This Complaint coming up before us for hearing on 28-09-11 in the presence of Sri P. Ramesh, advocate for complainant and opposite party remained absent and set exparte, upon perusing the material on record and having stood over till this day for consideration this Forum made the following:-
O R D E R
Per Sri A. Hazarath Rao, President:- The complainant filed this complaint under section 12 of the Consumer Protection Act seeking Rs.2,00,000/- being the insured amount together with interest @18% from the date of death of the policy holder, Rs.25,000/- towards deficiency of service and for costs.
2. In brief the averments of the complaint are these:
One Gottipati Pullamma on 16-10-09 obtained a life insurance policy from the opposite party. The said Pullamma is none other than the mother of the complainant. The said Pullamma died on 09-01-10 during subsistence of the policy. The complainant being a nominee submitted claim form to the opposite party along with the original policy bond. The opposite party on 24-03-10 sent a cheque for Rs.10,764.39 ps instead of Rs.2,00,000/-. Subsequently the complainant got issued a notice through her advocate. The opposite party though received notice kept quite without settling the claim. The conduct of the opposite party amounted to deficiency of service. The complainant suffered physically and mentally on such attitude of the opposite party. The complaint therefore be allowed.
3. The opposite party did not respond though received summons and as such he was set exparte.
4. Exs.A-1 to A-6 were marked on behalf of the complainant.
5. Now the points that arose for consideration in this complaint are:
- Whether the opposite party committed deficiency of service?
- Whether the complainant is entitled to compensation and if so to what amount?
- To what relief?
6. POINT No.1:- The complainant is the nominee as seen from Ex.A-1 policy. The assured Gottipati Pullamma died on 09-01-10 as seen from Ex.A-2. The policy commenced from 16-10-09, expires by 16-10-2027 and the annual premium was Rs.20,000/-.
7. The opposite party by Ex.A-3 letter dated 24-03-10 while repudiating the claim mentioned that the assured did not disclose of gynalogical investigations and suffering from ailments. It is well settled in law that the burden is on the insurance company to prove the suppression of material facts. But in this case the complainant filed Ex.A-4 letter addressed to the opposite party and is extracted below:
“I would like to request you that, the above patient was expired due to the cause of neuro dystrophy on 09-01-10.
But some of the neighbour was stated your surveyor she was expired of cancer. Actually she was suffered for vaginal malignancy on 25-09-07 and she got radium tolerance treatement on 13-1107 to 14-11-07 after that she was discharged in well condition.
But the neighbour could not able to tell to your surveyor property. You may be re-investigated if necessary and do justice to me in this case and arrange the said claim”.
8. The said averments of Ex.A-4 letter revealed that the complainant suffered from vaginal cancer. It is quite opt to mention here that the complainant filed this complaint after receipt of Ex.A-3 repudiation and the complainant died within three months after taking policy. It is not the case of the complainant that the insured did not suppress any ailment while obtaining policy. Ex.A-4 letter corroborated the contention of the opposite party and as such the repudiation by the opposite party under Ex.A-3 in our considered opinion is just and reasonable. For the discussion made supra we hold that the opposite party did not commit any deficiency of service and answer this point against the complainant.
9. POINT No.2:- In view of above findings the complainant is not entitled to compensation. We therefore answer this point also in favour of opposite party.
10. POINT No.3:- In view of above findings in the result the complaint is dismissed without costs.
Typed to my dictation by Junior Stenographer, corrected by me and pronounced in the open Forum dated this the 30th day of September, 2011.
MEMBER MEMBER PRESIDENT
APPENDIX OF EVIDENCE
DOCUMENTS MARKED
For Complainant:
Ex.Nos. | DATE | DESCRIPTION OF DOCUMENTS |
A-1 | 16-10-09 | Copy of policy issued by opposite party |
A-2 | - | Copy of death certificate of Gottipati Polamma |
A-3 | 24-03-10 | Copy of letter issued by opposite party to complainant |
A-4 | - | Letter addressed by complainant to opposite party |
A-5 | 24-03-10 | Account payee cheque issued by opposite party in the name of complainant |
A-6 | 03-09-10 | Copy of registered legal notice got issued by complainant to opposite party |
For opposite party: NIL
PRESIDENT
