, we accept the contention of the complainant side i.e, the deceased died due to Jaundice and it is a natural death. The version of the opposite parties cannot be accepted without placing any record before this Forum.
Regarding Ex.B-2 which is the non -judicial stamp paper executed by the complainant to the agent one Venkat Narayana is not tenable and considered and we reject the same document.
For the foregoing reasons given by us, we come to the conclusion that the opposite parties committed deficiency of service. As the opposite parties committed deficiency of service, the complainant is entitled to get the policy amount from the opposite parties.
In the result the complaint is allowed and we direct the opposite parties to pay an amount of Rs.1,00,000/- (Rs.One lakh only) to the complainants jointly and severally along with interest @7.5% pa. from the date of filing of the complaint till the date of deposit. We also direct the opposite parties to pay an amount of Rs.500/- towards costs.
So far as apportionment of the policy amount is concerned, Complainant No.1 is entitled to get an amount of Rs.55,000/- and complainants No.2 to 4 are entitled to get an amount of Rs.15,000/- each being minors, their respective shares shall be ordered tobe kept in any Nationalized bank till they attain majority.
A month’s time is granted to the opposite parties for the compliance of the order.
(Dictated to the Stenographer, transcribed by her, corrected and pronounced by us in the open Forum, today, the 2nd June, 2008).
Sd/- Sd/- Sd/-
Member Member President,
District Consumer forum, Warangal.
APPENDIX OF EVIDENCE
WITNESSES EXAMINED
On behalf of Complainant On behalf of Opposite Party
Affidavit of complainant filed Affidavit of O.P.1 filed.
EXHIBITS MARKED
On behalf of complainant
- Ex.A-1 LIC Premium of the deceased.
- Ex.A-2 Letter from LIC of India, to complainant, dt.1-4-05.
- Ex.A-3 Proposal Deposit receipt.
- Ex.A-4 Letter from LIC of India, Warangal to complainant, dt.31-3-06.
- Ex.A-5 O/c of legal notice issued to Opposite party, dt. 14-6-06.
- Ex.A-6 Acknowledgment card.
- Ex.A-7 Death Certificate issued by Panchayat Raj, department.
- Ex.A-8 Letter from Opposite party to Sreeshailam Advocate, dt.17-6-06.
- Ex.A-9 Postal cover.
On behalf of Opposite party.
1. Ex.B-1 is the Policy.
2. Ex.B-2 Indian Non Judicial stamp paper.
3. Ex.B-3 Medical Certificate issued by Rohini Hospitals, dt.23-2-06.
4. Ex.B-4 Medical Certificate issued by Rohini Hospitals, dt.23-2-06.
Sd/-
President.
