Orissa

Rayagada

CC/69/2019

Smt. Sunita Tadingi - Complainant(s)

Versus

The Branch Manager LIC of India - Opp.Party(s)

Self

17 Mar 2021

ORDER

DISTRICT   CONSUMER DISPUTES REDRESSAL COMMISSION,

POST  /  DIST: Rayagada,  STATE:  ODISHA,  Pin No. 765001.

                                                      ******************

C.C.case  No.     69      / 2019.                             Date.     17     . 3. 2021

P R E S E N T .

Sri   Gadadhara  Sahu,                                                      President.

Smt.Padmalaya  Mishra,.                                                 Member

 

Smt. Sunita  Tadingi, W/O: Late  BaburaoTadingi, At: Kandili, Po: Pitamahal,     Dist: Rayagada, State:Odisha,Cell No.77499-56624                                                                                …  Complainant.

Versus.

1.The  Branch Manager, L.I.C of India, Rayagada Branch, Rayagada,State:Odisha.

2.The  Divisional Manager, LIC of India, Berhampur Division, Jeevan Prakash, Kodasingi, Po: Berhampur,  Dist: Ganjam, pin No. 760 010, State:Odisha.

… Opposite parties.

Counsel for the parties:                         

For the complainant: - Self.

.For the O.Ps  :- Sri  K.Ch.G.S.Kumandan, Advocate, Rayagada.

JUDGEMENT.

The  crux of the case is that  the above named complainant alleging deficiency in service  against  afore mentioned O.Ps for non payment of death claim  assured  amount towards policy No.573013894  for which  the complainant  sought compensation  for redressal of the grievances raised by the complainant.

Upon  Notice, the O.Ps    put in their appearance and filed  written version in which  they refuting allegation made against them.  The O.Ps    taking one and another pleas in the written version   sought to dismiss the complaint as it is not maintainable  under the C.P. Act,  The facts which are not specifically admitted may be treated  as denial of the O.P.   Hence the O.Ps prays the forum to dismiss the case against  them  to meet the ends of justice.

Heard arguments from the learned counsel for the    O.P    and from the complainant.    Perused the record, documents, written version  filed by the parties. 

This forum  examined the entire material on record  and given  a thoughtful consideration  to the  arguments  advanced  before us by  the  parties touching the points both on the facts  as well as on  law.

                                                    FINDINGS.

Undisputedly the  complainant  is a legal married wife and  Ist. Legal heir  of Late Baburao Tadingi.  Undisputedly the policy  No.573013894  was  issued  in favour of the Death life assured  Late Babu Rao Tadingi  on DT.29.3.2011 (Copies of the policy bond is available in the file which is marked as Annexure-I). There is no dispute that  the complainant died  on Dt. 23.9.2017 (copies of the  death certificate is in the file which is marked as  Annexure-2).  Undisputedly the complainant  was  revived the above policy on Dt.22.9.2017 (copies  of the  revive letter  is in the file which is marked as Annexure-3).

The  main grievance  of the complainant  was that  after death  of  her  husband  she intimated the same to the O.P. for payment of  assured amount  but  the O.Ps had  repudiated the  death claim of the complainant vide their Lr. Dated.5.4.2019 addressed to the complainant. Hence this C.C. case before this District  Commission.

The O.Ps in their written version contended that the D.L.A had suppressed  disease  during revival of policy. Hence  the complainant is not  entitled any   claim from the  O.Ps. The O.Ps    taking one and another pleas in the written version

For better appreciaton  this District Commission relied citation which are mentioned here under.

It is held and reported  in C.P.R. 2013(1)  Page  No.278   where in the  Hon’ble  National  commission  observed “ Insurance claim can be dismissed for making  false declaration  about his habits and health.”

The actual  fact was not disclosed  by the life assured  while making  his personal statement at the time of   revival  the policy  on Dt. 22.9.2017  and gave wrong answers to question which are reproduce as under. 

QUESTIONS.                                                                                                           ANSWERS.

	Have you suffered from illness/disease requiring treatment for a week of more ?	No.
	Have had any electrocardiogram, X-ray or scanning, blood, urine or stool examination ?	No.
	Are  you  at present in sound health ?	Yes   good

From the statement of the life assured reproduced above, it is established that he had concealed true  and material   facts with respect to his health  at the time  of revival of    the insurance policy.   The medical report Annexure-4  clearly   reflect  that the life assured was  suffered for cancer disease.  It has been held  in catena of judgements that the contract  of insurance  is based on good faith and it is the life assured  who can given the correct  information  with respect to his health, which in  the instant case the life assured  had not given  and as such this forum feel that the O.P. had rightly repudiated complainants’  claim.This  suppression of material fact  which  had a bearing on granting   risk was clearly done  with an intention to deceive the  O.P. Such an act of non-disclosure of material facts violates  the principle of   ‘Uberrima Fide’  i.e. ‘Utmost Good Faith’ upon which the insurance contract is based on.  Hence, the death claim under the policy has been repudiated by the  O.Ps and communicated to the complainant on Dt. 5.4.2019 marked as Annexure-5.

As  stated above , the facts and material placed  on record go to show that the life assured was got insured by knowingly  and  deliberately  furnishing  wrong  information  to  the  O.P.  This  fraudulent  suppression  would   certainly  vitiate the policy. Therefore   the   complainant   would  not be  entitled  to benefit under  the  said  policy.

Thus,  it    becomes clear that even on merits, complainant is  not entitled to  any claim.

At  this stage this forum observed   the interest of justice  would met if  the O.Ps refund the  deposited premium amount by the deceased life assured  from Dt.29.3.2011 to 22.9.2017 with  interest  @ Rs.9% per annum from the date of receipt till realization  to the complainant  with in 30 days.

Hence  to  meet the  ends of justice, the following order is passed.                                                                    

                                ORDER.

        In  resultant    the complaint petition is allowed  in  part  on  contest .

The O.Ps  are ordered to refund  deposited  premium amount   by the deceased life assured  from Dt.29.3.2011 to 22.9.2017 with  interest  @ Rs.9% per annum from the date of deposit till realization  to the complainant  with in 30 days.  Parties are left to bear their own cost.

The OPs     ordered to make compliance the aforesaid Order within  45 days from the  date of  receipt  of this order.      .

   Serve the copies of above order to the parties free of cost.

 

Dictated and corrected by me

Pronounced on this  17th.   Day of     March,   2021.

 

                                      Member.                                President