Bihar

Muzaffarpur

CC/202/2015

Dhaneshwar Paswan - Complainant(s)

Versus

The Branch Manager, Bharti AXA Life Insurance Company Ltd. & Others - Opp.Party(s)

08 Mar 2016

ORDER

                                             District Consumer Forum, Muzaffarpur

          Complain Case No. –202/2015

Dhaneshwar paswan, S/o Late- Rampratap Paswan R/o vill-Asadharpur urf Rasulpure, Bedauliya Hajipur ……………………...……Complainants 

V/s

1. The branch Manager,  Bharti AXA life Insurance Company Ltd. 3^rd floor Om Shanti complex, opp. Zila School, Mithanpura, Muzaffarpur- 823001  
2.  The Chief Managing Directors,  Bharti AXA Life Insurance Company Ltd. Unit 601 & 602, 6^th floor, Rajeja Titanium, Off Western Express Highway, Goregaon (E) Mumbai- 400063.……………………opposite parties.

Date of order- 08-03-2016

                                                                                                  Present.

1. Shri Govind Prasad Singh

                                                                                                                        President,

       Consumer Forum Muzaffarpur

2.  Smt. Archana Singh

      Member

       Consumer Forum Muzaffarpur

For complainants-    Sri Amir Kr.    - Advocate

For opposite party-   not appeared  

 

Order

           

            The complainant has filed his case on 15-09-2015  for  his claim of Rs.  3,60,000/- sum assured amount,  Rs. 75,000/-  for mental, physical, harassment  and Rs. 21000/-as   litigation cost with  interest @ 18 %.

The case of complainant appears from his complaint petition supported with an affidavit that father   of the complainant  late Ram pratap Paswan now, deceased  has purchased a policy bearing no.-501-1497889 for sum assured  amount Rs. 3,60,000/- on 22-11-2013 and has paid premium of the said policy Rs. 18,000/- in which he has mentioned the name of complainant as nominee.  The company started risk of coverage of life  from 27-11-2013 the premium was annual  but unfortunately the said Rampratap Paswan began  to suffer from nausea, vomiting and anoressia from 31-1-2014 and was treated  by Dr. Samim Ahamad  but unfortunately  he died on 04-02-2014 accordingly the complainant being nominee has filed  death claim of said policy with documents  to the insurance company but the insurance company had not disposed of his death claim and not paid the claim amount as such he has filed this case with aforesaid claim with prayer that the opposite party is directed to the sought amount to his account no.- 939988. In the District Consumer forum Muzaffarpur.   

 The complainant has filed Xerox copy of first  premium receipt dated 27-11-2013 for Rs. 18,000/-  mentioning  the sum assured amount is Rs. 3,60,000/-, death certificate issued  by registrar  birth death  office dated 28-03-2014 mentioning  the date of death of Rampratap Paswan as 04-02-2014, Drs. Prescriptions dated 31-01-2014,   death birth register, certificate of Panchayat Samiti Sadsay and Mukhiya  date not mentioned Pan card and acknowledgment  of tax return for assessment  year 2012-2013. 2013-2014. He has also filed original death certificate, original birth certificate and original   receipts of acknowledgment  of tax return  and medical prescription. Further He has relied on and  filed  decision of Orissa State Consumer Dispute Redressal Commission published in III (2007) CPJ 246. The complainant has also filed his written argument  mentioning the same fact alleged in his complaint petition only the new fact is  legal aspects as well as decisions cited by him..

The complainant has further filed letter dated 31-03-2015 by which his claim was repudiated on the ground that the D.L.A had not disclosed  the other policies which is  necessary  as column – 4 (III) of the proposal form but under  investigation it was found that  he had purchasers   other policies but in repudiation letter the opposite party has not mentioned   any policies on which ground he has repudiated the claim.

In this case notice  against the opposite party for their appearance was issued  through  registered post on 26-09-2015 but the opposite party not appeared and after provided them sufficient  time it was presumed that service upon them  was properly and sufficiently  served and accordingly the case proceeded  for  Ex. Party hearing vide order dated 02-02-2016.

          Accordingly heard the complainant only as Ex. Party.

Considering the facts, circumstances, material available with the record   as per repudiation letter dated 31-03-2015 the assured sum amount, deposit of premium  and policy are admitted, only the claim was repudiated  on the ground that the . D.L.A has not disclosed the other policies which he had taken in his proposal form which was necessary but   at the same time the  opposite party  has not motioned  any other policy detail in his claim repudiation letter as such in our believe the claim of complainant  was wrongly  repudiated having no any proper reasons  as such the deficiency  against them clearly arises.

Accordingly we are of the opinion that the complainant is found able to prove   his case  having  no any material otherwise available against his case as such the case is allowed.  

          Accordingly the case is allowed and the opposite party no.1 and 2 are directed  to pay Rs. 3,60,000/- insured sum amount with interest @ 8 %   and they are  further directed to pay Rs. 30,000/- as  physical, mental , harassment litigation cost by D.D. or cheque in favour of complainant bearing a/c- 939988. Both the  payment  should be made  within 30 days of the order otherwise the complainant is entitle to get it recover from the process of law.

 

Member                                                               President