BEFORE THE DISTRICT CONSUMER’S FORUM: KURNOOL

Present: Sri. M.Krishna Reddy, M.Sc., M.Phil., Male Member President (FAC)

And

     Smt. S.Nazeerunnisa, B.A., B.L., Lady Member

Friday the 28^th day of June, 2013

C.C.No.104/2012

Between:

K.Siva Konda Reddy, S/o Late K.Rami Reddy,

D.No.6/54, Behind Sudha Garments, Banaganapalli Post and Mandal-518 124. Kurnool District.                                                      …Complainant

                                                    -Vs-      

   1.  The Branch Manager, Life Insurance Corporation of India,

        D.No.8-97-7, Banaganapalli - 518 124, Kurnool District.

   2.  The Senior Divisional Manager, Life Insurance Corporation of India,

        Divisional Office, P.B.No.10, College Road, KADAPA - 516 004.                      ...Opposite ParTies

This complaint is coming on this day for orders in the presence of Sri.P.Siva Sudarshan, Advocate for complainant and Sri.A.S.Umar Javid Ali, Advocate for opposite parties and upon perusing the material papers on record, the Forum made the following.

                                               ORDER

(As per Sri. M.Krishna Reddy, Male Member President (FAC)) 

C.C. No.104/2012

1.     This complaint is filed by the complainant under section 11 and 12 of Consumer Protection Act, 1986 praying a direction on opposite parties for the payment of :-

1. Assured amount with profits and interest with 24% per annum interest from the date of death of insured;

1. Rs.25,000/- towards compensation for mental agony and hardship;

1. Cost of the complaint;

2.    The complainant is son and nominee of insured Kasi Reddy Rami Reddy.  The insured died on 23-11-2009.  The insured Late K.Rami Reddy insured his life for sum assured amount of Rs.2,00,000/- under endowment assurance with profit and DAB from opposite parties on 28-05-2009.   The policy bears No.655642218 and the mode of premium payment is yearly.  The complainant being nominee submitted claim to opposite party.  But opposite party rejected the claim on a false ground of suppression of his correct age by the insured at the time of submission of proposal from.  Another policy bearing No.654192492 of the same insured with same date of birth was settled without any objection.  At the time of submitting the proposal, insured produced study certificate as proof of age.  After the death of insured instead of settling the claim opposite party rejected it on the ground of suppression of correct age.  Aggrieved by the decision of opposite party, the complainant filed this complaint before this Forum alleging deficiency of service seeking an order for the payment of appropriate reliefs.

3.     In reply to the notice of this Forum, opposite party No.2 filed their written version denying their liability to the complainants claim.  Opposite party No.2 admitted the issuance of endowment policy bearing No.655642218 dated 28-05-2009 and filing of claim pertaining to this policy after the death of insured on 23-11-2009.  Opposite party No.2 denied the allegation that the claim of complainant was rejected on a false ground that deceased life assured suppressed his correct age by submitting school certificate at the time of proposal.  In fact the school certificate filed as proof of age of life assured at the time of proposal is fake and fabricated for the purpose of insurance.  Since it is an early claim it is investigated. During investigation the school certificate filed by life assured as proof of age was sent to Head Master, Z.P.H. School, Owk to ascertain its genuineness.  After the verification of school records the Head Master to whom the certificate was sent replied on 25-01-2012 stating that the school certificate is not genuine.  Had the deceased life assured furnished the correct age proof, this policy would not have been issued to him.  Since the contract of insurance is utmost good faith, the claim of the complainant is repudiated after thorough verification of school certificate filed at the time of proposal as proof of age.  Hence opposite parties prayed for the dismissal of the case as there is no deficiency on their part.  Opposite party No.1 filed adoption memo.

4.     The complainant and opposite party filed their sworn affidavits.   Ex.A1 to A4 are marked by the complainant Ex.B1 to Ex.B4 are marked by the opposite parties.  Sri.P.Subba Rathanam gave his deposition on behalf of opposite parties and it is marked as RW1.

5.     Both parties filed their written arguments and submitted their oral arguments.

6.     Hence the points for consideration are:

1. Whether the complainant made out a case to prove deficiency on the part of Opposite Parties?

1. Whether the complainant is entitled for any relief?

1. To what relief?

7.      POINTS i and ii:- The facts admitted in the case are the deceased life assured (DLA) obtained two insurance policies from opposite parties

        1.     Policy bearing No.655642218 dated 28-05-2009 with sum assured for Rs.2,00,000/- marked as Ex.A1.

        2.     Policy bearing No.654192492 dated 21-06-2006 with sum assured for Rs.1,00,000/- marked as Ex.A4.

        For the above said two policies son of deceased life assured K.Siva Konda Reddy, was appointed as nominee.  Both Policies are endowment assurance with profit with DAB having date of birth entered as 01-07-1952.  In the event of death before date of maturity the nominee is entitled to receive sum Assured + Vested Bonus.  The life assured died on 23-11-2009 Ex.A2 is Death Certificate.  The complainant being nominee for both policies filed claim with required documents.  The claim in respect of policy No.654192492 was settled and the claim amount was paid to the nominee.  The claim pertaining to another policy No.655642218 was rejected on the ground that life assured filed a fake school certificate as proof of age suppressing his correct age.  Ex.A3 is repudiation letter.  Opposite parties contended that at the time of filing proposal for insurance (Ex.B1) the life assured enclosed date of birth certificate (Ex.B4) as age proof is proved to be fake and fabricated by the reply letter from the Head Master, Z.P.H. School, Owk dated 25-01-2012, (Ex.B3) to the letter dated 20-01-2012 of opposite party No.1 office (Ex.B2) to ensure the genuineness of Ex.B4.  The witness P.Subba Rathanam as RW1 deposed stating that the certificate Ex.B4 is not genuine. Hence he is not guilty of negligence. 

The complainant is contended that life assured submitted study certificate as proof of age at the time of filing insurance proposal Ex.B1.  The date of birth certificate Ex.B4 supposed to be fake according to opposite parties and RW1, was not filed by the life assured.  Further Head Master of a school is not competent to issue date of birth certificate as per rules.  Opposite parties neither examined the Head Master who is presently working at Owk nor the author of the certificate Ex.B4.  Moreover RW1 admitted that he is not the scribe of letter Ex.B3, but his clerk wrote it in Telugu and he signed.  It is also contended that the words “not genuine” are inserted by opposite parties after receiving Ex.B3 from RW1.  Basing on study certificate of life assured filed for age proof opposite parties issued insurance policy.  In view of the reasons stated above it can not be clearly inferred that Ex.B4 and the study certificate that was filed by life assured at the time of proposal are one and the same.  Opposite parties possessing another policy No.654192492 in which the same date of birth i.e., 01-07-1952 is noted with them, issued this policy No.655642218.  At this juncture the claim of it is rejected in the name of early claim investigation and suppression of correct age.  From what is stated above it can not be treated as deliberate concealment of fact and it is not a sufficient reason for repudiation of claim in respect of policy No.655642218.  So the action of opposite parties is not in order and the repudiation of claim is not justified. 

8.      Point No.iii:- As per the terms and conditions of the policy in the event of death of life assured the nominee is entitled to receive the sum assured + vested Bonus.  Hence it is allowed.  In addition to it 12% per annum interest is granted from the date of repudiation till the date of realization.  Rs.5,000/- is sanctioned  as compensation for mental agony.

9.     In the result, the complaint is allowed partly directing opposite parties jointly and severally to pay the sum assured + vested Bonus together with interest at 12% per annum, Rs.5,000/- is sanction for mental agony cost of the case is Rs.1,000/-.  Time for compliance is one month from the date of receipt of this order.

        Dictated to the stenographer, transcribed by her, corrected and pronounced by us in the open bench on this the 28^th day of June, 2013.

Sd/-                                                                          Sd/-

LADY MEMBER                                                                PRESIDENT (FAC)

       APPENDIX OF EVIDENCE

                                    Witnesses Examined

For the complainant : Nill            For the opposite parties : RW1

List of exhibits marked for the complainant:-

Ex.A1                Photo copy of Insurance Policy bearing No.655642218.

Ex.A2                Photo copy of Death Certificate issued by Gram Panchayat

dated 30-11-2009.

Ex.A3                Photo copy of Repudiation Letter dated 31-03-2012.

Ex.A4                Photo copy of Insurance Policy bearing No.654192492

List of exhibits marked for the opposite parties :-

Ex.B1                Policy Proposal Form dated 04-02-2009.

Ex.B2                Letter dated 20-01-2012 addressed to Head Master, Owk.

Ex.B3                Letter dated 25-01-2012 addressed to opposite party by

Head Master, ZP High School, OWk.

Ex.B4        Date of Birth Certificate issued by Head Master, Z.P.High

                School, OWk dated 24-01-2009.

RW1           Deposition of Sri P.Subba Ratham, Head Master, Z.P.H. School, Owk Village, Banaganapalli Mandal, Kurnool District dated 07-06-2013.

Sd/-                                                                           Sd/-

LADY MEMBER                                                            PRESIDENT (FAC)    

    // Certified free copy communicated under Rule 4 (10) of the A.P.S.C.D.R.C. Rules, 1987//

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Complainant and Opposite parties  :

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