BEFORE THE KARNATAKA STATE CONSUMER DISPUTES REDRESSAL COMMISSION,
BANGALORE (ADDL. BENCH)
DATED THIS THE 27th DAY OF OCTOBR 2022
PRESENT
MR. RAVISHANKAR : JUDICIAL MEMBER
MRS. SUNITA CHANNABASAPPA BAGEWADI : MEMBER
APPEAL NO. 1483/2012
1. | M/s Birla Sun Life Insurance Company Ltd., Rep. by its Managing Director, One Indiabulls Centre Tower-1, ‘15th & 16th Floor, Jupiter Mill Compound, 841 Senapati Bapat Marg, Elphinstone Road, Mumbai 400 013. | ……Appellant/s |
2. | Birla Sun Life Insurance Co., Ltd., Mandya Branch, Near Canara Bank, Mandya City. (By Smt. Sunanya Basu Malik) | |
V/s
Sri Ravi, S/o Late Venkatesh, House No.1866/1, Mangalavara Pet, 13th Cross, Channapatna Town, Ramanagara District. (By Sri M.Y. Srinviasan) | ..…Respondent/s |
ORDER
MR. RAVISHANKAR, JUDICIAL MEMBER
1. The appellants/Opposite Parties have preferred this appeal being aggrieved by the Common Order dt.19.05.2012 passed in CC.Nos.189/2011 & 202/2011 on the file of District Consumer Disputes Redressal Commission, Mandya which directed this appellant to pay a sum of Rs.3,02,000/- along with Rs.2,000/- litigation expenses in CC.No.202/2011.
2. The brief facts of the case are as hereunder;
It is the case of the complainant that the father of the complainant Late Mr. Venkatesh had obtained two insurance policies from the Opposite Party company to the tune of Rs.5,00,000/- and Rs.3,02,000/- respectively. The deceased Mr. Venkatesh had took two insurance policies one policy bearing No.003822839 obtained on 08.03.2010 for Rs.3,00,000/-. The complainant in CC.No.202/2011 Mr. Ravi, Son of an insured/deceased is the nominee to the said policy. The another insurance policy bearing No.004309250 obtained on 11.08.2010 for an insured amount of Rs.5,00,000/-. The complainant in CC.No.189/2011 Smt. Latha, Wife of an insured is the nominee to the policy. After receipt of the premiums, the appellant had issued a policy in favour of the life assured/ deceased Mr. Venkatesh. Such being the case, on 20.01.2011 the life insured died due to heart attack. Being the nominee to the policies, both complainants in CC.Nos. 189/2011 and 202/2011 have claimed for the assured amount from the Opposite Party company. After receipt of the claim form, the Opposite Party company repudiated the claim for the reason that the insured/deceased had suppressed the material facts as the insured was a chronic smoker and drinker since 30 years. Against which, the both the complainant filed a complaints before the District Commission alleging deficiency in service in not settling the claim. After trial, the District Commission dismissed the CC.No.189/2011 filed by Smt. Latha, wife of an insured/deceased and allowed the CC.No.202/2011 filed by Mr. Ravi, son of an insured/deceased and directed the Opposite Party company to pay an assured amount of Rs.3,02,000/- to the complainant along with costs and compensation.
3. Aggrieved by the said order, the appellants/ Opposite Parties are in appeal. Heard the arguments of appellant.
4. On going through the memorandum of appeal and the documents produced before the District Commission, we noticed here that the life assured Mr. Venkatesh in his lifetime had obtained two insurance policies one policy was on 08.03.2010 for an assured sum of Rs.3,00,000/- and made his son Mr. Ravi as nominee. Subsequently on 11.08.2010 again he obtained another policy for an assured sum of Rs.5,00,000/- and made his wife as a nominee. Subsequently the policy was issued from the appellant company. On 20.01.2011 the life assured was died due to heart attack. Subsequently the claim was made by both the nominees. The said claims were repudiated by the appellant company for the ground that the life assured suppressed his health condition prior to taking the policy and in the proposal form he stated his health is in good condition. Against which the nominees filed a complaints before the District Commission. The District Commission after observation of the documents produced by both parties have come to the conclusion that the policy obtained by the said life assured Mr. Venkatesh had no knowledge about his health condition (cancer) at the time of taking proposal and allowed the Complaint No.202/2011 directing the Opposite Party to pay the said amount. Subsequently another Complaint No. 189/2011 was dismissed for the reason that the life assured has knowing fully that he is suffering from cancer and not disclosed the same at the time of taking the policy, hence, on this ground the complaint was dismissed.
5. We noticed here that the District Commission had appreciated the documents produced by the Opposite Party that the case sheet issued by Kidwai Memorial Institute of Oncology dt.21.07.2010 wherein it was noticed that the deceased/life assured Mr. Venkatesh was suffering from CA-OESOPHAGUES cancer and life assured had obtained a policy bearing No.004309250 on 11.08.2010 whereas the CC.No.189/2011 was allowed as because the policy was obtained on 08.03.2011 prior to the diagnosis made by the Kidwai hospital and directed the Opposite Party to pay the amount of Rs.3,00,000/-. The District Commission has rightly appreciated the documents produced by the Opposite Party and directed the Opposite Party to pay an amount of Rs.3,00,000/- under the policy which was issued earlier to the hospitalization of the life assured.
6. The learned counsel for the appellant vehemently argued that the chronic smoking and alcohol leads to such cancer and life assured failed to express the said smoking and drinking habits at the time of taking the proposal and he has deliberately suppressed his health condition and obtained the policy which amounts to suppression of material facts. The appellant/Opposite Party failed to produce any materials before the District Commission to establish that the life assured had knowledge about his illness/cancer at the time of taking the first policy i.e. on 08.03.2010. Hence, the assured amount under the policy issued on 08.03.2010 is payable to the complainant. The District Commission has rightly appreciated the documents produced by both parties and allowed the CC.No.202/2011 and dismissed the CC.No.189/2011. We found that there are no any merits in the appeal. The Order passed by the District Commission is just and proper and is in accordance with law. No interference is required. Hence, the following;
ORDER
The appeal is dismissed.
The amount in deposit shall be transmitted to the District Commission for disbursement of the same to the complainant.
Forward free copies to both parties.
Sd/- Sd/-
MEMBER JUDICIAL MEMBER
KCS*
