This is a complaint filed by the complainants U/s. 12 of Consumer Protection Act against the Branch Manager LIC of India Raichur, Senior Divisional Manager LIC of India Raichur, herein-after referred as Respondents 1 & 2. The brief facts of the complaint may be summoned up as under:-<br /> <br /> Complainant NO-1 Kumar Malikarjun & complainant No-2 Kumari Akkamma are the minors and they are younger brother and younger sister of complainant No-3 Shambhavi. The minor complainants No-1& 2 are the beneficiaries and nominee of the assured. Consequent on the death of their natural father and mother, the complainants 1 & 2 claiming death claim covered under policy through their sister complainant No-3 who was appointed and nominated as their guardian. <br /> Late father of complainants by name Basavaraj Chandappa Doddamani was senior TCA [clerical work] in the office of Telecom Raichur. He had assured his life under three money back policy with profit + A.C.C benefits under policy numbers:<br /> 1.661301736 dt. 28-03-99 for Rs. 25,000/- nominee- Malikarjun son.<br /> 2.66131744 dt. 28-03-99 for Rs. 25,000/- nominee-Akkamma (complainant).<br /> <br /> 3. 661301402 dt. 12-02-99 for Rs. 50,000/- nominee Yellakka (wife).<br /> <br /> The policies are under salary saving scheme and made through agent and same are accepted. The Respondents issued policies to the complainant’s father. Their father died on 25-01-02. The mother of the complainants namely wife of assured also died on 28-02-04 who was also nominee of the policy No. 661301402.<br /> After the death of their father, Smt. Yellakka their late mother submitted an application dt. 18-08-03 to Respondent NO-1 enclosing with three policies and death certificate for settlement of claim. The Respondent No-1 informed through his official letter No. RRB/Claims dt. 18-08-03 stating that the said policy were repudiated and the same was already communicated vide letter No. MKTG claims 645/22/500/02-03 dt. 19-11-02 since the deceased has not disclosed correct material information about his health against Question No-11 in the Proposal Form and since the given information is false & they are having undisputed proof that the assured had suffered from Infective Hepatitis and had taken treatment from 1996 and died with the same disease. The complainants were shocked to learn about the repudiation of their claims under policy. In-fact there was no any concealment of material information about his death at the time of proposal by their father. Previously the Medical Examination conducted by the approved doctors did not clinically find any active ailments of Infective Hepatitis, as alleged. On examination of various organs showed everything is in normal limits as such the claim is lawful. The Respondents have summarily rejected their claim without regard to the merits of the case and without considering the consequences of such repudiation on the beneficiary.<br /> <br /> The Respondent had earlier repudiated the claim of other policy of their father bearing No. 66136094 & 633559948 and these complainants had filed Complaint No. 45/03 & 46/03 before this Forum and the same were allowed and award was passed by issuing directions to the Respondents for making payments of the policy amount with litigation costs vide Order dt. 25-08-05 and the Respondents have accordingly paid the awarded amount.<br /> <br /> The two complainants are minors and they have lost their mother who had made correspondence of the claim of her late husband (their father). After the death of their mother the complainants being un-aware about repudiation of the disputed policies and recently they noticed repudiation so there was delay in filing the complaint. The marriage of complainant No-3 was held before the death of their mother. However the complainants 1 & 2 are still minors and so this complaint is made for the benefits of minor complainants with an application for condonation of delay in filing the complaint with request to allow the application for admission and enquiry as the mistake is bonafide one.<br /> <br /> The assured was regular customer of Respondent Corporation having got policies in good-faith one after another for the benefit his family members consisting of children (complainants) and wife ( their mother). Prior to the death of assured he was healthy and had not taken any treatment for Infective Hepatitis. During the last five years their father had not taken any treatment except for enteric Fever, cough, vomiting and giddiness. The doctors who had examined the assured earlier had given treatment are qualified doctors and they have given certificate of fitness for attending the duties. The deceased was unaware of ailment of Infective Hepatitis earlier to the submission of proposal policy and had given answers accordingly. Therefore the proposal form is perfectly in-order and even considering the age and back history of his family with longtivity of life of family members cannot be doubted that treatment taken by the deceased father was about disease. The said disease cannot lead one to any inference that the deceased has died with the said disease. The Respondents rejected the claim of the complainant without any proof of detailed medical reports and failed to prove that their father having knowledge of disease which lead to his death had signed and had suppressed material facts in the proposal. The repudiation of the claim is not supported by legal and valid grounds. The repudiation is arbitarary.<br /> <br /> The Insurer coming from lower middle tracks and depend upon Corporation. After the death of their father and mother the complainants have made repeated requests to settle their claim expeditiously but Respondents rejected their claim on false grounds which amounts to deficiency in service by the Respondents. Therefore the Respondents are liable for payment of amount under policy along with compensation and costs. Hence for all these reasons the complainants have prayed for direction to Respondents to pay the policy amount under three policies totaling to Rs. 1,00,000/- along with ACC benefits and with interest at the rate of 24% p.a. from the date of death of their father till realization. Further to direct the Respondents to pay Rs. 50,000/- towards compensation for mental agony suffered by the complainants and Rs. 30,000/- towards cost of litigation and Rs. 50,000/- towards damages.<br /> <br /> 2. The Respondents 1 & 2 have filed a common written statement contending that all the allegations made in the complaint are all false and untenable in law and complainants are called upon to proof each and every allegations in the complaint. The Respondents have repudiated the claim under three policies of late B.C. Doddamani on 19-11-02 and communicated the same to the assignee. The complainants having raised dispute on 17-01-06 hence the complaint is time barred.<br /> <br /> All the three policies of late B.C. Doddamani assigned in favour of Zilla Mahila Pattanna Sahakari Bank Ltd., Raichur for valuable consideration on 23-08-01. The assignee claimed the amount under policies and Respondents communicated the decision of repudiation on 19-11-02 to the Assignor. Hence the complainants not have any right/title over the policies & competent to file this complaint. Therefore they are not entitled to the sum assured under policy. As the preamble of insurance contract clearly excludes the element of interest payment, the question of interest payment does not arise. As the Respondent is not deficient in service the point of paying any relief/compensation does not arise. Hence for all these reasons the Respondents have prayed for dismissal of the complaint with costs.<br /> <br /> 3. During the course of enquiry the complainants have filed sworn affidavit of complainant No-3 for self and has natural guardian of minor complainants No- 1 & 2 as evidence and has got marked as many as [28] documents at Ex.P-1 to P-28. In-rebuttal the Respondents-corporation has filed sworn affidavit of Divisional Manager LIC of India (Respondent NO-2) on behalf of Respondents as evidence and have got marked [15] documents at Ex.R-1 to R-15.<br /> <br /> 4. Heard the arguments of both sides besides and perused the records. The following points arise for our consideration:-<br /> 1.Whether the complaint is barred by limitation and thereby not maintainable?<br /> <br /> 2.Whether the complainant proves deficiency in service by the Respondents as alleged?<br /> <br /> 3.Whether the complainant is entitled to the compensation sought for?<br /> <br /> 5. Our finding on the above points are as under:-<br /> <br /> 1. In the negative. 2.In the affirmative. 3. As per final order.<br /> <br /> REASONS<br /> POINT NO.1:-<br /> <br /> 6.There is no dispute that late father of the complainants by name B.C. Doddamani during his life time had taken three Money back policies on 28-03-99 and 12-02-99 respectively and their father died on 25-01-02. The complainants have produced three policy Bonds at Ex.P-1 to P-3. Ex.P-1 is policy Bond bearing No. 661301402 dt. 12-02-99 for sum of Rs. 50,000/- and Yellakka the wife of policy holder B.C.Doddamani (mother of the present complainants) is the Nominee. Ex.P-2 is policy Bond bearing No. 661301736 dt. 28-03-99 for sum of Rs. 25,000/- and minor Complainant No-1 Malikarjuna S/o.late policyholder is the Nominee. Ex.P-3 policy Bond bearing No. 661301744 dt. 28-03-99 for sum of Rs. 25,000/- and minor Complainant No-2 Akkamma, D/o. policyholder the Nominee. The date of maturity of first policy at Ex.P-1 is 12-02-19, the maturity date of second policy at Ex.P-2 is 28-03-2019 and the third one at Ex.P-3 is 28-03-2014. The complainants have produced copy of death certificate of policyholder B.C.Doddamani at Ex.P-8 showing his date of death on 25-01-02. They have also produced death certificate of their mother Yellakka at Ex.P-9 showing the date of her death as 28-02-04. The complainants have also produced School Leaving Certificate of Complainant No-1 Mallikarjuna at Ex.P-5 and Akkamma Complainant NO-2 at Ex.P-6. In Ex.P-5 & Ex.P-6 the date of birth of Mallikarjuna & Akkamma are shown as 31-07-1988 and 01-06-1990 respectively. Complainants have also produced repudiation letter dt. 19-11-02 at Ex.P-7 addressed to Chandavva. The complainants have also produced another repudiation letter dt. 18-08-03 at Ex.P-4 addressed to Smt. Yellakka (their late mother) informing the repudiation of the claim under three policies as on 19-11-02.<br /> <br /> 7. Admittedly nominee of policy under Ex.P-2 & P-3 are minor son (Malikarjuna) and minor daughter (Akkamma) of policyholder. The nominee of first policy at Ex.P-1 is late Yellakka wife of policyholder who is mother of complainants. The repudiation letter dt. 19-11-02 produced at Ex.P-7 shows that this letter is addressed to one Smt. Chandavva W/o. B.C. Doddamani in-respect of policy No. 633559948 (Not concerned in this case) on the life of late B.C.Doddamani for assured sum of Rs. 25,000/-. This letter interalia discloses that deceased policyholder had suppressed material facts while answering to question No.11 (a to i ) and in-fact he was suffering from Infective Hepatitis for which he had taken medical treatment and was on medical leave for 215 days and so the Respondent corporation repudiated the claim under name of the said policy. Ex.P-4 is another Repudiation letter dt. 18-08-03 addressed to Smt. Yellakka W/o. late B.C. Doddamani regarding death claim under three policies in-question. This letter discloses the repudiation of liability under the policies on account of deceased having with-held correct information regarding his health at the time of effecting the assurance and the same is informed already to RZMPS Bank on 19-11-02. The Respondents have produced copies of three Repudiation letters addressed to Raichur Zilla Mahila Pattanna Sahakari Bank Ltd., Raichur dt. 19-11-02 at Ex.R-4, Ex R-10 & R-15 in-respect of three policies. A perusal of these letters it shows repudiation of policy for material suppression of health by Policy-Proposar-Late policyholder. The Respondents have also produced copy of three Policy Bonds of late Policyholder along with Forms of Assignment of the said policy Bonds executed by policyholder B.C. Doddamani infavour of Raichur Zilla Mahila Sahakari Pattanna Sahakari Bank at Ex.R-2 & Ex.R-3, Ex.R-6 & Ex. R-7 and Ex.R-12 & Ex.R-13 respectively. Respondents have produced two letters dt. 23-08-01 at Ex.R-14 and another letter dt. 04-05-02 at Ex.R-9 of RZMPS Bank addressed to them (LIC of India) that late policyholder B.C.Doddamani had applied loan and requested to assign the said three policies with them. The Respondents have also produced a letter of Raichur Zilla Mahila Pattanna Sahakari Bank dt. 04-05-02 addressed to them (Manager LIC of India Raichur) at Ex.R-9 claiming the amount under three policies of late policyholder who had assigned in their favour (RZMPS Raichur). So from the above it is clear that late policyholder had assigned the three policies with Raichur Zilla Mahila Pattanna Sahakari Bank Ltd., by executing assignment in the year 2001 in-connection with loan obtained from said Sahakari Bank which is not in dispute. The Respondent Corporation in-turn has replied to Manager RZMPS Bank on 19-11-02 regarding repudiation of three policies vide Ex.R-4, Ex.R-10, and Ex.R-15. The complainants have produced a letter to RZMPS Bank Ltd., dt. 21-07-06 at Ex.P-27 stating that Guarantor/surety one M.K. Sharma, Cashier, BSNL has refunded the entire loan amount on 19-03-04 received the three pledged policies. <br /> <br /> 8. As stated supra as per letter at Ex.P-4 dt. 18-08-03 the Respondent Corporation had informed Yellakka W/o. policyholder (the mother of present complainants) the repudiation of three policies which was already informed to RZMPS Bank on 19-11-02. Assuming that late Yellakka the nominee of first policy at Ex.P-1 and mother of Mallikarjuna and Akkamma the nominees of policy at Ex.P-2 & Ex.P-3 had knowledge of repudiation letter dt. 19-11-02 even earlier to the Repudiation letter dt. 18-08-03 but this Yellakka has died on 28-02-04 as per her death certificate at Ex.P-9. Then it shows that this Yellakka had died within two years of stipulated period of limitation for filing complaint against the repudiation of three policies. So merely this Yellakka having not challenged the said repudiation but for her death the minor complainants 1 & 2 who are nominees of the two policies at Ex.P-2 & Ex.P-3 and beneficiaries of the third policy at Ex.P-1 in-question cannot be deprived of their legitimate right to file their complaint within two years after they attaining the age of majority as per section 6 of Indian Limitation Act R/W section 24(A) of C.P.Act. However this complaint is filed through their sister Shambhavi complainant No-3 as their guardian is to be and the same is held well within period of limitation. This our view is supported by decision of Hon’ble High Court of Karnataka reported in AIR 1973 Mysore Page 50. Hence we hold that the complaint filed by the minor complainants as nominee of two policies each held by them and as beneficiaries of third one being the children of late nominee their mother is well within time and not time barred as alleged. So Point No-1 is answered in the Negative.<br /> <br /> POINT NO.2:-<br /> <br /> 9. The complainants have contended that the repudiation of three policies by the Respondents is improper and un-reasonable. There was no any concealment of material information about his health at the time of proposal as the medical examination conducted by the approved doctors did not clinically by any ailment of Infective Hepatitis as alleged. The repudiation letter dt. 19-11-02 at Ex.R-4, Ex.R-10 & Ex.R-15 produced by the Respondents under three policies discloses that B.C. Doddamani the policyholder had with hold material information regarding his health at the time of effecting the insurance by false answering question No.11 (a to i ) with regard to his health. In-fact the deceased had suffered from Infective Hepatitis for which he had consulted medical men and had taken treatment in the hospital and he was on medical leve for 215 days from 10-07-96 to 11-02-97, 133 days from 17-02-97 to 29-06-97 and 41 days from 30-07-2000 to 08-09-2000 and the deceased did not however disclose these facts in his proposal and suppressed material information and so they have repudiated the claim under the policy and they are not liable to pay policy amount.<br /> <br /> 10. Respondents have produced Proposal Form Insurance at Ex.R-11. In this Form question No-11 (a to h) regarding suffering of ailments like Lever, Stomach, Heart, Lungs, Kidney, Brain or Nervous system, Diabetes, Tuberculosis, High Blood Pressure, Low Blood Pressure, Cancer, Epilepsy, Herniya, Hydrocele, Leprosy or any other diseases and medical treatment taken for more than a week in the hospital preceding five years and use of alcohol drinks, narcotics, tobacco in any form or any other drug etc., by the proposar have been answered in the Negative as “No” and question No-11 (i) regarding usual status of health has been answered as “Good”. This proposal form is filled up by one Gururaj Upadaya LIC Agent, Raichur and bear the signature of proposar- late B.C. Doddamani and also the signature of LIC Agent. The Respondents have not produced any scrap of paper like medical certificate or medical records to show that the late policyholder was suffering from Infective Hepatitis and had taken treatment in the hospital as alleged in the repudiation letter at Ex.R-4, Ex.R-10 & Ex.R-15. Of course the complainants have produced a copy of letter dt. 23-07-02 of Telecom District Manager, Raichur the employer of deceased policyholder addressed to Respondent No-1 furnishing Extract of Leave availed by the employee- policyholder on medical grounds. This Leave Extract shows leave availed for (12) days, (4) days, (6) days, (12) days, (3) days, (5) days, (2) days, (41) days, (24) days, (14) days during the span from 26-04-99 to 31-12-01 on different dates and not at a stretch. The complainants have also produced Xerox copies of medical certificate issued by attending doctors namely Dr. K.Gururaj, Dr. Shanker Gowda, Dr. R.Sureshkumar & Dr. Md. Nizamuddin at Ex.P-11 to Ex.P-26. Out of these medical certificates some are in-respect of suffering of fever and some are suffering from Enteric Fever. The last medical leave availed as per Ex.P-10 is for (14) days from 18-12-01 to 31-12-01 under supporting medical certificate at Ex.P-26 shows patients-B.C.Doddamani was suffering from fever. Admittedly the policyholder B.C.Doddamani has died on 25-01-02 as per Ex.P-8. This death certificate shows the place of death of the deceased at Bissaladinni village of Hungunda Tq. in Bagalkot District. As stated supra the Respondents corporation has not produced any medical certificate or medical records showing that the deceased policyholder had suffered from Infective Hepatitis and was on medical leave for (215) days from 10-07-96 to 11-02-97, (133) days from 17-02-97 to 29-06-97 & (416) days from 30-07-2000 to 08-09-2000. Even they have not produced any evidence or piece of paper that death of the deceased was due to alleged ailment.<br /> <br /> 11. Learned Counsel for the complainants vehemently argued that this Forum has already negatived the allegation of the Respondents that late policyholder B.C.Doddamani had suffered from Infective Hepatitis in the earlier complaint filed by the very complainants in-respect of other LIC policy of deceased policyholder filed in DCFR.No. 45/03 & 46/03 vide common judgement dt. 25-08-05 and has produced certified copy of the same at Ex.P-28 and the said judgement having not been challenged by the Respondent-Corporation and the Respondents have paid the awarded amount by complying the said order, has become final. The Respondent Corporation have not produced any piece of paper that they have challenged the order of award passed in DCFR.No. 45/03 & 46/03. A close perusal of this common order dt. 25-08-05 at Ex.P-28 it discloses that the Respondent Corporation had taken the very contention of suppression of material facts by falsely answering question No.11 (a to j) in the proposal form and that the very said deceased policyholder was in-fact suffering from Infective Hepatitis and had taken treatment and was on medical leave and this allegation of the Respondents has been dealt with and discussed at length in Point NO-1, of the said judgement and has been held that the Respondents have failed to prove Point NO-1, on the basis of the decision of the Hon’ble National Commission and Hon’ble Supreme Court reported in 2005 (1) CPR Page 104 (NC) Head Note & AIR 2001 SC Page 549 Head Note (B).<br /> <br /> 12. In the instant case also as discussed above, the Respondents Corporation absolutely have not produced any cogent and convincing material to prove that late policyholder had suffered from Infective Hepatitis and for that he had taken medical treatment and was on medical leave as alleged and that the death of the deceased policyholder is out-come of ailment of Infective Hepatitis. Under these circumstances it follows that the Respondents have failed to prove material suppression of facts by the deceased policyholder. This our view is supported from the decision of Hon’ble National Commission and Hon’ble Supreme Court reported in:<br /> 1)2005 (1) CPR 104 (N.C.) Head Note which interalia reads thus:-<br /> <br /> ……… LIC rejected claim on ground of suppression of material facts about health__ Burden of proof on LIC__ Not discharged by evidence or on affidavit__ Whether certificate of treatment simplicitor can be made basis of repudiation of claim? (No)__ State Commission was right in its finding__ Appeal dismissed”.<br /> <br /> AIR 2001 SC Page 549 Head Note (B) which reads as under:-<br /> <br /> “Merely on grounds that deceased had with-held correct information regarding his health at time of effecting insurance with Corporation__ Not proper__ matter of repudiation of policy should not be deal with in a mechanical and routine manner but should be one of extreme care and caution”.<br /> <br /> Hence for all these reasons we hold that the Respondents have failed to prove Point No-1 so it is answered in the negative.<br /> <br /> POINT NO.3:-<br /> <br /> 8. The complainants have claimed for payment of policy amount under three policies together with interest at 24% p.a. from the date of death of their father-policyholder till realization and have also claimed Rs. 50,000/- as compensation for mental agony and torture and Rs. 50,000/- towards damages & Rs. 30,000/- towards cost of litigation.<br /> So far as the policy amount under three policies is concerned, the complainants are entitled to receive the policy amount together with its benefits. In so-far as the claim for interest at 24% p.a., and Rs. 50,000/- for mental agony & Rs. 50,000/- towards damages & Rs. 30,000/- towards cost of litigation are concerned, it shows that the complainants are claiming compensation under three different heads though they are entitled only under one head as compensation covering all the above heads in-consequence of repudiation of their claim. So in-view of our discussions on Point NO-1&2 and having regard to the facts and circumstances of the case, we feel it just and proper to award a global compensation of Rs.15,000/- including cost of litigation. In this view of the matter we pass the following order:<br /> <br /> ORDER<br /> The complaint of the complainants is allowed in part.<br /> <br /> The Respondents shall pay the amount under three policies with all its benefits together with Rs. 15,000/- towards global compensation including cost of litigation.<br /> <br /> The Respondents shall comply this order within a period of six weeks from the date of receipt of copy of this order.<br /> <br /> Dictated to the Stenographer, typed, corrected and then pronounced in the open Forum on 29 -09-06.)<br /> <br /> Sd/-<br /> Sri. N.H. Savalagi<br /> President<br /> Dist.Consumer Forum-Raichur.<br /> <br /> Sd/-<br /> Sri.Pampannagouda <br /> Member.<br /> Dist.Consumer Forum-Raichur.<br /> <br /> Sd/-<br /> Smt.Kavita Patil <br /> Member.<br /> Dist.Consumer Forum-Raichur.<br />