[Delivered by Smt. M. Anuradha, Member]

          This Complaint is filed on 01-07-2014 by the Complainant, under Section 12 of the Consumer Protection Act, 1986 (registered on 15-03-2014), claiming Rs.1,00,000/- together with bonus and interest in addition to Rs.10,000/- towards mental agony and for costs for repudiating the Policy, bearing No.677015112 issued by the Opposite Party.

1.       The material averments of the Complaint filed by the Complainant, so far as the present controversy is concerned, in brief are as follows:

2.       The sister of the Complainant by name Gunja Kanna @ Kannamma took Policy, bearing No.677015112 from the Opposite Party on 27-12-2011 for a sum of Rs.1,00,000/-, putting her as nominee and paid premiums to the CB-II, Machilipatnam Branch, with plan and term 149-65-20 and died on 05-07-2012 due to massive heart attack and that inspite of representations, the Opposite Party did not pay the above amount.  Whereas, it is the main contention of the Opposite Party as per the material averments made in its written version filed before the Forum that the deceased suppressed about the death of her husband that the Complainant failed to submit B, B-1 forms and that on account of such suppression of material fact, claim of the claimant was repudiated. 

3.       The claimant filed her proof affidavit and marked Exs.A-1 to A-9 in support of her case before the Forum.  The Opposite Party filed the proof affidavit of its Branch Manager and marked Exs.B-1 to B-5 to substantiate its case before the Forum.  While at the time of hearing arguments, both parties filed written arguments in the Forum.

4.       The points for consideration are:

1)       Whether there is any deficiency in service on the part of the Opposite Party?          

2)       Whether the Complainant is entitled to have the reliefs as sought for?

3)       To what relief?

Point No.1:

5.       The following are the admitted facts in this case.  On Gunja Kanna @ Kannamma is the sister of the Complainant and the deceased took a Policy, bearing No.677015112 for a sum of Rs.1,00,000/- on 27-12-2011, under the original of   Ex.A-1 putting the Complainant as nominee and paid premiums under the Plan and Term 149-65-20 and died on 05-07-2012, which can be revealed in Ex.A-2 Death Certificate.  When the Opposite Party marked copies of Policy Form, Death Claim Rules and Policy Schedule as Exs.B-1 to B-5 respectively, the Complainant marked registered Notice got issued by her to the Opposite Party as Ex.A-3 and the reply letter by the Opposite Party to the counsel of the Complainant as Ex.A-5 and the Complainant got issued a letter to the Branch Office-II of the Opposite Party as Ex.A-6, before the Forum.

6.       As far as the Life Insurance Policy is concerned, it is a contract of utmost good faith and there should not be any suppression of material facts on the part of the deceased while submitting proposal form for the Policy in question.  The attention of the Forum in this connection has straightway been diverted to Ex.B-1 copy of Proposal Form and Ex.A-1 policy copy of the deceased life assured. 

7.       It is the main contention of the Opposite Party that though the husband of the life assured was not alive by the date of taking the original of Ex.B-1, the same was suppressed and that the same would amount to suppression of fact.  In order to substantiate the above contention, the Opposite Party has drawn the attention of the Forum to Ex.A-2 the Death Certificate. No doubt a mention is made in Ex.A-2 that the husband of the life assured was not alive by the date of death of the life assured, but the gap between Exs.B-1 and A-2 is more than six months and the Opposite Party has not placed any material to prove that husband of life assured died by the date of original of Ex.B-1.  So, there is no suppression of fact on the part of the life assured in this case. 

8.       It is the further argument of the Opposite Party that as per Ex.B-3 Circular issued by Central Office, the Complainant is not entitled to have any reliefs.  But, as per Ex.B-3, instructions mentioned therein came into force with effect from 17-03-2013.  Whereas, the Policy in question was obtained the life assured on 27-12-2011.  So, Ex.B-3 will not help the case of the Opposite Party in anyway. 

9.       The last contention taken by the Opposite Party is that the claimant failed to submit the relevant documents to him.  But, as per Ex.A-6 letter, the Complainant submitted all the relevant information submitted to the Branch Manager and Ex.A-7 Postal Acknowledgement is to the effect that such information was received by the concerned officer.  Accordingly, the above contention is negatived.     

10.     The learned advocate for Opposite Party, while arguing, has submitted the following decisions:

          (1) 1992 CPJ 493 (NC).    

          (2) 2010 (1) CPR 67.

          (3) 2006 (4) CPJ P.1.

          There cannot be any dispute with regard to the propositions laid down by their lordships in the above cases.  But, when the Forum considers the facts of the above three cases, it is very clear that they are entirely different to that of the case on hand.   

11.     Thus, in view of the above discussion, the Forum is of the opinion that there is deficiency in service on the part of the Opposite Party.  Accordingly the Point is answered.

Point No.2:

12.     In view of the answering Point No.1 in the above, the Complainant is entitled to have the requisite reliefs as sought for.  Accordingly, the Point is answered.

13.     In view of the answering Points 1 and 2 in favour of the Complainant and against the Opposite Party, the Complaint is allowed.

Point No.3:

14.     In the result, the Complaint is allowed.  The Opposite Party is directed to pay a sum of Rs.1,00,000/- (Rupees One Lakh only) to the Complainant towards insurance amount to the Complainant together with interest at the rate of 9% per annum from the date of the filing of the Complaint till the date of realization.  The Opposite Party is further directed to pay another sum of Rs.2,000/- (Rupees Two Thousand only) towards costs of the Complaint.  Time given for compliance of this Order is 30 (thirty) days from the date of receiving copy of this Order.                   

Typed by P.V.S.S. Prakasa Sastry, Junior Stenographer, to my dictation, corrected by me and pronounced by us in the open Forum, this the 19^th day of February, 2015.

                                                                                                                                      Sd/-

President

                                                Sd/-                                Sd/-

Member                          Member

District Consumer Forum-I,

Krishna, Machilipatnam

APPENDIX OF EVIDENCE

Witnesses examined

For the Complainant:                          For the Opposite Party:

P.W.1:          Gunja Saramma.                      D.W.1: P.V. Srinivasa Rao,

                   (by chief affidavit).                                       Senior Divisional Manager,

                                                                                       LIC of India, Machilipatnam.

                                                                                        (by chief affidavit).

DOCUMENTS MARKED

On behalf of the Complainant:

On behalf of the Opposite Party:

                                                                                                                                               Sd/-

                                                                         President