Between:

M.Achanna,H/o Late M.Kistamma,

H.No.1/168, Enugubala Village & Post, Yemmiganur Mandal – 518 360,

Kurnool District.                                                 

…Complainant

                                                    -Vs-      

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

   D.No.12-17, Bus Stand Road, Yemmiganur – 518 360,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.M.Sivaji Rao, Advocate for complainant and Sri.G.MD.Habeebur Rahman, Advocate for opposite parties 1 and 2 and upon perusing the material papers on record, the Forum made the following.

                                              ORDER

(As per Smt. S.Nazeerunnisa, Lady Member)                                                             C.C. No.37/2012

1.     This complaint is filed under section 11 and 12 of C.P. Act, 1986 praying:-

(a)          To direct the opposite parties jointly and severally to pay the assured amount with profits with interest at the rate of 24% from the date of death;

(b)          To pay a sum of Rs.25,000/- towards the compensation for causing mental agony and hardship;

(c)           To pay the cost of this complaint;

And

(d)          To pass any other order or orders that are deem to be fit and proper in the circumstances of the case.

2.    The case of the complainant in brief is as under:- The complainant is the husband of Late M.Kistamma.  Late M.Kistamma insured her life with the opposite parties under the policy bearing No.655429926 for Rs.1,00,000/-.  The yearly premium payable under the policy is Rs.3,604/-.  The period of the policy is 16 years.  On 20-10-2010 the insured died suddenly.    The complainant being the nominee under the policy submitted the claim to the opposite parties.  The opposite parties repudiated the claim on the ground that the insured suppressed the material facts regarding her age in the proposal form and that the insured was 54 years at the time of the proposal and the same was not disclosed by the insured and mentioned as 48 years in the proposal form.  The repudiation of the claim by the opposite parties is illegal.  On the date of proposal the age of life assured was 48 years.  There is a deficiency of service on the part of the opposite party in not honouring the claim of the complainant.  The opposite parties caused mental agony by falsely repudiating the claim of the complainant.   Hence the complaint.

3.     Opposite party No.2 filed written version and the same is adopted by opposite party No.1.  It is stated in the written version of opposite party No.2 that the complaint is not maintainable.   It is admitted that opposite party No.1 issued policy in favour of insured Mangali Kistamma for a sum of Rs.50,000/- with date of commencement 28-10-2009.  The policy was issued on the basis of age declared by her in the proposal form as 48 years.  The opposite parties repudiated the claim of the complainant on the ground that the life assured suppressed the material fact as regards to her age.  On the date of proposal her age was 54 years, she falsely declared her age as 48 years in the proposal form.  There is no deficiency of service on the part of opposite parties.  Hence the complaint is liable to be dismissed. 

4.     On behalf of the complainant Ex.A1 to A3 are marked and sworn affidavit of the complainant is filed. On behalf of the opposite parties Ex.B1 to B8 are marked and sworn affidavit of opposite party No.2 is filed.

5.     Both sides filed written arguments.

6.     Now the points that arise for consideration are:

                     i.        Whether there is deficiency of service on the part of Opposite Parties?

                    ii.        Whether the complainant is entitled for the reliefs as prayed for?

                  iii.        To what relief?

7.      POINTS i and ii:-  Admittedly Mangali Kistamma who is the wife of the complainant obtained policy bearing No.655429926 in her name on 28-10-2009 under Ex.B4.  The sum assured under the policy was Rs.50,000/- along with other benefits.  Yearly premium payable under the policy was Rs.3,604/-.  The life assured died on 20-10-2010.  Ex.A2 is the death certificate issued by the Registrar of Birth and Deaths, Municipal Corporation, Kurnool dated 07-12-2010.  It is the case of the complainant that after the death of life assured, the complainant, being the nominee under the policy submitted claim to opposite parties.  The opposite parties repudiated the claim under Ex.A3=Ex.B8 dated 18-02-2010, on the ground that the insured suppressed the material facts as regards to her age in the proposal form.  It is further case of the complainant that the life assured has submitted the Ration Card to prove her age as 48 years.  The Medical Officer of opposite parties determined her age as 48 years and the agent of opposite parties Mr.C.B.Naganna also attested the same as 48 years.  It is also well known to the opposite parties.  After verification opposite parties issued the policy to deceased life assured. 

8.     According to opposite party No.2 the deceased life assured has wrongly mentioned her age as 48 years in the proposal form Ex.B1 dated 31-10-2009 and made a false statement in Ex.B2 declaration of age form No.3260 – 5098 as regards to her age.  The opposite party No.2 filed Certificate of Hospital Treatment, Government General Hospital, Kurnool Ex.B5, and Medical attendance Certificate Ex.B6 dated 11-08-2011, where in the age of life assured mentioned as 55 years.

9.     The learned counsel appearing for the opposite parties further contended that in the family Member Certificate issued by Thasildar, Yemmiganur dated 30-07-2011 Ex.B7, the age of insured son is mentioned as 39 years and on the basis of it the age of life assured was 54 years at the time of taking the policy.  In Ex.B7 the age of life assured is not mentioned.  It is not a proof regarding the age of life assured.  It is determined, the legal heirs of deceased life assured.  Ex.B5 and Ex.B6 are reliable in respect of health condition of the deceased life assured, but not the age of the life assured.  So the contention of opposite party No.2 is not accepted.

10.    The learned counsel appearing for the complainant contended that insured already submitted Ration Card along with proposal form Ex.B1.  After due examination of insured by its own medical examiner, it was certified under Ex.A1, that she was aged 48 years at the time of submission of proposal form and also confirmed the same by its own agent Mr.C.B.Naganna under Ex.B2.  Opposite parties issued the policy on the basis of Ration Card and Medical Examination of its own Medical Officer.  As seen from Ex.B1, Ex.B2 and Ex.A1 it is clear that on the date of proposal, the age of insured was 48 years.  The opposite parties could not establish that the life assured was 54 years and suppressed the said fact in the proposal form.  The repudiation of the claim by opposite parties is not just and proper.  There is a deficiency of service on the part of opposite parties.  The complainant who is nominee under the policy is entitled for an assured amount of Rs.50,000/- along with other benefits. 

11.    In the result, the complaint is partly allowed directing the opposite parties jointly and severally to pay assured amount of Rs.50,000/- along with other benefits under the policy to the complainant and Rs.500/- as a cost of the case. 

        Dictated to the stenographer, transcribed by her, corrected and pronounced by us in the open bench on this the 10^th day of September, 2012.

  Sd/-                                                                          Sd/-

  LADY MEMBER                                                          PRESIDENT                  

                                  APPENDIX OF EVIDENCE

                                    Witnesses Examined

For the complainant : Nill            For the opposite parties : Nill

List of exhibits marked for the complainant:-

Ex.A1                Photo copy of Declaration of Age (F.No.5096)

dated 31-10-2009.

Ex.A2                Photo copy of Death Certificate issued by Registrar of

                Births & Deaths, Kurnool Municipal Corporation,

                Kurnool District, dated 07-12-2010.

Ex.A3                Repudiation Letter dated 18-02-2012.

List of exhibits marked for the opposite parties:-

Ex.B1                Photo copy of Proposal Form dated 31-10-2009.

Ex.B2                Photo copy of Form Nos.3260, 5098 dated 31-10-2009.

Ex.B3                Photo copy of Declaration of Age (F.No.5096)

dated 31-10-2009.

Ex.B4                Policy bearing No.655429926.

Ex.B5                Certificate of Hospital Treatment Form No.3816 Claim

                Form B1 dated 11-08-2011.

Ex.B6                Medical Attendant’s Certificate Form No.3784 Claim

                Form “B” dated 11-08-2011.

Ex.B7                Family Members Certificate issued by Thasildar,

Yemmiganur dated 30-07-2011.

Ex.B8                Office copy of Repudiation Letter dated 18-02-2012.

 Sd/-                                                                                           Sd/-

LADY MEMBER                                                                PRESIDENT         

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

Copy to:-

Complainant and Opposite parties  :

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