Date of filing:29.3.2014.
Date of disposal:18.11.2014.
BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM - II:
VIJAYAWADA, KRISHNA DISTRICT
Present: SMT N. TRIPURA SUNDARI, B. COM., B. L., PRESIDENT (FAC)
SRI S.SREERAM, B.COM., B.A., B.L., MEMBER
TUESDAY, THE 18TH DAY OF NOVEMBER, 2014.
C.C.No.91 of 2014
Between:
Dasari Somaiah, S/o Subbaiah, Hindu, 63 years, Occ:Retired Employee, R/o H.No.31-213, Ashok Nagar, Nandigama Village and Mandal, Krishna District.
. … Complainant.
AND
1. The Branch Manager, LIC of India, Jaggayyapet Branch, Kodad Road, Jaggayyapet, Krishna District.
2. The Branch Manager, LIC of India, Opp:DVR Government General Hospital, Nandigama, krishna District.
3. The Divisional Manager, LIC of India, Divisional Office, Jeevan Prakash, P.B.No.24, Batchpeta, Machilipatnam, Krishna District.
. … Opposite Parties.
This complaint coming on before the Forum for final hearing on 12.11.2014, in the presence of Sri P.Chitti Babu, Advocate for complainant and Sri D.V.S.Lokeswara Rao, Advocate for opposite parties and upon perusing the material available on record, this Forum delivers the following:
O R D E R
(Delivered by Hon’ble President (FAC) Smt N. Tripura Sundari)
This complaint is filed under Section 12 of the Consumer Protection Act, 1986.
The averments of the complaint are in brief:
1. One Bandaru Venkata Sivamma is the niece of the complainant who obtained three different Jeevan Saral Policies for an amount of Rs.2,50,000/- each from the opposite parties 1 and 2 through its proposals dated 1.1.2011, 31.1.2011 and 21.3.2012 respectively. The 3rd opposite party issued three policies in her name. The complainant is the nominee under these three policies. The authorized agents of the LIC approached Bandaru Venkata Sivamma on different occasions and explained about the benefits in the LIC policies and obtained proposal forms from her on different dates. The said Sivamma studied up to 9th class long back. She is unable to fill up the proposal forms and accordingly the agents of the LIC filled all the columns of the proposal forms and obtained her signatures and also signed at the place provided for signature of the person who filled the proposal form. After fully satisfied with the information provided by her the agents of LIC got medical check up to her with their panel doctors and obtained the doctors signatures also on the space provided in the proposal form. After fully satisfied with the information provided by Venkata Sivamma the 3rd opposite party issued three policies. While so on 18.4.2012 the policy holder died suddenly due to heart attack at her residence. The complainant who is the nominee under the said policies informed the said fact to the LIC agents. The complainant submitted claim form along with original policy bonds to the 3rd opposite party through the agents. After enquiry the 3rd opposite party repudiated the claims vide their letter dated 28.8.2013 stating that they have decided to repudiate the liability under the policies on account of the deceased having withheld material information regarding her previous policies, occupation and income at the time of taking the insurance policies with them. The reason for repudiation is not tenable. At the time of obtaining the policies the agents of the opposite parties obtained proposal form at their convenience and subsequently when the claims are raised by the nominees then only they raised different types of objections and repudiated the claims of the insured. With a dishonest intention to evade payment under the above three policies the opposite parties repudiated the claim of the complainant, which amounts to deficiency in service. Hence the complainant is constrained to file this complaint against the opposite parties praying the Forum to direct the opposite parties to pay an amount of Rs.7,50,000/- under three policies to pay Rs.1,00,000/- towards compensation for mental agony and to pay Rs.10,000/- towards costs.
2. The version of the opposite parties is in brief;
The opposite parties denied all the allegations of the complaint and admitted the facts that the deceased B.Venkata Sivamma obtained three different Jeevan Saral Insurance Policies from the opposite parties under Policy (1) No.676009520 dated 28.1.2011, (2) Policy No.676008989 dated 19.1.2011 and (3) policy No.676027318 dated 21.3.2012 from the opposite party Jaggaiahpet Branch and Nandigama Branch respectively for an amount of Rs.2,50,000/- under each policy and the complainant is the nominee under these policies. The deceased/life assured B.Venkata Sivamma filled and signed the proposal form only after understanding the contents of the proposal forms which are in Telugu. Basing on the information given, opposite parties issued the above said three policies and also the agreement between the opposite parties and deceased/policy holder is based on the contract. The deceased/life assured obtained another two policies (1) 672895227 dated 28.1.2003 for Rs.75,000/- and (2) 675891750 dated 28.12.2010 for Rs.3,00,000/-. The total insurance is Rs.11,25,000/-. While taking the first mentioned policies the details of the previous policies are not mentioned. As per the rules of the opposite parties the deceased/life assured is eligible for insurance of maximum Rs.5,00,000/-. Had the deceased/life assured had mentioned all her previous policies without any omission, the opposite parties have not issued the first mentioned three policies. The deceased had deliberately withheld the information regarding her previous policies with an intention to obtain maximum insurance. The opposite parties repudiated the claims after taking due consideration of all facts. Reply to the complainants registered post letter dated 28.8.2013 and another letter dated 28.8.2013 the opposite parties repudiated the claim under the policies on account of deceased having withheld the material information regarding her previous policies, occupation and income at the time of obtaining the policies from the opposite parties. In terms of the policy contract and the declaration contained in the forms of the proposal for assurance the opposite party repudiate the claim. The complaint is not maintainable on the ground of suppression of material facts and misrepresentation of statements on proposal. Hence there is no deficiency in service on the part of the opposite parties and prayed to dismiss the complaint with costs.
3. On behalf of the complainant he gave his affidavit and got marked Ex.A.1 to Ex.A.8. On behalf of the opposite parties Sri P.Sasidhar, the Authorized Person of the opposite parties gave his affidavit and got marked Ex.B.1 to Ex.B.8.
4. Heard and perused.
5. Now the points that arise for consideration in this complaint are:
1. Whether there is any deficiency in service on the part of the opposite parties
towards the complainant in repudiating the claim of the complainant?
2. If so is the complainant entitled for any relief?
3. To what relief the complainant is entitled?
POINTS 1 AND 2:-
6. On perusing the material on hand it is not disputed that the deceased/life assured obtained three different Jeevan Saral Policies for an amount of Rs.2,50,000/- each from the opposite parties on 1.1.2011, 31.1.2011 and 21.3.2012 respectively and the Dasari Somaiah the complainant herein is the nominee under the above said policies Ex.A.1, Ex.A.2 and Ex.A.3 policy schedules and under Ex.B.2 proposal forms. While so on 18.4.2012 the policy holder died suddenly due to heart attack at her residence. The certificates under Ex.A.7 and Ex.A.8 proves her death. As the complainant is nominee under the said policies, informed the said fact to the opposite parties and submitted claim form along with original policy documents to the opposite parties. But the opposite parties repudiated the claim under Ex.A.4, Ex.A.5 and Ex.A.6 stating that the opposite parties repudiated the liability under the said policies on account of having withheld material information regarding her previous policies, occupation and income at the time of taking the insurance policies with them. The opposite parties say that the deceased/life assured studied 10th class as per Ex.B.5 and she filled the proposal forms and signed. She obtained another two policies (1) 672895227 dated 28.1.2003 for Rs.75,000/- and (2) 675891750 dated 28.12.2010 for Rs.3,00,000/-. The total insurance is Rs.11,25,000/-. While taking the first mentioned policies the details of the previous policies are not mentioned. As per the rules Ex.B.8 of the opposite parties the deceased/life assured is eligible for insurance of maximum Rs.5,00,000/-. Had the deceased/life assured had mentioned all her previous policies without any omission, the opposite parties have not issued the first mentioned three policies. The opposite parties repudiated the claims after taking due consideration of all facts having withheld the material information regarding her previous policies occupation income at the time of obtaining the policies from the opposite parties. Hence the claims repudiated on the ground of suppression of material facts, misrepresentation on statements of proposals.
7. On perusing the proposal forms we the Forum noted the deceased/life assured Venkata Sivamma made a declaration that her occupation is private school teacher, her education qualifications are SSC and annual income is Rs.70,000/- and in her second proposal her qualification is SSC annual income is Rs.2,10,000/- her occupation is saries business and in her third proposal her educational qualification is inter, her occupation is kirana business. Thus she stated various statements in her proposals. She did not mention about her policies 672895227 and 675891750 in three proposal forms. The proposal forms were signed by her on the second page of proposal form and in column of doctor’s signature we noted that in this application the doctor signed stating that the applicant signed on the proposal form after giving answers to the questions in column No.10 and she agreed and signed on the same.
8. The counsel of the complainant relied on a citation held in 2003 (3) CPR 25 (NC) Osuri Devendra Phanikar, Petitioner Versus Desk to Desk Couriers & Cargo Ltd., Respondent that the conditions on the reverse are of a small print which were not explained to the complainant and that there is an error in exercise of jurisdiction by Consumer Forums in granting compensation and costs for deficiency in courier service in the instant case. The above case is different from the present case on hand.
9. The opposite parties relied on some citations mentioned as below.
(1) In LIC and Anr., Appellants Versus Manik Sudhakar Dahale and Ors., Respondents 2010(3) CPR 531 Maharashtra State Consumer Disputes Redressal Commission, Mumbai. In a contract of insurance parties must observe utmost good faith.
(2) In Vijay S.Pradhan (Dr.), complainant Versus Niteen C.Dedhia (Dr.) & Ors., Opponents 2010 (3) CPR 533 Maharashtra State Consumer Disputes Redressal Commission, Bombay.
“A policy of life assurance was granted upon the basis of a proposal which concluded with a declaration that the answers given in the proposal were true to the best of the proposers knowledge and belief and an agreement that the proposal and declaration should be the basis of the contract and that if it should thereafter appear that the proposer had made any untrue statement therein the policy should be void and the premiums forfeited”.
10. The citations filed by the opposite parties squarely applicable to the present case on hand. We agree with the submissions and citations of the counsel of the opposite parties. We came to conclusion that there is clear suppression of facts and misstatements in the proposal forms and the opposite parties rightly repudiated the claims of the complainant. Therefore we hold that there is no deficiency in service on the part of the opposite parties and the complainant is not entitled for any relief.
POINT No.3:-
11. In the result, the complaint is dismissed without costs.
Typewritten by Stenographer, corrected by me and pronounced by us in the open Forum, this the 18th day of November, 2014.
PRESIDENT(FAC) MEMBER
Appendix of evidence
Witnesses examined
For the complainant: For the opposite party:
P.W.1 Dasari Somaiah D.W.1 P.Sasidhar,
Complainant Authorized person
(by affidavit). Of the opposite parties
(by affidavit).
Documents marked
On behalf of the complainant:
Ex.A.1 . . Photocopy of insurance policy.
Ex.A.2 . . Photocopy of insurance policy.
Ex.A.3 . . Photocopy of insurance policy.
Ex.A.4 28.08.2013 Letter from the 3rd opposite party to the complainant.
Ex.A.5 28.08.2013 Letter from the 3rd opposite party to the complainant.
Ex.A.6 28.08.2013 Letter from the 3rd opposite party to the complainant.
Ex.A.7 20.07.2012 Certificate of Death issued by Registrar of Births andDeaths, Guntur.
Ex.A.8 18.01.2012 Photocopy of receipt issued by Maha Prasthana SevaSamithi, Pithruvanam, Bongaralabeedu, Guntur.
On behalf of the opposite party:
Ex.B.1 28.08.2013 Photocopies of three Letters from the 3rd opposite party
to the complainant.
Ex.B.2 . . Photocopies of three application forms for insurance.
Ex.B.3 . . Photocopy of house hold card.
Ex.B.4 . . Photocopy of Identity card issued by ElectionCommission.
Ex.B.5 . . Photocopy of Form of Transfer Certificate issued by Head Master, VZP High School, Penumaka, Guntur District.
Ex.B.6 . . Photocopy of insurance policy.
Ex.B.7 . . Photocopy of proposal review slip.
Ex.B.8 01.03.2005 Instructions given by LIC of India.
PRESIDENT(FAC)
