Haryana

StateCommission

A/294/2015

KOTAK MAHINDRA OLD MUTUAL LIFE INSURANCE CO. - Complainant(s)

Versus

SONIA DUDEJA - Opp.Party(s)

K.S.CHEEMA

03 Sep 2015

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION HARYANA, PANCHKULA

                                                 

First Appeal No  :      294 of 2015

Date of Institution:      26.03.2015

Date of Decision :       03.09.2015

 

1.     The Branch Manager, Kotak Mahindra Old Mutual Life Insurance Company Limited, Sector-12, Karnal.

 

2.     Kotak Mahindra Old Mutual Life Insurance Company Limited, Central Processing Centre, 8^th Floor, Godrej Coliseum behind Everard Nagar, Sion (East) Mumbai 400022.                                 

Appellants-Opposite Parties

Versus

 

Smt. Sonia Dudeja wife of late Sh. Rajesh Kumar s/o Sh. Chaman Lal, Resident of House No.40-G, Station Area, Nilokheri, District Karnal.

                                      Respondent-Complainant

 

CORAM:             Hon’ble Mr. Justice Nawab Singh, President.

                             Shri B.M. Bedi, Judicial Member.

                             Mrs. Urvashi Agnihotri, Member.                                                                     

Present:               Shri Hitender Kansal, Advocate for appellants.

                             Ms. Simarpreet Kaur, Advocate for respondent. 

 

                                                   O R D E R

 

NAWAB SINGH J.(ORAL)

 

This appeal of Kotak Mahindra Old Mutual Life Insurance Company Limited (for short ‘Kotak Life Insurance’) - Opposite Parties, is directed against the order dated December 16^th, 2014, passed by District Consumer Disputes Redressal Forum (for short ‘District Forum’), Karnal, in Complaint No.389 of 2012, filed by Smt. Sonia-Complainant-respondent.

2.      Rajesh Kumar–since deceased (hereinafter referred to as ‘Insured’)-husband of complainant-respondent, purchased a Life Insurance Policy bearing No.01388337 (Exhibit C-5) from the Kotak Life Insurance, on November 7^th, 2008 for Rs. 2,50,000/. The Term of the policy was 10 years. The installment premium payable was Half Yearly. The insured did not pay the installment of premium due on May 7^th, 2009. So, the policy lapsed. He paid the premium on January 31^st, 2010 to get the policy revived by filing revival form Exhibit A-3 and the Kotak Life Insurance revived the policy.

3.      The insured also purchased another policy No.01884730 (Exhibit C-3) from the Kotak Life Insurance on February 11^th, 2010 for Rs.1,60,000/-. The Term of the policy was 20 years and the installment premium payable was Half Yearly.

4.      The Insured died on March 26^th, 2010 due to illness. The complainant filed claim before the Kotak Life Insurance. The Kotak Life Insurance paid only Rs.31,077/-, that is, fund value of policy No.01388337 (Exhibit C-5) and denied to pay the remaining insured amount on the ground that the insured was not having good health prior to the date of revival of the policy, that is, January 31^st, 2010 and the same was concealed by him at the time of obtaining the policy.  

5.      Aggrieved thereof, the complainant filed complaint under Section 12 of the Consumer Protection Act, 1986. 

6.      The Kotak Life Insurance-Opposite Parties, contested the complaint by filing reply reiterating the fact stated above.

7.      After evaluating the pleadings of the parties and the evidence brought on the record, the District Forum, vide impugned order accepted complaint and issued direction to Kotak Life Insurance as under:-

“…….we accept the present complaint and direct the Ops to make the payment of sum insured in respect of the insurance policy 01388337 and 01884730 alongwith interest @ 9% per annum from the date of filing of the present complaint i.e. 14.08.2012 till its actual realization. The complainant shall also be entitled for a sum of Rs.25000/- for the harassment caused to him and a sum of Rs.2200/- towards legal fee and litigation expenses. The Ops shall make the compliance of this order within a period of thirty days from the date of receipt of the copy of this order.”

8.      It is not in dispute that the Life Insurance Policy (Exhibit C-5) was revived by the Kotak Life Insurance on January 31^st, 2010. It is also not disputed that the insured had purchased the second policy (Exhibit C-3) on February 11^th, 2010. There is nothing on the record to show that the insured was suffering from any disease prior to the date of revival of the policy, that is, January 31^st, 2010 and that the said ailment was within the knowledge of the insured. Mere mention of ailment in the hospital record does not prove that the insured was aware of that disease on the date of revival of the policy. That being so, it cannot be said that the insured made false declaration at the time of obtaining/revival of the policy. Therefore, the Kotak Life Insurance-opposite parties are liable to pay the sum assured to the complainant. No case for interference in the order of the District Forum is made out.

9.      In view of the above, the appeal fails and is hereby dismissed.

10.    The statutory amount of Rs.25,000/- deposited at the time of filing the appeal be refunded to the complainant-respondent against proper receipt and identification in accordance with rules, after the expiry of period of appeal/revision, if any.

 

Announced 03.09.2015

Urvashi Agnihotri Member

B.M. Bedi Judicial Member

Nawab Singh President

CL