BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM RAICHUR.
COMPLAINT NO. (DCFR) CC. 34/2012.
THIS THE 9th DAY OF NOVEMBER 2012.
P R E S E N T
1. Sri. Pampapathi B.sc.B.Lib. LLB PRESIDENT.
2. Sri. K.H. Sri Ramappa, B.A.LLB. MEMBER.
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COMPLAINANT :- Sri. Sidramappa S/o. Shanmukappa, aged 61 years,
Occ: Agriculturist, R/o. Turvihal, Tq. Sindhanoor, Dist: Raichur.
//VERSUS//
OPPOSITE PARTIES :- 1. The Branch Manager, Pragathi Gramina Bank, Branch
Turvihal, Tq. Sindhanoor, Dist: Raichur.
2. The Chief Operating Officer, Canara HSBC Oriental
Bank of Commerce, L.I. Co., Ltd., 6th floor, the Land mark Building Next to Nalli silks, M.G. Road, Bangalore
CLAIM : For direct the opposites to pay policy amount of Rs.
2,50,000/- with interest and cost.
Date of institution :- 23-04-12.
Notice served :- 16-05-12.
Date of disposal :- 09-11-12.
Complainant represented by Sri. T.M. Swany, Advocate.
Opposite No-1 represented by Sri. Sateesh.V. Advocate.
Opposite No- 2 represented by Sri. S.B.H. Advocate.
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This case coming for final disposal before us, the Forum on considering the entire material and evidence placed on record by the parties passed the following.
JUDGEMENT
By Sri. Pampapathi President:-
This is a complaint filed by complainant Sidramappa against the opposite No-1 Pragathi Gramina Bank and Opposite No-2 Canara SSDC Oriental Bank of Commerce L.I.C. Ltd., Bangalore U/sec. 12 of Consumer Protection Act for to direct the opposites to pay policy amount of Rs. 2,50,000/- with interest and cost.
2. The brief facts of the complainant’s case are that, his son by name Somashekar subscribed LIC policy from opposite No-2 Insurance Company for assured sum of Rs. 2,50,000/- commencing from 23-03-2010 to 23-03-2076. He paid premium regularly. The complainant is a nominee under the policy. Somashekar policyholder died on 12-05-2010 due to cardio respiratory arrest. The complainant being a nominee under the policy, intimated the death of Somashekhar opposites and filed claim petition with required documents, but neither opposite No-1, nor opposite No-2 shown interest in settling his claim on untenable grounds and thereby both opposites found guilty under deficiency in their services, accordingly, he filed this complaint for the reliefs as noted in it.
3. The opposite No-1 appeared in this case through its Advocate, filed its written version by contending that, it acted as per the request of complainant for getting policy from opposite No-2 and forwarded premium to it. It is as per circular issued by Government of India. The claim is in between the complainant and opposite No-2, bank is nothing to do with the claim of complainant. Hence, there was no deficiency in service on its part and accordingly, it prayed for to dismiss the complaint among other grounds.
4. Opposite No-2 appeared separately through its Advocate, filed written version by contending that, deceased Somashekhar was suffering from Retro viral disease and he was on regular treatment with Anti Retroviral Therapy since 2007. The same was not disclosed in his proposal form filed by him. Insurance Company issued policy in the name of deceased Somashekhar in good faith. He died due to the said decease, as such, the claim of the complainant was not considered, however, it issued a cheque bearing No. 526184 dt. 24-06-2010 for a total amount of Rs. 36,634.36 without prejudice to the rights to repudiate, further claim repudiated on the ground of non disclosure of material facts with regard to his health. Hence, there was no deficiency in service on its part. It denied all other allegations made against it, and prayed for to dismiss the complaint among other grounds.
5. In-view of the pleadings of the parties. Now the points that arise for our consideration and determination are that:
1. Whether the complainant proves that, his son by name Somashekhar subscribed LIC policy by name Stay Smart Plan from opposite No-2 Company through opposite No-1 bank by covering risk period from 23-03-2010 and thereafter the policyholder Somashekhar died on 12-05-2012 due to cardio respiratory arrest and thereafter complainant being a nominee under the policy filed claim petition, but opposite No-2 not settled maturity amount under the policy and repudiated his claim on untenable grounds and thereby both opposites found guilty under deficiency in their services.?
2. Whether complainant is entitled for the reliefs as noted in it.?
3. What order?
6. Our findings on the above points are as under:-
(1) In the affirmative.
(2) As discussed in the body of this judgement and as noted in the final order.
(3) In-view of the findings on Point Nos. 1 & 2, we proceed
to pass the final order for the following :
REASONS
POINT NOs.1 &2 :-
7. To prove the facts involved in these two points, affidavit-evidence of the complainant was filed, who is noted as PW-1. The documents Ex.P-1 to Ex.P-11 are marked. On the other hand, affidavit-evidence of opposite No-2 was filed, who is noted as RW-1. Documents Ex.R-1 to Ex.R-7 are marked. Affidavit-evidence of opposite No-1 was filed, who is noted as RW-2. One document marked as Ex.R-8.
8. In the instant case, opposite No-1 bank not denied the fact of advancing agricultural loan to Somashekhar at his life time and subscribing of LIC policy from opposite No-2 by name Stay Smart Plan commencing risk from 23-03-2010 and its maturity date is on 23-03-2076 for assured sum of Rs. 2,50,000/-.
9. It appears from the evidence of complainant and opposite No-2, as well as evidence of opposite No-2 bank, it is very much clear that, bank has no direct role in deciding the claim of complainant, as such, we are of the view that, opposite No-1 bank is of formal party in this case.
10. Now, the subscription of the policy, the date of commencement of the risk, its maturity date, sum assured under the policy and also the complainant being the nominee under the said policy are not in dispute.
11. The defence taken by the opposite No-2 Insurance Company for to repudiate the claim full amount of the complainant is that, deceased Somashekhar was suffering from Retro viral disease and he was under the treatment since 2007 i.e, prior to filing his proposal form dt. 11-03-2010. hence, he suppressed the material facts regarding his sufferings from the said disease in his proposal form. Accordingly, the full claim of complainant was repudiated only on that ground.
12. The complainant is contending that, his son Somashekhar died due to cardio respiratory arrest on 12-05-2010.
13. In a case suppression of material facts regarding previous disease by the policyholder in his proposal form, has to be proved by the Insurance Company only, it cannot take the shelter or weakness of the complainant’s case.
14. Admittedly the proposal form was submitted on 11-03-2010, the risk under the policy commencing from 23-03-2010, policyholder died on 12-05-2010 i.e, within the risk period.
15. Opposite No-2 filed number of documents with medical records to show that, deceased was under treatment of Anti Retroviral Therapy for his retro viral disease since 2007.
16. Admittedly opposite No-2 Insurance Company not filed affidavit-evidence of any one of the doctors said to have treated Somashekhar since 2007 for Retro viral disease. Simply some of the medical records filed without filing the affidavit-evidence of authors f the records.
17. The learned advocate for complainant relied on following two rulings:
(1) I (2009( CPJ 161 NC.
Vanita Ben Retilal Ful Baria V/s. LIC of India.
(3) III 1998 CPJ 475
Divisional Manager LIC of India & anr V/s. Savitri Devi.
and submitted before us that, the opposite No-2 Insurance Company has not discharged its burden of proving suppression material facts with regard to suffering of the said decease by Somashekhar at his life time or prior to filing proposal form. The defence taken by the Insurance Company is for to denial the claim of complainant. If, really he was suffering from that decease, then why Insurance Company not produced affidavit-evidences of any one of the doctors said to have treated him since 2007 till his death. He took support of the principles of the above said two rulings and submitted before us that, the medical records filed by opposite No-2, cannot be taken into consideration and thereby, complainant has proved the death of the son by cardio respiratory arrest.
18. In the light of the submissions made by the advocates on both sides and also the principles of the rulings referred above, more particularly the principles held by their lordships of the National Commission in a judgment cited at Sl.No. 1, we are of the clear view that, opposite No-2 Insurance Company not proved the alleged suppression of material facts with regard to prior suffering from retro viral disease by Somashekhar and he was under treatment since 2007, opposite No-2 also not proved the fact that, the policyholder Somashekhar suppressed the said facts in his proposal form with an intention to get illegal monetary benefit out of the policy from opposite No-2.
19. In the circumstances stated above, the contention of the opposite No-2 for repudiating the claim of complainant is not supported by required evidences, accordingly we hold that, the denial of the entire claim of complainant by opposite No-2 is deficiency in its service, accordingly we answered Point No-1 in affirmative.
POINT NO.2:-
20. In the instant case the maturity value of Rs. 2,50,000/- however, he received an amount of Rs. 36,634.36/- vide cheque bearing No. 526184 dt. 24-06-2010 by opposite No-2 and thereby complainant is entitled to get an amount of for Rs. 2,14,366/- from opposite No-2 Insurance Company.
21. The complainant is entitled to get an amount of Rs. 3,000/- towards deficiency in service from opposite No-2 and Rs. 2,000/- towards cost of litigation. The complainant is entitled to get interest at the rate of 9% p.a. on Rs. 2,19,366/- from the date of this judgment till realization of the full amount. Accordingly we answered Point No-2.
POINT NO.3:-
26. In view of our findings on Point Nos-1 & 2, we proceed to pass the following order:
ORDER
The complaint filed by the complainant is partly allowed.
The complainant is entitled to get total amount of Rs. 2,19,366/- from Opposite No-2 only.
The complainant is entitled to get interest at the rate of 9% p.a. on Rs. 2,19,366/- form opposite No-2 from the date of this judgment till realization of the full amount.
Complaint against opposite No-1 is dismissed.
Opposite No-2 Insurance Company is given one month time, to make the payment with interest to the complainant.
Intimate the parties accordingly.
(Dictated to the Stenographer, typed, corrected and then pronounced in the open Forum on 09-11-2012)
Sri. K.H. Sri Ramappa Sri. Pampapathi,
Member. President,
District Consumer Forum Raichur. District Consumer Forum Raichur.
