BEFORE THE DISTRICT FORUM:KURNOOL
Present: Sri. T.Sundara Ramaiah , B.Com B.L., President
And
Sri. M.Krishna Reddy , M.Sc., M.Phil., Male Member
Monday the 26th day of July, 2010
C.C.No 126/09
Between:
G. Akkamma, W/o. Late G.Pedda Gaddanna,
H.No.17/225, Kallubavi Street, Adoni, Kurnool District. …..Complainant
-Vs-
1. The Branch Manager, Shriram Life Insurance Company Limited,
H.No.450/3, 20th Ward, 1st Floor, Nakatha Building, Main Road-518 301, Adoni, Kurnool District.
2. The Assistant General Manager, M/s. Shriram Life Insurance Company Limited,
U-Con PlaZA, D.No.40/324, Kurnool-518 001. …Opposite PartieS
This complaint is coming on this day for orders in the presence of Sri.G.Sreenivasulu, Advocate, for complainant , and Sri.S.V.Krishna Reddy and Sri.B.V.Ramana Reddy , Advocates 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 )
C.C 126/09
1. This complaint is filed U/S 12 of CP Act 1986 seeking direction on the Ops to pay the sum assured of Rs.50,000/- plus accrued bonus with interest, Rs.25,000/- for mental agony and cost of the complaint.
2. The case of the complainant in brief is that the complainant husband insured his life for Rs.50,000/- under policy No. NP 080600035679 with Ops. The term of the policy is 12 years commencing from 28-03-2006 to 28-03-2018. The complainant husband died on 02-07-2006 , on which date the policy was in force. The complainant is the widow and nominee of the policy holder. The complainant submitted the claim forms with all necessary enclosures to the Ops in time. The Ops repudiated the claim on the principle of “UBERRIMA FIDE” alleging that at the time of taking policy , the deceased suppressed the facts with regard to his health , habits etc., which were denied by the complainant . As per the complainant the policy was issued after subjecting the deceased to various medical tests and satisfying reports. The repudiation letter was also sent to him after receiving a legal notice by the Ops .Therefore the callous
and indifferent attitude of Ops clearly amounts the deficiency of service , that made the complainant to file a case against Ops in the Forum seeking appropriate reliefs.
3. The complainant filed his sworn affidavit and documents marked as Ex.A1 to A4 in support of his case.
4. In pursuance of the notice of this forum , the Ops contested the case by filing written version through their counsel denying their liability to the complainants claim.
5. In the written version OP.No.2 submits that the complainant’s husband knowing the benefits of the policy insured his life under “Shri Life” at the Ops not disclosing his health condition in the proposal form supplied to him. Basing on the information provided proposal form, the policy was issued to the deceased with all good faith accepting the risk on his life. After receiving death information of the policy holder, the claim forms were supplied to the nominee , which was returned to him in the month of March , 2007 after issuing reminders. Since it was an early claim, an investigation was conducted , and during the investigation , G.Veeranna , a neighbour of the deceased gave a statement that the deceased was alcoholic, smoker and was hospitalized for 20 to 30 days in Area Hospital, Adoni due to ill health. Taking the statement of G.Veeranna as basis, the OP repudiated the claim of the complainant on the principle of ““UBERRIMA FIDE”. Thus there is no deficiency of service on the part of the OP and therefore prayed for the dismissal of the case with cost.
6. On behalf of Ops to support their case sworn affidavit and documents are marked as Ex.B1 to B6 are filed.
7. On the basis of the above pleadings the points for consideration are
(i) whether the complainant has made out any case to prove the deficiency of service on the part of the Ops satisfying its liability to the complainant’s claim ?
(ii) what is the quantum of compensation than can be awarded to her?
8. Point No.1:- Ex.B2 the original of Ex.A1 clearly establishes that the complainant’s husband insured his life with OP for Rs.50,000/- covering the risk. Ex.A2 is the death certificate. It shows that the death of the complainant’s husband took place on 02-07-2006 at Adoni. Ex.B3 proves that the policy is in force on the date of the death of the complainant’s husband. Ex.B1 ,the proposal for insurance , furnishing the details of personal medical history of life to be assured and agents recommendation for the acceptance of the proposal after his discreet enquiries. From the above documents the contention of the complainant that her husband insured his life with Ops , died on 02-07-2006 i.,e when the policy was inforce and din not suppress the facts regarding his health and habits are proved beyond reasonable doubts. There was no suppression of material fact. The ground on which the claim was rejected is not reasonable.
The Ex.B4 a statement of G.Veeranna, regarding health habits etc of the deceased, has no authenticity and legal validity. Hence the contention of OP on the basis of Ex.B4 in repudiating the claim through the letter Ex.A4 or B5 can not be accepted and such contention does not absolve the liability of Ops.
In view of what is stated above, the forum holds that the complainant has established the facts entitling him to receive compensation under different heads as claimed by him.
9.Point No. 2: The widow of the deceased claimed the insured amount of Rs.50,000/- plus vested bonus as promised in the policy. Death of the insured occurred when the policy was inforce. Looking the facts and circumstances of the case, the claim is allowed accordingly.
The Ops did not take any action on the submission of claim forms in full shape and inspite of legal notice. Therefore the complainant is entitled compensation for mental agony .
10. For the reasons set out above the complaint is allowed directing the Ops to pay Rs.50,000/- plus vested bonus towards policy amount , Rs.5,000/- for mental agony and Rs.1,000/- towards the cost of the case, payable within 6 weeks from the date of this order.
Dictated to the stenographer, transcribed by her, corrected and pronounced by us in the open bench on this the 26th day of July , 2010.
Sd/- Sd/-
MALE 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 Copy of Insurance Policy bearing No. NP 0806000035679
Ex.A2. Copy of the death certificate.
Ex.A3. Office copy of the legal notice.
Ex.A4. Repudiation letter dated 31-12-2007 .
List of exhibits marked for the opposite parties:
Ex.B1. Proposal form.
Ex.B2. Original Policy schedule.
Ex.B3. Original policy receipt.
Ex.B4. Original letter given by G.Veeranna dt:15-03-2007.
Ex.B5. Copy of repudiation letter dt:31-12-2007 , Original postal receipt of RPAD.
Ex.B6. Original acknowledgement card.
Sd/- Sd/-
MALE 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
Copy was made ready on :
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