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
And
Smt. S.Nazeerunnisa, B.A., B.L., Lady Member
Thursday the 16th day of June, 2011
C.C.No.34 /2011
Between:
Kommu Sekhar, S/0 K.Pedda Papadu,
H.No.14/130, Kondapeta Colony,Banaganapalli-518 124. …Complainant
-Vs-
1. The Branch Manager,
Bajaj Allianz Life Insurance Company Limited,
S.V. Complex,
Second Floor,
H.No.40/581A,
Kurnool-518 004.
2. The Senior Divisional Manager, Bajaj Allianz Insurance Company Limited,
GE PLAZA, Air Port Road, PUNE-411 006.
...Opposite ParTies
This complaint is coming on this day for orders in the presence of Sri P.Siva Sudarshan, Advocate for complainant and opposite parties 1 and 2 as called absent for upon perusing the material papers on record, the Forum made the following.
ORDER
(As per Sri. T.Sundara Ramaiah, President)
C.C. No. 34/2011
1. This complaint is filed under section 12 of C. P. Act, 1986 praying:-
- To direct the opposite parties to pay the policy amount of Rs.1,00,000/- with interest at 24% P.A. from the date of death of the decreased i.e. 09-12-2008 to till the date of realization.
(b) To grant a sum of Rs.10,000/- towards mental agony;
(c) To grant a sum of Rs.5,000/- towards cost of the complaint;
And
- To grant any other reliefs as the Hon’ble Forum deems fit and proper in the circumstance of the case.
2. The case of the complainant in brief is as under:- The complainant’s brother Kommu Bala Thimmaiah took insurance policy bearing No.0104821097 from opposite parties in July 2008. The period of policy is from 02-08-2008 to 02-08-2028. The complainant is the nominee under the policy. The complainant’s brother Kommu Bala Thimmaiah died due to Heart Attack on 09-12-2008. Later the complainant submitted the claim form to opposite party No.1 with relevant documents. On 29-09-2009 opposite party No.1 repudiated the claim of the complainant stating that the deceased not disclosed in the proposal form that he was under Antiretroviral Therapy. The deceased did not take Antiretroviral Therapy as stated in the repudiation letter. Opposite parties are liable to pay the assured amount. Hence the complaint.
3. Opposite parties 1 and 2 set exparte.
4. On behalf of the complainant Ex.A1 to A4 are marked and sworn affidavit of the complainant is filed.
5. Complainant filed written arguments.
6. The points that arise for consideration are:
- Whether there is deficiency of service on the part of Opposite Parties?
- Whether the complainant is entitled for the reliefs as prayed for?
(c) To what relief?
7. POINTs 1 and 2:- It is the case of the complainant that her brother Kommu Bala Thimmaiah obtained insurance policy from the opposite parties and the period of policy is from 02-08-2008 to 02-08-2020. The complainant filed Ex.A1 copy of the policy issued by the opposite parties. It is mentioned in the said policy that the complainant is the nominee and that the period of policy is from 02-08-2008 to 02-08-2028. It is also the case of the complainant that her brother Kommu Bala Thimmaiah died on 09-12-2008 due to Heart Attack. Ex.A3 is death certificate issued by the Doctor in Peoples Nursing Home, Banaganapalli. In Ex.A3 it is mentioned that Kommu Bala Thimmaiah died on 09-12-2008 due to A.M.I. It is the case of the complainant that her claim was repudiated by the opposite parties holding that the deceased suppressed the material facts regarding his in proposal form. According to opposite parties the deceased was taking Antiretroviral Therapy prior to the date of the proposal. It is for the opposite parties to establish that the deceased was taking Antiretroviral Therapy and that he died because of the disease. The opposite parties did not come forward to contest the matter. The complainant filed Ex.A3 where in it is mentioned that the cause of the death of the deceased is AC Myocardial Infarct. There is no evidence on record to show that the deceased was taking Antiretroviral Therapy by the date of the proposal. The repudiation of the claim of the complainant by the opposite parties is not on sound grounds. The failure on the part of the opposite parties in settling the claim amounts to deficiency of service. The complainant who is the nominee under the policy is entitled for the sum assured.
8. In result, the complaint is partly allowed directing the opposite parties jointly and severally to pay to the complainant assured amount of Rs.1,00,000/- with interest at 9% per annum from the date of repudiation of the claim i.e., 29-09-2009 till the date of payment along with cost of Rs.500/-.
Dictated to the stenographer, transcribed by her, corrected and pronounced by us in the open bench on this the 16th day of June, 2011.
Sd/- Sd/- Sd/-
MALE MEMBER PRESIDENT LADY MEMBER
APPENDIX OF EVIDENCE
Witnesses Examined
For the complainant : Nil For the opposite parties : Nill
List of exhibits marked for the complainant:-
Ex.A1 Letter dated 26-09-2008 of opposite parties.
Ex.A2. Claim Repudiation letter of opposite party No.1
dated 29-09-2009
Ex.A3 Photo copy of Death Claim form.
Ex.A4 Death certificate issued by Panchayat Secretary,
Banaganapalli.
List of exhibits marked for the opposite parties:- NILL
Sd/- Sd/- Sd/-
MALE MEMBER PRESIDENT LADY MEMBER
// 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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