BEFORE THE A.P STATE CONSUMER DISPUTES REDRESSAL COMMISSION HYDERABAD.
F.A.NO.364 OF 2010 AGAINST C.C.NO. 74 OF 2009 DISTRICT VIJAYAWADA
Between:
M/s HDFC Standard Life Insurance rep. by its Branch Manager,
D.No.40-1-182, 1st Floor,
Appellant/opposite party
A N D
Smt Aged 49 years, R/o 40-5-8,
Jalaja Vijayawada.
Respondent/complainant
Counsel for Appellants Sri TVS Counsel for Respondents Sri
F.A.NO.806 OF 2010 AGAINST C.C.NO. 74 OF 2009
Between:
Smt Aged 50 years, R/o 40-5-8, Tikkle Road, Vijayawada, Krishna Dist.
Appellant/complainant
A N D
M/s HDFC Standard Life Insurance rep. by its Branch Manager,
D.No.40-1-182, First Floor,
M.I.Tower,
Labbipet, Vijayawada, Krishna Dist.
Respondent/opposite party
Counsel for Appellant Sri
Counsel for Respondent Sri TVS
QUORUM: SRI R.LAKSHMINARASIMHA RAO, HON’BLE MEMBER
AND
SRI THOTA ASHOK KUMAR, HON’BLE MEMBER
FRIDAY THE DAY OF MARCH
TWO THOUSAND TWELVE
Oral Order (As per Sri
***
1. Both appeals arise from the same order. The complainant has filed F.A.No.806 of 2010 whereas the opposite insurance company has filed F.A.No.364 of 2009.
2. The complainant’s husband during his life time obtained HDFC Unit Linked Youngster Plan Policy bearing No.10398191 for a term of 10 years from the opposite party insurance company for a sum of `2,50,000/-. The policy commenced from 21.11.2005. The complainant’s husband paid 3 yearly premiums at `50,000/- each. Subsequently, on 23.11.2007 the policy holder died while undergoing treatment at Apollo Speciality Hospital, Chennai. The complainant being the nominee under the insurance policy submitted claim form submitted along with the relevant forms to the opposite party insurance company on 9.1.2008. The opposite party has repudiated the claim of the complainant on the ground that her husband suppressed his ill-health at the time of taking the policy. Hence, the complainant has filed complaint before the District forum alleging deficiency in service on the part of the opposite party insurance company.
3. The complainant has filed her affidavit and the documents Exs.A1 to A12. On behalf of the opposite party insurance company, its Manager has filed the affidavit and the documents Exs.B1 to B9.
4. The District Forum has allowed the complaint on the premise that the complainant’s husband has not suppressed any material fact in regard to his health condition at the time of taking the insurance policy.
5. Dissatisfied with the award passed by the District forum the complainant has filed the appeal claiming interest on the amount of `2
6. Feeling aggrieved by the order of the District Forum, the opposite party insurance company preferred the appeal contending that the district Forum has not appreciated the documents filed by the insurance company showing that the policy holder was suffering from giddiness, vertigo, low HP and microcytic anaemia and that he was on medication prior to the date of taking the insurance policy.
7. The opposite party insurance company issuing the unit link youngster plan covering the risk on the complainant’s husband for a sum assured of `2 It is not denied that the complainant’s husband paid three instalments and he died on 23.11.2007. He died 2 years after taking the policy.
8. The repudiation of the claim was made on the ground that the complainant’s husband suppressed the fact that he was suffering from giddiness, vertigo, lo HP and microcytic anaemia. In support of its claim the opposite party insurance company has submitted the medical record of The insurance policy issued is a medical policy. The panel doctor of the opposite party insurance company examined the complainant’s husband and certified that he was not suffering from any disease.
9. The opposite party insurance company has not placed any contemporaneous evidence on record to show that the complainant’s husband was suffering from serious illness that Giddiness as in the common parlance is a symptom and not a disease. The complainant’s husband was not treated as an inpatient in any hospital prior to or at the time of taking the insurance policy. The opposite party insurance company has got examined the complainant’s examined subjecting him to pathological tests and having come to a conclusion that he was not suffering from any major disease warranting hospitalization and shortfall of his lifespan, had issued the insurance policy. We not see, in the circumstances any infirmity in the finding recorded by the District Forum that the complainant’s husband had fraudulently suppressed any material information causing the decision formation process on the part of the opposite party insurance company in the matter of issuing insurance policy. The District Forum has relied upon the decisions of the
10. The District Forum has referred to the following decisions:
1. Mothoolal
2. P.Sarojam
3. P.C.Chacko &
4. LIC of India
11. In the circumstances, the appeal filed by the opposite party insurance company is liable to be dismissed. Equally, the appeal filed by the complainant is liable to be dismissed for the reason that the District forum has awarded a sum of `5,000/- towards compensation and in our view the amount awarded as compensation would meet the ends of justice.
In the result, both the appeals are dismissed. The parties shall bear their own costs.
MEMBER
MEMBER
Dt.30.03.2012
KMK*
