This complaint  having come up for final hearing before us on  01.07.2015  on perusal of the material records  and on hearing the  arguments of  Thiru.N.K.Shanmugam, the counsel for the complainant and  Thiru. M.G.Rajamohan,  the counsel for the 1st opposite party  and Thiru.S.Manickavel Pandiyan,  the counsel for the 2 and 3^rd opposite parties  and subsequently having been set exparte and having stood  before us for consideration, till this day the Forum  passed the following   

By President, Thiru..P.G.Rajagopal, B.A.B.L., 

                       This complaint is filed by the complainant u/s 12 of the Consumer Protection Act 1986.                    

2) The gist of the  complaint filed  by the complainant  is that one Thiru.Sekar, the husband of the first complainant and  the  father of the 2^nd and 3^rd complainants took  Life Insurance policy No. NP091200090186  with the 2^nd opposite party and paid the first premium amount  from out of the chit amount received by him from the chit transaction with the first opposite party, the period of policy was 15 years and the  next due date for the payment of premium was 28.03.2013 as per the letter sent by the 2^nd opposite party on 17.04.2012. The said Sekar had another  life insurance policy in policy No. NP091100069087 for the sum of Rs. 1,00,000/-  and the premium amount was Rs. 10,192/-. The said Sekar died  at 11.45 A.M   on 02.04.2012 and the complainants as legal heirs of the deceased policy holder sent their proposal forms claiming the policy amount under  the said two policies.  The  earlier  policy No.091200090186  had been repudiated by the second opposite party by their letter dated  30.08.2012 and when the  complainants filed an appeal before the 3^rd opposite party, the Internal Claims Review Committee,  the said committee  also confirmed  the order of repudiation  rejecting the claim of the complainants.  The deceased Sekar died of sudden Heart attack and he had not suppressed any material facts in the proposal form as alleged by the opposite parties in the repudiation letter.  Further the proposal form was filled up only by the agent of the second opposite party and the  diabetes of the policy holder was not  the reason for the heart attack   causing his  death. Therefore the repudiation of the earlier  policy by the second opposite party is  sheer deficiency of service and they have not given any reply with respect to the 2^nd policy No. NP091100069087  till date which is also  deficiency of service on their part.   The complainant therefore  prays  for an order to  direct the  second opposite party to pay the  policy amount of Rs. 5,00,000/- and Rs.1,00,000/-  due under the said insurance policies No. NP 091200090186  and NP091100069087 respectively with interest  from the  date of  their claim application  and also  pay a sum of Rs.3,00,000/- towards compensation of  their mental agony caused to them.  

3)  The first opposite party filed his written version.  The 3^rd opposite party was represented by his counsel Thiru.S.Manickavel Pandiyan  who undertook  on 11.03.2013 the date of  first hearing of this complaint, to file vakalath for opposite party-2 also; but  despite several  adjournments  the said  counsel had not filed vakalath for opposite party-2 and written version  was also  not filed for opposite party-3 and in consequences thereof  on  12.06.2014 the 2^nd and 3^rd opposite parties were set exparte.

4) The gist of  the written version filed by the 1st opposite party is that they have nothing to do with the  insurance policies claimed by the complainant in as much as they are only dealing with the  chit  transaction  and the deceased Sekar was a subscriber with them  in a chit group  for the value of Rs.5,00,000/-  and on  12.02.2012 in the 9^th  auction  he auctioned the chit for Rs.3,00,000/- and deducting expenses of Rs. 250/-   in the prize money  on 06.03.2012 the opposite party gave a cheque No.1223 drawn on the  City Union Bank, Kumbakonam  for Rs. 2,37,750/- and another cheque  No. 1224 for Rs.50,000/- on 05.03.2012  drawn in favour of  the second opposite party  at the request of the said Sekar to be paid towards his premium amount for his life insurance policy with the  second opposite party.  Therefore,    the  first opposite party has nothing to do with the  claim amount under the said  two policies  mentioned by the complainants except  issuing the cheque for Rs.50,000/- towards the premium amount   in favour of the second opposite party.  The  first opposite party has nothing to do with the said life insurance policy  taken by the  deceased Sekar with the second opposite party.  The first opposite party  has therefore to be exonerated  from  the complaint.  

5) The 3^rd complainant has filed his proof affidavit reiterating all the averments made in his complaint and filed 11 documents which are marked as Ex.A.1 to Ex.A.11.The first opposite party filed his proof affidavit in support of his defense and filed two documents which are marked as Ex.B.1 and Ex.B.2.Written arguments have been submitted by the 3^rd complainant and the 1^st opposite party.

6)   The points for Determination are:

                     1) Whether there is  any deficiency of service on the part of the opposite parties?

                     2) Whether the complainant is entitled to any relief? If so to what relief?

7)POINT  NO.1:  The main allegation of the  complainant is that  the  deceased Sekar, the husband of the first complainant and the father of the 2^nd and 3^rd complainants  took two policies with the 2^nd opposite party  one for Rs.5,00,000/- and he paid the first premium  and the due date for the payment of the  next premium is  28.03.2013 and he had another policy for Rs.1,00,000/- the premium amount  being Rs. 10,192/- and the due  date for the payment of the next premium was  28.03.2013.  But the policy holder  died  on 02.04.2012 owing to sudden heart attack and the 2^nd and  3^rd opposite parties have  repudiated their claim for the policy amount under the earlier policy for Rs.5,00,000/- on the  ground that the deceased policy holder wrongly gave an information as if he  was not suffering from  diabetes  in the proposal form and the deceased policy holder did not give any  false information  or suppressed  any material facts  and the proposal form itself was filled up by the agent of the second opposite party and the said diabetes was not the reason  for the heart attack causing  the death of the deceased policy holder.  The repudiation is done by the 2^nd and 3^rd opposite  parties wantonly  in order to evade  their  liability to pay the amount to the complainants  and further  they have  not  given even  a reply with respect to the  another policy for Rs.1,00,000/- and thus they have committed deficiency of service and  are liable to pay the policy amount  as well as  the compensation  as claimed by them  in the complaint.  

8)  The main contention of the first opposite party is that he has nothing to do with the life insurance policies issued by the 2^nd opposite party and  his company deals with chit transaction and the deceased  Sekar was a subscriber to the chit conducted by them for Rs.5,00,000/- and the Sekar   took the chit for Rs. 3,00,000/- and the sum of Rs.50,000/-  was as per his request   transferred to  the second opposite party towards  premium for his life insurance scheme.  Apart from that the first opposite party has nothing to do with the claim of policy amount made by the complainants.  Therefore the first opposite party has to be exonerated from the complaint.

9) As far as the first opposite party is concerned  it is true that they are  only  the company  dealing  with only chit transaction  and has nothing to do with the issue of  life insurance policies to the deceased Sekar.  Ex.B.1 shows that the Sekar was a subscriber  to a group of chit for the value of Rs.5,00,000/-  and at the 9^th auction he won the prize money of Rs.3,00,000/- bidding  the amount for  Rs.2,00,000/- and Ex.B.2 is the letter given by the said Sekar  requesting  the first opposite party to pay  from out of the  prize money, to pay Rs.50,000/- towards the premium for the life insurance policy with the second opposite party.  Though the first and second opposite parties  belong to the  same group of  company, the first opposite party is only dealing with  the chit transaction having a separate registered office at  a particular address and the second opposite party is the company dealing  with  issue of life insurance company  having separate office at a different address.  Therefore, the first opposite party has only given a cheque in favour of the second opposite party towards the first premium amount for the life insurance policy issued by the second opposite party to the deceased Sekar who won the prize money in the  chit auction  held by the first opposite party.   Therefore the first opposite party has nothing to do with the claim of the complainants or their   repudiation of the second opposite party.  Since he  belongs to the same group of  company  the first opposite party  seems to have been added as a formal party and there is no deficiency of  service on the part of the first opposite party.   

10)  On the side of the complainants  Ex.A.1 is the letter sent by the  2^nd opposite party to the deceased Sekar on  17.04.2012 informing  that his proposal was accepted  and the policy pack was despatched  to him.  It is stated  that  his policy No. NP091200090186 issued  on 31.03.2012 had been discharged to him and the first renewal  premium of Rs.49,946 will be due  on  28.03.2013.  Ex.A.9 is another renewal premium notice sent to the deceased policy holder Sekar for the policy No.NP091100069087 informing   that the due date for the payment of premium is  11.05.2012 and the premium  amount to be paid is Rs. 10,192/-.  Ex.A.4 is the death certificate of the policy holder and  it has  revealed that the policy holder  died on  02.04.2012 at  Anbu Hospital, Kumbakonam.  Therefore it is very well proved that the policy holder died when the policy was in force  and  before the expiry of the  due date for the payment of the premium.  Ex.A.2 is  the  renewal reminder notice dated 23.05.2012 sent by the 2^nd opposite party  to the deceased policy holder.  Ex.A.3 is the certificate given by the Anbu Hospital stating that the cause of  death of the deceased policy holder at 11.45 am on 02.04.2012 was sudden cardiac arrest.  Ex.A.5 is the legal heir certificate  issued by the  Tahsildar, Kumbakonam  stating   that the  complainants are the  surviving  legal heirs of the deceased policy holder.  Ex.A.6 is the letter of repudiation dated 30.08.2012 sent by the  second opposite party to the first complainant  the nominee  under the policy.  Ex.A.7  is the  representations  dated 01.10.2012  made  by the first complainant to the 3^rd opposite party  by way of an appeal against the order of  repudiation of the second opposite party.  Ex.A.8 is  the letter  of the third opposite party  dated  09.10.2012 upholding the decision of  repudiation of the first opposite party. Ex.A.10 is the   voucher made  for the payment  by the second opposite party to the complainant.   Ex.A.11 is only the current months due  intimation given by the first opposite  party to the deceased Sekar in connection with his chit transaction with him.

11) As per the  Ex.A.6 even though the 2^nd opposite party has repudiated the claim of the complainants on the ground  that the deceased policy holder suppressed the fact of his having diabetes  by answering  negative for the related question No.25 in the proposal form and as he had not disclosed the pre health ailment of diabetes  their claim is repudiated  as the policy  itself has become a void one. But the 2^nd and 3^rd opposite parties have not filed their objections  to the allegation made in the complaint before this Forum and they have been set exparte therefor.  In such circumstances the contention of the complainant that the deceased  Sekar had only subscribed the signature  in the proposal form and all the contents  were filled up by the agent of the 2^nd opposite party only and further the said Sekar suddenly died of heart attack and his ailment of diabetes is not the immediate  reason for the death of the deceased policy holder.  The very failure  on the part of the 2^nd and 3^rd opposite parties to appear  before this Forum and file their objections gives an inference to this Forum that the allegations made in the complaint are true as they are not  refuted by the opposite parties.  Further it is quite probable and believable  that diabetes is not the immediate cause for the death of the deceased policy holder as a person having   high level of cholesterol  or Hypertension  could also  have to die of  consequential  heart attack and therefore the repudiation of the claim of the complainants  by the second opposite party is neither reasonable nor valid and it is  nothing but  their deficiency of service and the repudiation of the 2^nd opposite party as well as the upholding  of the said repudiation by the 3^rd opposite party is nothing but sheer deficiency of service on their part.

12) POINT NO.2:-  In the result, the complaint is  allowed in part.  The 2^nd opposite party is  directed to pay the sum of Rs.5,00,000/- (Rupees five lakh only)  the policy amount under the policy No. NP091200090186   and Rs.1,00,000/-(Rupees one lakh only)  the policy amount under  the policy No. NP091100069087 with interest at the rate of 12% per annum from 02.04.2012 the date of death of the policy holder till the date of payment and the opposite parties  2 & 3 are  directed to pay jointly or severally  the sum of  Rs.2,00,000/-(Rupees two lakh only)  towards  compensation  for the mental agony of the complainants owing to their deficiency of service.  The 2^nd opposite party is directed to pay the said policy amount to the complainants within 45 days from the date of this order failing which the said policy amount shall carry  further interest  at the rate of 18% per annum from the date of this order till the date of its payment. The opposite parties  2 and 3  are also directed to pay the   compensation amount   to the complainants  within 45 days  from the date of this order, failing which the said amount shall carry  an interest at the rate of 12% per annum  from the date of this order till the date of its payment.  The opposite parties 2 and 3  are further directed to pay  jointly or severally  the sum of Rs.3000/- (Rupees  three thousand only) to the complainants towards  the cost of this litigation.  The complaint  as against the first opposite party is dismissed.

                This order was dictated by me to the Assistant, transcribed by her and corrected and pronounced by me on this 15th day of July 2015.

MEMBER -I                                                                                                 PRESIDENT

List of documents on the side of the complainant:-

List of documents on the side of the   Opposite parties :    

MEMBER -I                                                                                         PRESIDENT