Tripura

StateCommission

F.A 14/2014

The Claim Review Committee & Others. - Complainant(s)

Versus

Smt. Tanusree Roy(Ghosh) - Opp.Party(s)

Mr.S.Pandit,Adv.,Mr.P.Saha,Adv., Mr.A.Debnath,Adv

11 May 2015

ORDER

 

STATE CONSUMER DISPUTES REDRESSAL COMMISSION,

TRIPURA

 

 

APPEAL CASE No.F.A-14/2014

 

1. The Claim Review Committee

Aviva Life Insurance Co.India Ltd.,

Aviva Tower, Sector Road,

Opposite Golf Course,

DLF Phase-V,Section-43,Gurgaon-122003.

 

2. The Branch Manager,

Aviva Life Insurance Co.India Ltd.

H.G.B.Road, P.O-Agartala,

District-West Tripura.

                   ….    ….    ….    ….    Appellants.

                   Vs

Smt. Tanusree Roy(Ghosh),

W/O Shri Rana Ghosh,

Town Pratapgarh, Central Road Extension,

P.O-Agartala, P.S-West Agartala,

District-West Tripura.

               ….    ….    ….    ….    Respondent.

 

 

PRESENT :

       

             HON’BLE MR.JUSTICE S.BAIDYA,

             PRESIDENT,

             STATE COMMISSION

                          

                  MRS. SOBHANA DATTA,

             MEMBER,

               STATE COMMISSION.

               

 

For the Appellants : Mr.S.Pandit,Adv.,Mr.P.Saha,Adv. & Mr.A.Debnath,Adv.

          For the respondent : Mr.D.D.Choudhury,Adv.& Mr.S.Paul,Adv.

                                            

Date of Hearing         :     10.04.2015.

Date of delivery of Judgment  :

J U D G M E N T

 

S.Baidya,J,

            This appeal filed on 02.06.2014 by the appellants under Section 15 of the Consumer Protection Act., 1986 is directed against the judgment and order dated 11.03.2014 passed by the Ld. District Consumer Disputes Redressal Forum, (in short District Forum), West Tripura, Agartala in case No.C.C-37 of 2013 whereby the Ld. District Forum allowed the complaint filed under Section 12 of the C.P.Act, 1986 directing the O.Ps, the appellants herein to pay the sum assured against the two policies namely WSG 1645323 for Rs.64,000/- and LSP 1544853 for Rs.1,50,000/- together with interest @ 9% p.a. from the date of filing of the complaint before the District Forum till realization, to the complainant within one month of the date of receipt of the copy of the judgment  with a further direction to the O.Ps to pay a sum of Rs.1,500/- to the complainant as cost of litigation.      

2. The case of the appellant-O.Ps as narrated in the memo of appeal, in brief, is that after duly deliberating and understanding all the terms and conditions of the plan Shibani Roy(DLA) filled up and signed the proposal forms for two policies on two different dates namely on 27.07.2007 for Rs.64,000/- and also on 30.04.2007 for Rs.1,50,000/- with declaration that she had made complete, true and accurate disclosure of all the facts and circumstances as may be relevant for the acceptability of the risk and had not withheld any information as may be relevant for the acceptability of the proposal and also by way of answering “NO” to all the questions at page 4 of the proposal form concerning family and personal details of the life to be insured.                                                 
3. He also stated that basing on the information provided and declaration made in the proposal forms and on receipt of the premium the two policies mentioned above were issued to the DLA(Shibani Roy) on 02.08.2007 and 21.05.2007, but on 26.10.2009 the appellants received a Death Claim Intimation along with copy of the death certificate of the deceased life assured from the respondent-complainant i.e. daughter of DLA who is the nominee of the said DLA in respect of said two policies stating that the DLA passed away on 20.09.2009.
4. It is also stated that on receipt of the claim intimation the appellants requested the respondent to provide record of any illness in the past three years and any other relevant documents concerning Shibani Roy and thereafter on going through the documents submitted by the respondent-complainant, the appellants arranged for an investigation through SRK investigation Pvt. Ltd. and therefrom, the appellants came to know from the medical treatment record procured from the Cancer Hospital, Tripura that DLA was suffering from Carcinoma Cervix since March, 2007 and was getting treatment from the said Cancer Hospital as OPD patient i.e. the DLA was suffering from Cancer prior to the signing of the proposal forms for two policies, but the DLA in the proposal forms suppressed that fact of her suffering from Cancer and as such, the appellants repudiated the claim of the respondent-complainant on the ground that the DLA in the proposal forms suppressed the material facts.
5. It is also stated that the respondent then being the complainant filed the complaint under Section 12 of the C.P.Act against the present appellants who contested the said complaint case by filing written objection alleging that the DLA suppressed the material fact and thereby concealing her suffering from the Cancer in the proposal forms got two policies issued by the appellants in her favour fraudulently.
6. It is also stated that the Ld. Forum considering the pleadings of the parties and evidences passed the impugned judgment and thereby being aggrieved and dissatisfied with the impugned judgment, the appellants have preferred the instant appeal on the grounds that the Ld. Forum while passing the impugned judgment has failed to appreciate that the complaint is false, malicious, incorrect and malafide, that the Ld. Forum failed to appreciate that the complaint lacks of cause of action and the complaint was based on mere surmises and conjectures and that the Ld. Forum being failed to appreciate the fact and circumstances of the case erroneously passed the impugned judgment which is not sustainable in law and is liable to be set aside.             

Points for consideration.

7.       The points for consideration are (1) whether the Ld. District Forum was proper, legal and justified in passing the impugned judgment and (2) whether the judgment under challenge is liable to be set aside.     

                         Decision with Reasons.

8.  Both the above mentioned points are taken up together for the sake of convenience and brevity.
9. The learned counsel for the appellants submitted that it is true that the appellants engaged an investigating agency to make investigation into the cause of death of the DLA-Shibani Roy. He also submitted that from the result of the investigation, it was established that the DLA was suffering from Cancer and she was treated in Cancer Hospital, Tripura as OPD patient since March, 2007. He also submitted that in spite of his earnest effort, he could not produce the investigator as a witness before the Ld. District Forum nor could he produce the original investigation report for establishing the case made out by the present appellants in the written objection filed in the District Forum. He also submitted that he only produced some zerox copies of the treatment papers of DLA in the District Forum, but he could not succeed to get those zerox copies of the medical papers exhibited in the District Forum as documentary evidence. He also submitted that in spite of his attempt, the O.Ps, the appellants herein even could not adduce any oral evidence in support of the case made out in the written objection. He also submitted that the Ld. District Forum considering the pleadings of the parties and other materials passed the impugned judgment and the O.Ps as appellants have filed the instant appeal challenging the appropriate and justifiability of the impugned judgment.  
10. The learned counsel for the appellants also submitted that in this appeal, the appellants filed an application under Order 41 Rule 27 read with Section 151 of the C.P.C. praying for adducing additional evidence in this appeal before this Commission. He also submitted that the appellants simply filed that application unaccompanied by any documentary evidence or the oral evidence on affidavit of any witness. He also submitted that said application of the appellants was rejected vide Order dated 30.01.2015 being not tenable in law on the ground that the Order 41 Rule 27 of the C.P.C. does not contemplate for production of any document by issuing summons. He also submitted that against that order dated 30.01.2015, in spite of his instruction, the appellants did not move the Hon’ble National Commission and as a result, the said order dated 30.01.2015 has become final and binding on the appellants.
11. The learned counsel for the appellants also submitted that at this stage legally he is not in a position to make any submission for adducing alleged additional evidence in this appeal. He then submitted that considering the facts and circumstances of the case of the appellants as made out in the memo of appeal, the Hon’ble Commission may pass appropriate order and judgment as deem fit and proper by way of allowing the appeal.  
12. The learned counsel for the respondent submitted that mere filing a written objection against the complaint lodged under Section 12 of the C.P.Act, 1986, the appellants herein practically did nothing in the District Forum to substantiate the case made out in the written objection. He also submitted that the appellants took no effective step in the District Forum for proving medical treatment papers as documentary evidence by way of calling for the records from the appropriate authority in support of their alleged case made out in the written objection. He also submitted that as per case of the appellants, SRK, Investigation Pvt. Ltd. was appointed by the appellants who made investigation into the cause of death of the DLA, but neither any investigator was examined in the district Forum nor any investigation report in original was produced in support of the case of the appellants. He also submitted that the appellants as O.Ps practically did nothing in the District Forum, barring filing a written objection against the complaint. He also submitted that in that circumstances, the Ld. District Forum finding no contrary evidence and also finding no evidence in support of the case of the O.Ps and relying on the evidences adduced from the side of the complainant, the respondent herein passed the impugned judgment which being proper, legal and justified should be affirmed and the appeal liable to be dismissed.    
13. We have gone through the pleadings of the parties, the evidences adduced in the District Forum, the impugned judgment and the memo of appeal. We have also considered the submissions of the learned counsels of both sides made before us. No doubt, the Consumer Protection Act, 1986 is a beneficial legislation and with a view to render substantial justice to the person harassed on account of negligence and deficiency in service on the part of the other side, it is well settled principle of law that strict proof of any document as per the provision of the Indian Evidence Act does not require to be followed. But there should be a guarantee regarding the authenticity and the accuracy of the document intended to be adduced as documentary evidence. But the appellants as O.Ps did nothing in this regard. Mere zerox copy of a document does not ifsofacto give any guarantee regarding its authenticity and accuracy. So, it is found that the appellants as O.Ps miserably failed to take any effective step in this regard.   
14. The alleged investigation report in original is obviously with the office of the appellants and the appellants could easily be produced that report before the District Forum as documentary evidence by way of examining the alleged investigator. So, it is found that the O.Ps also miserably failed in this regard.  
15. The appellants as O.Ps have made out the case in the written objection in support of the plea of repudiation of the claim of the complainant. But mere pleading unsupported by any evidence is not the ifsofacto proof of the matter pleaded. The pleading of a party pleaded either in the complaint or in the written objection requires to be substantiated by adducing cogent and reliable evidences. But in the instant case, we find that the appellants as O.Ps totally failed to prove their pleading of repudiating the claim of the respondent-complainant as narrated in the written objection. That being the position, it is palpable that the pleading of the O.Ps made out in the written objection without any evidence becomes a myth and is found without any basis.
16. We have meticulously gone through the impugned judgment wherefrom, we find that the Ld. District Forum elaborately and categorically discussed all the aspects of the case and ultimately arrived at the conclusion and passed the impugned judgment which, according to us, being found proper, legal and justified should be affirmed and as such, the impugned judgment calls for no interference by this Commission and accordingly, the appeal having no merit is liable to be dismissed.    
17. In the result, the appeal fails. The impugned judgment dated 11.03.2014 passed by the Ld. District Forum, West Tripura, Agartala in case No.C.C. 37/13 is hereby affirmed. There is no order as to costs.

   

                      MEMBER                                             PRESIDENT

                            State Commission                                    State Commission

                                    Tripura                                                      Tripura