BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM RAICHUR.
COMPLAINT NO. (DCFR) CC. 107/10.
THIS THE 17th DAY OF MAY 2011.
P R E S E N T
1. Sri. Pampapathi B.sc.B.Lib. LLB PRESIDENT.
2. Smt. Pratibha Rani Hiremath,M.A. (Sanskrit) MEMBER.
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COMPLAINANT :- Smt. Chanamma W/o. Late. Siddappa, Major Occ:
Household, R/o. Tavaga Village, Tq. Lingasugur, Dist: Raichur.
//VERSUS//
OPPOSITE PARTIES :- 1. State Bank of India, Life Insurance Company
Ltd., Registered Office, State Bank Bhavan, Madama, Kama Road, Nariman Point, Mumbai- 400 021.
2. State Bank of Hyderabad, Hutti, Tq. Lingasugur Dist: Raichur By its Branch Manager.
3. The Office of the Insurance Ombudsman, No. 6-2-46, 1st floor, Moin Court, AC Cards, Lakdi-ka-pool, Hyderabad- 500 004.
CLAIM : For to direct the opposites to pay Insurance
Policy amount of Rs. 1,00,000/- with Rs. 10,000/- towards damages and cost with interest.
Date of institution :- 07-12-10.
Notice served :- 07-01-11.
Date of disposal :- 17-05-11.
Complainant represented by Sri. Mallangouda, Advocate.
Opposite No. 1 represented by Sri. Yadavendra Katti, Advocate.
Opposite No-2 represented by Sri. I.M. Patil, Advocate.
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This case coming for final disposal before us, the Forum on considering the entire material and evidence placed on record by the parties passed the following.
JUDGEMENT
By Sri. Pampapathi President:-
This is a complaint filed by complainant Smt. Channamma against the opposite Nos. 1 to 3 U/sec. 12 of Consumer Protection Act, for to direct the opposites to pay Insurance Policy amount of Rs. 1,00,000/- with Rs. 10,000/- towards damages and cost with interest.
2. The brief facts of the complainant’s case are that, her deceased husband Siddappa was working in the Engineering Department of opposite No-2. At his lifetime he opted SBI Life Insurance Policy under SBH Depositors Scheme in the month of August-2005 from opposite No-1 through opposite No-2. Necessary premiums towards said policy was deducted in the salary of Siddappa. The said Siddappa died on 31-07-06, leaving behind complainant as a nominee and legal heir of him. After the death of Siddappa, she filed claim petition with required documents, but opposite No-1 sent a letter dt. 24-03-09 by repudiating her claim on the ground of suppression of pre-existing decease of Siddappa. The said facts are not correct. He was not suffering from any diseases till his death. Opposite No-3 Insurance Ombudsman not considered her request. Hence this complaint is filed against all the opposites for the reliefs as prayed in her complaint.
3. Opposite No-1 Insurance Company filed written version in detail by mainly contending that, the complaint is barred by limitation. The Siddappa policyholder was suffering from so many diseases prior to filing proposal form. He suppressed the material facts obtained Insurance Policy and after enquiry, it reveals that, he took treatment on so many occasions, as such the claim of complainant was rejected and prayed for to dismiss the complaint among other grounds.
4. Opposite No. 2 SBH Hutti, Branch contended that, Siddappa paid premium towards said Life Insurance, it acted as a middleman in between the complainant and opposite No-1. It has no role of any kind either in filing proposal form or in issuing the policy to Siddappa, there is no deficiency in service on its part accordingly, it prayed for to dismiss the complaint among other grounds.
5. Opposite No-3 Insurance Ombudsman, sent a letter dt. 24-12-10 to this Forum by contending that, there was a dispute in between the complainant and opposite No-1, he acted as an ombudsman in considering the claim of complainant. Dispute is not directly related to him. Hence the complaint filed by the complainant is not maintainable against him and prayed for to dismiss it.
6. In-view of the pleadings of the parties. Now the points that arise for our consideration and determination are that:
1. Whether this complaint is barred by limitation as contended by opposite No-1. In view of section 24(A)(1) of C.P. Act..?
2. Whether the complainant proves that, opposite No-1 Insurance Company failed in providing service to her by repudiating her claim on untenable grounds, even though, she is entitled to get policy amount of her husband It shown its negligence and thereby all opposites found guilty under deficiency in their services.?
3. Whether complainant is entitled for the reliefs as prayed in her complaint.?
4. What order?
7. Our findings on the above points are as under:-
(1) This complaint is barred by limitation U/sec. 24(A)(1) of C.P. Act.
(2) In Negative.
(3) In view of the findings on Point Nos-1 & 2, the complainant is not entitled for any one of the reliefs as prayed in her complaint.
(4) In-view of the findings on Point Nos. 1 to 3, we proceed
to pass the final order for the following :
REASONS
POINT NO.1 :-
8. Section 24(A)(1) of C.P. Act is in respect of limitation period to file Consumer Complaint. According to said provision the District Forum, State Commission, or National Commission shall not admit a complaint unless it is filed within two years from the date on which the cause of action has arisen.
9. Section 24(A)(2) provides to file complaint beyond limitation period of two years, only in case complainant satisfy the District Forum, State Commission, or National Commission as the case may be that, he/she had sufficient cause for not filing the complaint within such period of two years.
10. In the instant case, it is undisputed facts that, policyholder died on 31-07-06. This fact is confirmed by death certificate Ex.P-1. Ex.P-3 is the repudiation letter dt. 24-03-09 by opposite No-1. In the light of these facts, we have to ascertain, what is the exact date of cause of action arisen to the complainant to file this complaint and to see as to whether this complaint is barred by limitation U/sec. 24(A)(1) of C.P. Act or not.
11. The word cause of action as noted in 24(A)(1) of C.P. Act is consisting of bundle of facts, which differs from case to case, we cannot apply one formula or one fact to all the cases to determine the date of cause of action. Keeping in view of the legal meaning of the word cause of action as noted U/sec. 24(A)(1) of C.P. Act, we have to appreciate the present case of complainant.
12. As already stated above, the policy holder Siddappa died on 31-07-06 Ex.P-3 a repudiation letter of opposite No-1 dt. 24-03-09. From the said facts the date of cause of action 31-07-06, the complainant not filed consumer complaint within two years from the date of death of her husband Siddappa. She also not filed any documents to show that, she filed claim petition before opposite No-1 within a period of two years to show that cause of action was continuous one till 24-03-09. Her documents Ex.P-1 to Ex.P-4 are not related to that aspect. Ex.P-1 is the death certificate of Siddappa. Ex.P-2 is the copy of the Pass Book issued by opposite No-2. Ex.P-3 is the repudiation letter of opposite No-1dt. 24-03-09 and Ex.P-4 is a representation given by her to ombudsman dt. 25-10-10. Except these documents, no other documents are out coming from the side of the complainant to hold that, cause of action for her is continuous one from the date of death of her husband Siddappa till date of repudiation letter dt. 24-03-09.
13. Now let us see, as to whether, the repudiation letter Ex.P-3 of opposite No-1 dt. 24-03-09 creates any cause of action to complaint to file this complaint. Admittedly Ex.P-3 is a letter after more than two years from the date of death of Siddappa. So, in view of the absence of any documents from the complainant to show that, she filed her complaint within two years from the date of death of her husband ie, 31-07-06 or her cause of action was continuous till Ex.P-3, we are of the view that, Ex.P-3 repudiation letter beyond two years from the date of death of Siddapa will not create any cause of action to the complainant to file this complaint. Hence we are of the view that, this complaint is barred by limitation U/sec. 24(A)(1) of C.P.Act as it is filed near about five years after the death of Siddappa. This complainant not filed any application to condone such delay with sufficient cause as required U/sec. 24(A)(2) of C.P. Act, as such, this is time barred complaint, accordingly we answered Point No-1.
POINT NO.2:-
14. The claim of complainant was repudiated by the opposite No-1 on the ground that, late Siddappa suppressed the material facts regarding his prior health condition while filing proposal form and obtained LIC policy and thereby the reasons for his death was investigated and found that, he was suffering Cirrhosis of lever prior to filing proposal form.
15. In view of such defence taken by opposite No-1, it is settled law that, the burden of proving suppression of material facts regarding his prior health condition of Siddappa is on the opposite No-1. In order to discharge this burden opposite No-1 filed affidavit-evidence of it and also affidavit-evidence of investigating agency, who have been noted as RW-1 & 2, affidavit-evidence of opposite No-2 was filed who is noted as RW-3. Totally documents Ex.R-1 to Ex.R-12 are marked.
16. On the other hand, affidavit-evidence of complainant was filed, who is noted as PW-1 and documents Ex.P-1 to Ex.P-4 are marked.
17. We have given our attention to Ex.R-4 & Ex.R-5. Ex.R-4 is the case history regarding the treatment taken by the deceased Siddappa by admitting in the hospital from 13-09-04 to 01-11-04. It shows, the history of the patient as he was alcoholic, suffering from jaundice, heptostenonegaly and cirrhosis of lever. Further records are showing that, he was under constant treatment for the said decease till 05-06-06. Ex.R-5 is the certificate issued by the hospital authority regarding the treatment given to Siddappa, when he was again admitted on 27-07-06.
18. Keeping in view of the facts noted in Ex.R-4 & Ex.R-5 let us see other facts regarding the Insurance Policy Siddapa paid first premium on 31-08-05, therefore this fact shows that, deceased might have filed proposal form earlier to it. The said Siddappa not disclosed decease suffering by him as noted in case sheet. Ex.R-4 & Ex.R-5 at the time of filing proposal form. The above facts was confirmed by the affidavit-evidence of RW-2 investigator. The principles of the rulings referred by opposite No-1 in his written version along with the above facts and circumstances as noted in Ex.R-4 & Ex.R-5. It is a fact that opposite No-1 has discharged its burden of proving the fact that, deceased suppressed the material facts with regard to his prior health condition and treatment taken by him in his proposal form fraudulently to obtain policy from opposite No-1. Now coming to the evidence of complainant whether it over come the records and affidavit-evidence of RW-2, we are of the view that, documents filed by the complainant. Ex.P-1 to Ex.P-4 or affidavit-evidence of PW-1 not sufficient to disprove the above said medical records and affidavit-evidence of RW-2, as such, we are of the view that, opposite No-1 has proved the fact suppression of material facts by Siddappa with regard to sufferings of deceases prior to obtaining LIC policy from opposite No-1, fraudulently with an intention to get monetary benefit out of it, as such, we answered Point No-2 as in Negative.
POINT NO.3:-
19. Opposite No-2 & 3 are not necessary parties to this complaint, however both of them have appeared in this case and submitted their respective role in this case, we are of the view that, complainant failed in proving any kind of deficiency in service on the part of opposite No-1 or by opposite No-2 & 3, accordingly, the complainant is not entitled for any one of the reliefs as prayed in this complaint.
POINT NO.4:-
20. In view of our findings on Point Nos-1 to 3, we proceed to pass the following order:
ORDER
The complaint filed by the complainant against opposite Nos-1 to 3 is dismissed.
Intimate the parties accordingly.
(Dictated to the Stenographer, typed, corrected and then pronounced in the open Forum on 17-05-11)
Smt.Pratibha Rani Hiremath Sri. Pampapathi,
Member. President,
Dist.Forum-Raichur. Dist-Forum-Raichur.
