Before the District Consumer Disputes Redressal Forum, Rohtak.
Complaint No. : 37.
Instituted on : 17.01.2017.
Decided on : 08.10.2018.
- Suman aged about 26 years wd/o Late Sh. Sumer s/o Sh. Krishan.
- Prince(minor) s/o Late Sumer Singh through his mother Smt. Suman being natural guardian and next friend.
- Krishan s/o Ami Lal
All residents of village Koyal Tehsil Narwana District Jind.
………..Complainant.
Vs.
- Shri Ram Life Insurance Company Ltd. at Ashoka Plaza 2nd Floor near Maina Complex through its Branch Manager Rohtak District Rohtak.
- Shri Ram Life Insurance Company Ltd., Plot No.31 & 32, 5th & 6th Floor Ramky Selenium , Besides Andhra Bank Training Centre. Financial District Gachibowli, Hyderabad-500032.
……….Opposite parties.
COMPLAINT U/S 12 OF CONSUMER PROTECTION ACT,1986.
BEFORE: SH.NAGENDER SINGH KADIAN, PRESIDENT.
SH. VED PAL, MEMBER.
SMT. SAROJ BALA BOHRA, MEMBER.
Present: Sh. Ramesh Sharma, Advocate for the complainant.
Sh.Gulshan Chawla, Advocate for the opposite parties.
ORDER
NAGENDER SINGH KADIAN, PRESIDENT:
1. Brief facts of the case are that husband of the complainant had obtained a policy from the respondents bearing No.NP131600023626 on dt. 11.02.2016 for a period of 25 years with accidental or incidental benefits. That unfortunately on 19.03.2016 the husband of the complainant suffered pain and had died. That complainant contacted the opposite parties for getting the insurance claim and deposited the original policy copy and other relevant documents to the office of respondents. But the opposite parties refused to pay the claim amount to the complainant without any sufficient cause or reason on some flimsy grounds. That the act of opposite parties is completely against the law and principal of natural justice. It is therefore, prayed that the OPs may kindly be directed to pay Rs.288000/- alongwith interest, compensation and litigation expenses as explained in relief clause.
2. Notice of the complaint was issued to the opposite parties. Opposite parties in their written reply has submitted that late Sumer Singh submitted proposal for insurance on 11.02.2016 and the policy was issued on 15.02.2016. That non disclosure of the kidney disease, prior to the date of proposal and also about the treatment of same was material for issuance of the policy which ought to have been revealed by the life assured in the proposal form. Had the life assured disclosed about the ailment the answering opposite party would have restrained themselves from entering into an agreement and would not have issued the policy in question. That the LA had taken treatment of the said ailment from BPS Government Medical College for Women, Khanpur Kalan(Sonepat). That the claim of the complainant was rightly repudiated vide repudiation letter dated 02.11.2016 duly served upon the complainant. Opposite parties prayed for dismissal of complaint with costs.
3. Both the parties led evidence in support of their case.
4. Ld. Counsel for the complainant in his evidence has tendered affidavit Ex.PW1/A, documents Ex.P1 to Ex.P8 and closed his evidence. On the other hand ld. Counsel for the opposite parties has tendered affidavit Ex.RW1/A, documents Ex.R1 to Ex.R5 and has closed his evidence.
5. We have heard ld. counsel for the parties and have gone through the material aspects of the case carefully.
6. The perusal of the documents itself shows that the treatment record placed on record by the respondents regarding the illness is not corroborative. The perusal of report Ex.R2 shows that the name of the patient is Sumer and age is mentioned as 20 years whereas the deceased LA was of 27 years. Moreover, in this report the name of father and residential address is not mentioned. The OPs have not produced any document to prove that the treatment record placed on record by the respondents is of deceased LA Sumer s/o Sh. Krishan in any manner. It has not been mentioned in the reply or any other document that regarding which ailment the deceased took treatment from BPS Khanpur Hospital. No opinion of any doctor or written submission has been placed on record that deceased LA was suffering from any ailment or took treatment from BPS Khanpur. As such the respondents have wrongly repudiated the claim and the complainants/LRs are entitled for the claim under the policy.
8. In view of facts and circumstances of the case, complaint is allowed and it is directed that opposite parties shall pay the amount of Rs.288000/-(Rupees two lac eighty eight thousand only) alongwith interest @ 9% p.a. from the date of filing the present complaint i.e. 17.1.2017 till its actual realization, other benefits under the policy, if any to the complainants within one month from the date of decision. It is also made clear that out of the awarded amount Rs.80000/-(Rupees eighty thousand only) shall be paid to the father of deceased Sumer Singh namely Krishan i.e. complainant no.1, Rs.108000/-(Rupees one lac eight thousand only) to the wife of LA namely Suman i.e. complainant no.1 and Rs.100000/-(Rupees one lac only) to the son of complainant namely Prince(minor) i.e. complainant no.2, all the alleged amounts alongwith interest @ 9% p.a. from the date of filing the present complaint i.e. 17.1.2017 till its actual realization respectively to the complainants. However the amount after disbursement on account of complainant no.2 of minor son Prince should be deposited in any nationalized bank till his majority and will be paid to him on attaining the date of majority.
9. Copy of this order be supplied to both the parties free of costs.
10. File be consigned to the record room after due compliance.
Announced in open court:
08.10.2018. ................................................
Nagender Singh Kadian, President
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Ved Pal Hooda, Member.
…………………………..
Saroj Bala Bohra, Member.
