BEFORE THE DISTRICT FORUM: KURNOOL
Present: Sri K.V.H.Prasad, B.A., LL.B., President
And
Smt C.Preethi, M.A., LL.B., Member
Friday the 23rd day of March, 2007
C.C. No.155/2006
D.Yangamma, M/o. Late. D.Seshanna,
Hindu, aged 52 years, House-wife,
Resident of Gargeyapuram village,
and post. Kurnool District. …Complainant
-Vs-
1. The Branch Manager,
Life Insurance Corporation of India,
Kurnool.
2. The Divisional Manager,
Life Insurance Corporation of India,
Divisional Office, “Jeevan Prakash”,
College Road, KADAPA. …Opposite parties
This complaint coming on this day for orders in the presence of Sri. C.C.V. Ranga Reddy, Advocate, Kurnool for complainant, and Sri. I. Anantha Rama Sastry, for opposite parties No.1 & 2 and stood over for consideration till this day, the Forum made the following:-
ORDER
As per Sri. K.V.H. Prasad, President
1. This case of the complainant is filed seeking an order against the opposite parties directing them to pay to the complainant Rs.40,000/- and Rs.50,000/- assured sum under policies number 652180337 and 652683197 respectively along with interest at 18% per annum from the date of the demise of the policy holder till realization, Rs.20,000/- as compensation for mental agony and Rs.2,000/- as costs of this case alleging deficiency of service of the opposite parties in repudiating the claim of the complainant.
2. The brief facts of the complainants case are that D.Seshanna Son of the complainant has insured himself for Rs.40,000/- and Rs.50,000/- under above said two policies on 28-9-2002 and 28-11-2002 respectively appointing complainant as his nominee and while the said the policies were inforce the said policy holder died on 19-3-2003 and the claim laid by the complainant was repudiated by the opposite parties alleging the death was suicidal and within one year of commencement of policy and the representation of complainant thereafter was also paid a deaf ear by the opposite parties and the repudiated of complainant’s claim as improper.
3. In pursuance of the receipt of the notice of this forum as to this case of the complainant, the opposite parties caused their appearance through their counsel and denying the truth of the complaint contentions and requiring its strict proof and thereby denying their liability filed the written version of opposite party No.2 and its adoption by the opposite party No.1.
4. The written version of the opposite party No.2 even though admit the deceased as their policy holder but alleges his demise due to consumption of pesticide as published in Eenadu Daily dated:20-3-2003 and the demise of the policy holder being within two years of the policy, the claim is treated as early claim and in investigation revealed the demise of policy holder was on account of consumption of pesticides and the claim was repudiated as the condition No.6 of policy holds policy void, if the policy holder commits suicide within one year of the commencement of the policy and as such there is any deficiency of service in repudiating the claim of the complainant and so seeks dismissal of the complaint with costs.
5. In substantiation of the contentions while the complainant’s side has taken reliance on documentary record in Ex.A1 to A3 and the sworn affidavit of the complainant besides to the replies to the interrogatories exchanged, the opposite party side has taken reliance on documentary record in Ex.B1 and B2 and the sworn affidavit of the opposite party No.2 besides to the replies to the interrogatories exchanged.
6. Hence, the point for the consideration is whether the complainant has made out the alleged deficiency of service on the part of the opposite parties and thereby their liability to make good of the complainant’s claim.
7. The Ex.A1 is the letter dated:28-2-2005 of the opposite party No.2 addressed to the complainant. It envisages that D.Seshanna as holder of policy No.652180337 and 652683197 as committed suicide and the said suicide being within one year from the date of the commencement of the policy, the claim laid by the complainant on said policies became null and void and in terms of the policy contract and therefore nothing is payable thereunder. The written version of the opposite party takes reference to the condition No.6 of the policy to say death of the policy holder due to suicide within one year of the commencement of the policy makes the said policy contract null and void. The Ex. B1 and B2 are the said policies on the name of deceased D.Seshanna on which the claim was the laid by the complainant, consequent to demise of policy holder, alleging it as natural death.
8.As the opposite parties contend the demise of the policy holder was on
account of suicide and the said demise of policy holder was within one year from the date of commencement of said policies, the points remaining for further adjudication are 1) whether the death of the policy holder is natural or suicide 2) whether the death of the policy holder i.e, D.Seshanna is not suicidal even their is governed by the so called condition No.6 of the policy.
9. The demise of the policy holder is a matter of fact. To say the said
demise of the policy holder was suicidal on account of consumption of pesticides, the opposite party side except taking reference in its written version to Eenadu Daily news paper dated:20-3-2003 did not see into record its substantiation by any cogent corroborative material of its investigation. Hence in the absence of any such cogent proof, in corroboration to so called paper news, such as F.I.R., P.M. report and inquest panchanama and the statements of witnesses who are in Know of said suicidal demise of policy holder which would have been certainly placed if there is any truth in said pretext, it cannot of conclusively held that the demise of said policy holder was a suicidal one. When no such material is there to hold the demise of policy holder was suicidal, in all its naturality and probability the death of policy holder remains necessarily as natural one. Hence, the opposite parties are remaining erred in holding the demise of said policy holder- D.Seshanna as suicidal.
10.The condition No.6 of the policy in Ex.B1 and B2 – standing on the
name of D.Seshanna – this policy holder reads as under.
“Suicide: This policy shall void if the life assured commits suicide (whether sane or in sane at time) at any time on or after the death on which the risk under the policy has commenced but before the expiry of one year from the date of this policy and the corporation will not entertain any claim by virtue of this policy except to extent of a third parties bonafied beneficial interest acquired in the policy for valuable consideration of which notice has been given in writing to the office to which premiums under this policy were paid last, at least one calendar month prior to death”.
11.From the above what remains clear is that the policy acquires void ness
if the life assured commits suicide before the expiry of one year from the date of the policy and thereon the corporation will under any obligation to entertain the claim by virtue of the said policy. Hence, it governs only when the death of the assured was suicidal one that too within one year of the commencement of the policy.
12.But in this case the demise of the policy holder was not been proved by
the opposite parties with any cogent material as suicidal one, and in that circumstance the demise of the policy holder remains as a natural death and so natural death of a policy holder after commencement of the policy being not governed by the said condition No.6, the policies of the policy holder under which the claim was set up by the complainant is not hit by condition No.6 of the policy in Ex.B1 and B2.
13. Thus, the deficiency of the opposite parties are remaining crystal clear
not only it Ex.A1 in its conduct of not entertaining the claim of the complainant but also in not entertaining the representation of the complainant made in Ex.A2 with true facts and in not giving any follow up action to its letter Ex.A3.
14.From the very averments of para No.3 of written version it appears that
the opposite party has entertained the other two claims of said complainant laid on two other policies of same deceased policy holder without taking any objections as to the mode of demise of said policy holder, perhaps the mode of death either suicidal or natural doesn’t matter very much in the policy which has completed more than one year by the time of said demise of policy holder.
15.However in the circumstances discussed above as the death of the
policy holder happens to be a natural death and the first page of Ex.B1 and B2 in its colum pertaining to payments to be made, says sum assured plus vested bonus to be paid on the contingency of death of policy holder before the date of maturity, the complainant who is claiming benefits of her deceased son’s policies under Ex.B1 and B2 on the event of the demised of said policy holder on natural death, the complainant is undoubtedly remaining entitled to the assured sum of said policies in Ex.B1 and B2 along with vested bonus.
16.As the opposite parties by their deficient conduct of not entertaining
the claim and paying a deaf ear to the representation of the complainant in Ex.A2 and not giving follow up action to Ex.A3 has caused sufficient mental agony and driven the complainant to the forum for redressal of her grievances, the opposite parties are remaining liable to pay the compensation and costs to the complainant in prosecuting this matter.
17.Consequently, and in the result of the above discussion the complaint
is allowed directing the opposite parties No.1 and 2 – who are branch office which issued said policies and Divisional office which is having control over the opposite party No.1- respectively, jointly and severally to pay to the complainant the sum assured under Ex.B1 and B2 along with vested bonus and Rs.8,000/- as compensation for mental agony, and Rs.2,000/- as costs within one month of the receipt of this order. In default the opposite parties shall jointly and severally liable to pay to the complainant the award with 9% interest per annum from the date of said default till realization.
Dictated to the stenographer, transcribed by him, corrected and pronounced in the Open bench on this the 23rd day of March 2007.
MEMBER PRESIDENT
APPENDIX OF EVIDENCE
Witnesses Examined
For the Complainant: Nil For the Opposite Parties: Nil
List of Exhibits marked for the complainant:-
Ex.A1 Repudiation letter, Dt:28-2-2005 of opposite party No.2 to the
complainant.
Ex.A2 Repudiation of complainant Dt:12-5-2005 to opposite party along with
acknowledgement.
Ex.A3 Reply of opposite party No.2, Dt:14-5-2005 to Ex.A2.
List of Exhibits marked for the opposite parties:-
Ex. B1original policy bond No.652180337.
Ex.B2 original policy bond No.652683197.
MEMBER PRESIDENT
Copy to:
1. D.Yangamma, M/o. Late. D.Seshanna, Hindu, aged 52 years, House-wife,
Resident of Gargeyapuram Village, and post. Kurnool District.
2. Sri. C.C.V. Ranga Reddy, Advocate, Kurnool.
3. The Branch Manager, Life Insurance Corporation of India, Kurnool.
4. The Divisional Manager, Life Insurance Corporation of India.
Divisional Office, “Jeevan Prakash”, College Road, KADAPA.
5. Sri. I. Anantha Rama Sastry, Advocate, Kurnool.
Copy was made ready on:
Copy was dispatched on:
Copy was delivered to parties:
