Between:

Sagi Rama Devi, W/o late Narayana Raju, 38 years,

Hindu, House hold duties, residing at Door No.5-239,

Rameswar Colony, Opposite to Sri Rama Temple, Garividi,

Vizianagaram.                                          

                                                                                                                                                                                                                    ……Complainant

And

1. Life Insurance Corporation of India,

Rep., by the Branch Manager,

Life Insurance Corporation of India,

Garividi, Vizianagaram District.

2. Life Insurance Corporation of India,

Rep., by the Senior Divisional Manager,

Life Insurance Corporation of India,

Divisional Office, Claims Department,

Jeevitha Bhima Road, P.B.No.411,

3. Life Insurance Corporation of India,

Rep.,by Zonal Manager,

Life Insurance Corporation of India,

South Central Zonal Office, “Jeevan Bhagya”,

Saifabad, Hyderabad.

                                                                                 ……Opposite parties

          This complaint is coming on for final hearing before us in the presence of Sri Ch.Chandra Sekhara Rao, Advocate for the complainant and Sri                          K. Venkateswara Rao, Advocate for O.Ps 1 to 3 and having stood over for consideration, the Forum made the following:-

SRI T. SRIRAMA MURTHY,PRESIDENT

O   R   D   E   R

          This is a complaint filed under Section 12 of Consumer Protection Act seeking the relief to direct the O.P to pay the insurance amount of Rs.1,25,000/- and  Rs.20,000/- towards compensation and to pay costS of the complaint to the complainant on the following averments:

          The complainant’s husband by name Sagi Narayana Raju has taken 5 Insurance Policies from the O.P while he was alive and the O.P’s settled the claim of 4 policies and paid the Insurance amount to the complainant.  But the O.P did not settle the claim of the policy bearing No.695193242 dated 28-3-2010 for a sum of Rs.1,25,000/- and repudiated the same having no just cause.  The complainant was appointed as a nominee of the deceased Sagi Narayana Raju in all the policies.  Narayana Raju died on 17-6-2010 due to heart attack and after his demise she being the nominee made claims and got the claim amount of 4 Policies.  For the reasons best known to O.Ps, they did not settle the disputed policy and having no just cause they have repudiated the claim and intimated the said fact to the complainant through a letter dated 31-3-2012.  The complainant sent a representation to the 3^rd O.P for re-consideration of her claim but of no avail.  The men of O.Ps were in dereliction of duties and as there is deficiency in service on their part the complainant suffered mental agony and financial loss.  Hence the complaint.

          The 2^nd O.P filed counter and the same was adopted by O.Ps 2 and 3 by filing a memo.   In the counter the O.Ps have traversed the material allegations made in the complaint and have averred that there is no consumer and service provider relationship in between the parties and the provisions of Consumer Protection Act are not made applicable to this case.  It is averred that the deceased husband of the complainant had taken two policies at Vizianagaram and he did not disclose the said fact in the proposal form dt.31-3-2010 and has availed the disputed policy.  Had he disclosed about the existence of the earlier policies the 1^st O.P would have called for special report with regard to health of the deceased as per LIC Rules.  Since the deceased did not disclose the relevant facts in his proposal form dt.31-3-2010 the claim of complainant was repudiated.  The men of O.Ps were not in dereliction of duties and as there is no deficiency of service on their part and the complaint merits no consideration it is liable to be dismissed.

          To substantiate the complainant’s case she filed her evidence affidavit and got marked Ex.A.1 to A.3.  On behalf of O.Ps they filed the affidavit evidence of R.W.1 and got marked Ex.B.1 to B.4.  Perused the material placed on record and heard the arguments of respective parties.

Now the point for consideration is whether there is any deficiency in service on the part of O.P and whether the complainant is entitled to get the reliefs prayed for ?

          Points:-  It is the specific contention of complainant that her husband has taken the disputed policy to cover the risk of his life and due to heart attack he died on 17-6-2010 and after his demise the complainant being the wife and nominee of the deceased filed a claim petition before the O.Ps and as the O.Ps did not settle the claim she has approached this Forum to get her grievance redressed.  The O.Ps did not dispute about the taking of disputed policy by the deceased.  Their contention is that the deceased having availed 4 more policies before issuance of disputed policy, he did not disclose about the existence of earlier policies and as such the claim of complainant was repudiated on the ground of non discloser of material facts and as the men of O.Ps were not in dereliction of duty and as there is no deficiency of service on their part, the complaint deserves to be dismissed.

          In the counter filed by the respondents it is clearly averred that policy No.695193242 was issued to the complainant on the information given by him and as he answered the various questions mentioned in the proposal form the 1^st O.P having believed the same to be true issued the policy and after demise of the deceased the O.Ps came to know that the deceased did not disclose about taking of two more policies from Vizianagaram LIC Branch before he was given disputed policy. 

          In Ex.B.2 which is the copy of insurance policy there are various columns and as per column No.9 the insured was asked to disclose about taking of earlier policies upon which he disclosed about the 4^th policy only which is dated 19-11-2009 for Rs.50,000/-.  Though the deceased was asked to disclose about the number of policies taken by him, there is no whisper in the policy document that the claim is liable to be repudiated for not disclosing the earlier policies.  Even if it is believed that the deceased did not deliberately disclose about the existence of 3 more policies in Ex.B.2 it cannot be said that the O.Ps were deprived to know about the issuance of earlier policies by them in favour of deceased.  They could have verified their own records to know whether some more policies were taken by the deceased from them before taking the disputed policy.   It is not the case of O.Ps that the deceased had a decease and was expecting that he would die shortly and having suppressed the fact of his ailment he availed the 5^th policy to cause loss to the O.Ps.   As seen from the pleadings it is manifest that the deceased died due to heart attack when such is the case it cannot be said that to have a wrongful gain the deceased obtained 5 policies from the O.Ps.  As seen from Ex.B.2 the deceased disclosed about the existence of a policy dt.19-11-2009.  If really the non- discloser of all the policies taken by the deceased in column No.9 of the policy document, is a ground for repudiation they should have repudiated the other 4 policies, but they did not do so.  The material placed on record clearly reveals that the O.Ps have settled 4 policies and paid the policy amounts to the complainant.  Under such circumstances they should have considered the disputed policy and should have paid the sum assured under the policy to the complainant.  Since the O.Ps having no just cause repudiated the claim of complainant it can safely be held that there is deficiency in service on the part of the men of O.Ps and as the complainant was made to run to their office many a time she must have suffered mental agony and as such she is entitled to get the reliefs prayed for, in part.

          In the result, the complaint is partly allowed and the O.Ps are directed to pay Rs.1,25,000/- (Rupees one lakh, twenty five thousand only) to the complainant being the assured sum and also to pay a sum of Rs.5,000/- (Rupees five thousand only) towards mental agony of the complainant and to pay Rs.2,000/- towards costs which includes advocate fee of Rs.500/- (Rupees five hundred only). The O.Ps are further directed to comply this order within one month from today.

Dictated to the Typist, transcribed by her, corrected by me and pronounced by us in the open Forum, this the  11^th  day of May, 2015.

Member                                                           President.

C.C. 59 of 2014

APPENDIX OF EVIDENCE

WITNESSES EXAMINED

     For P.W.1                                                                  For R.W.1                                                                               

DOCUMENTS MARKED.

For complainant:-

1. Ex.A.1 Xerox copy of Policy bearing No.695193242 dt.28-3-2010
2. Ex.A.2 Repudiation letter  from O.P.2 dt.31-3-2012
3. Ex.A.3 letter received from O.P.3 dt.30-11-2013

For O.P:-   

1. Ex.B.1 Letter from Claims department dt.31-3-2012
2. Ex.B.2 LIC form dt.31-3-2010
3. Ex.B.3 Status report of policy dt.24-12-2014
4. Ex.B.4 Postal acknowledgement                       

                                                                                                                                                                                                                 President.