Karnataka

Chitradurga

CC/94/2016

R.Manjunataha S/o Rudrappa - Complainant(s)

Versus

The Branch Manager,HDFC Standard Life Insurance Co Ltd., - Opp.Party(s)

Shri.P.S.Sathyanarayana Rao

03 May 2017

ORDER

COMPLAINT FILED ON:07/10/2016

DISPOSED      ON:03/05/2017

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, CHITRADURGA.

 

CC.NO: 94/2016

 

DATED: 3^rd MAY 2017

PRESENT: - SRI. T.N. SREENIVASAIAH  : PRESIDENT                                   B.A., LL.B.,

                   SRI.N. THIPPESWAMY        : MEMBER

                          B.A., LL.B.,   

 

 

 

……COMPLAINANT/S	R. Manjunatha S/o Rudrappa @ Rudrachari, Age: 38 Years, Bhavana Tailor, Bhavasara Nilaya, Gopalapura Main Road, Chitradurga.   (Rep by Sri.P.S. Sathyanarayana Rao, Advocate)
V/S
…..OPPOSITE PARTIES	1. The Branch Manager, HDFC Standard Life Insurance Company Limited, No.255, Nabaraj Building, I Floor, Above More Stores, 4th Main, IP.J Extension, Near Ram and Company Circle, Davanagere-577002.   2. The Authorized Signatory, Legal Team, HDFC Standard Life Insurance Company Limited, 4th Floor, Block II A, Esquire Center, No.8, MG Road, Near Trinity Circle, Metro Shop, Bangalore-01.   3. The Authorized Signatory, Legal Team, HDFC Standard Life Insurance Company Limited, 11th Floor, Lodha Excellus Apollo Mills Compound, N.M. Joshi Marg, Mahalakshmi, Mumbai, India.      (Rep by Sri.B.S. Shivamurthy, Advocate for OP 3, OP No.1 and 2 ex-parte)

ORDER

SRI. T.N. SREENIVASAIAH:   PRESIDENT

The above complaint has been filed by the complainant u/Sec.12 of the C.P Act, 1986 for the relief to direct the OPs to pay a sum of Rs.9,50,000/- with interest @ 18% p.a, Rs. 10,000/- towards damages towards mental agony and Rs.5,000/- towards costs.

2.      The brief facts of the case of the above complainant are that, he is the son of deceased Rudrappa @ Rudrachari S/o Hanumanthappa, has taken HDFC Life Click 2 Protect policy bearing No.16195057 from OPs for his life risk during his life time.    It is further submitted that, OP No.1 has issued a policy bearing No.16195057 in the name of father of complainant by receiving premium amount of Rs.9,932/- on 31.07.2014 and the same was acknowledged.  Due to some problems, the complainant was not able to remit the second premium amount within the stipulated period.  As per the instructions of the OP No.1 the father of the complainant submitted all the relevant documents for revival of the policy as per their requirements.  After scrutinizing and satisfying the same, the OP No.1 has renewed the policy bearing No.16195057 and acknowledged the cheque No.631636 dated 30.07.2014 for second premium amount vide receipt No.ADU d21295 on 31.07.2014 and give the renewal premium receipt for having renewed the policy and the policy of the father of the complainant was in force at the time of his death.  It is further submitted that, the father of the complainant died on 03.09.2014 due to massive heart attack by leaving his LRs.  As per the instructions of the OPs Company, the complainant has submitted all the documents for speedy disposal of death claim.  On 26.11.2014 the complainant has written a letter to the OP Company for proceedings of correspondence.  The OPs have not settled the claim of the complainant.  Hence, the OPs have committed deficiency of service and complainant has suffered mental agony and financial loss.  In this regard, the complainant has approached and demanded the OPs for so-many times through phone and in letters but, the OPs have not settled the claim, it is unfair trade practice rendered by the OP Company.  In this regard the complainant has issued legal notice to the OPs on 08.09.2016.  OPs are denying and refused to settle the claim.  After the death of the insurer, the OPs have raised the question of date of birth.  When once the policy has been accepted by scrutinizing the documents the policy cannot be cancelled and the reply given by the OPs are not acceptable.  The cause action for the complaint arose on 27.08.2015 when the complainant has issued legal notice to the OPs which is within the jurisdiction of this Forum.  Therefore, the complainant respectfully prayed before this Forum to allow his complaint with cost. 

3.      On service of notice, OP No.1 and 2 remained absent and they placed ex-parte.  OP No.3 appeared through Sri. B.S. Shivamurthy, Advocate and filed version denying the allegations made in para-2 to 10 of the complaint.  It is further stated that, the policy was issued to the deceased policy holder on the basis of his application dated 22.07.2014 for purchase of the policy namely HDFC Life 2 protect policy for a sum assured of Rs.14,50,000/- towards death benefits.  The proposal was accepted based on the information provided in the proposal form and policy was issued on 02.08.2014.  It is further submitted that, on intimation of death while processing the claim came to know that the life assured has declared his date of birth as 4^th June 1964 and produced transfer certificate as proof of the same.  On the basis of this document the age of the life assured is 49 years at the time of his death.  However, through investigation it is established that, the correct age of the life assured is 71 years at the time of his death.  The date of birth declare by the life assured in the application was false.  As per the Adhar and voter ID cards, the year of birth mentioned as 1944.  So, the age of the life assured is 71 years.  It is further submitted that, as per the proposal form the date of birth of life assured was 01.07.1964 and date of birth of nominee/complainant is 27.08.1976, where the difference of age between father and son is only 12 years.  

It is further submitted that, the deceased policy holder has failed to declare correct age and he acted against doctrine of good faith by suppressing material facts.  The life assured has violated the terms and condition of the policy.  Due to the violation of the terms and condition of the policy, the OPs have repudiated the claim of the complainant.  Non-disclosure of material facts is violation of terms and condition of the policy.  Due to the violation of the terms and condition of the policy, the OP has repudiated the claim of the complainant and therefore, there is no deficiency of service on the part of OP and prayed for dismissal of the complaint.               

4.      Complainant has examined as PW-1 by filing affidavit evidence and the documents Ex.A-1 to A-5 were got marked. On behalf of OPs, one Sri. Kumar. B.G, Asst. Manager, Legal has examined as DW-1 by filing the affidavit evidence and Ex.B-1 to B-3 documents have been got marked.  

5.      Arguments heard.

6.      Now the points that arise for our consideration for decision of above complaints are that;

 

(1)  Whether the complainant proves that the OPs have committed deficiency of service for settling the claim made by him and entitled for the reliefs as prayed for in the above complaint?

              (2) What order?

          7.      Our findings on the above points are as follows:-

          Point No.1:- Partly in Affirmative.

          Point No.2:- As per final order.

REASONS

8.      It is not in dispute that, the father of complainant deceased Rudrappa @ Rudrachari S/o Hanumanthappa has taken HDFC Life Click 2 Protect policy bearing No.16195057 from OP No.1 for his life risk during his life time by paying premium amount of Rs.9,932/- on 31.07.2014.  Due to some problems, the complainant was not able to remit the second premium amount within the stipulated period.  As per the instructions of the OP No.1, the father of the complainant submitted all the relevant documents for revival of the policy as per their requirements and after scrutinize and satisfaction, the OP No.1 has renewed the policy bearing No.16195057 by acknowledging the cheque bearing No.631636 dated 30.07.2014 for second premium amount vide receipt No.ADU d21295 on 31.07.2014 and the policy was in force at the time of his death. The father of the complainant died on 03.09.2014 due to massive heart attack.  As per the instructions of the OPs Company, the complainant has submitted all the documents for speedy disposal of death claim.  On 26.11.2014 the complainant has written a letter to the OPs Company for proceedings of correspondence but, they have not settled the claim of the complainant which is a deficiency of service.  Complainant has approached and demanded the OPs so-many times through phone and by writing letters but, the OPs have not settled the claim, which is an unfair trade practice rendered by the OP Company.  After the death of the insurer, the OPs have raised the question of date of birth.  When once the policy has been accepted by scrutinizing the documents the policy cannot be cancelled and the reply given by the OPs are not acceptable.  The OPs have neglected to settle the claim of the complainant, it is purely a deficiency of service and unfair trade practice on the part of the OPs. 

9.      In support of his contention, the complainant has filed his affidavit evidence and reiterated the contents of complaint and relied on the documents like Death certificate of deceased Rudrachari @ Rudrappa marked as Ex.A-1, Office copy of the legal notice dated 08.09.2016 marked as Ex.A-2, reply notice dated 21.09.2016 marked as Ex.A-3, postal receipts and served acknowledgement marked as Ex.A-4 and Ex.A-5.

10.    On the other hand, it is argued by the OP No.3 that, the policy was issued to the deceased on the basis of his application dated 22.07.2014 namely HDFC Life 2 protect policy for a sum assured of Rs.14,50,000/- towards death benefits.  The proposal was accepted based on the information provided in the proposal form and policy was issued on 02.08.2014.  On intimation of death while processing the claim, came to know that the life assured has declared his date of birth as 4^th June 1964 and produced transfer certificate as proof of the same.  On the basis of this document the age of the life assured is 49 years at the time of his death.  However, on thorough investigation it is established that, the correct age of the life assured is 71 years at the time of his death.  The date of birth declared by the life assured in the application was false.  As per the Adhar and voter ID cards, the year of birth mentioned as 1944.  So, the age of the life assured is 71 years.  As per the proposal form the date of birth of life assured was 01.07.1964 and date of birth of nominee/complainant is 27.08.1976.  The difference of age between father and son is only 12 years. 

It is further argued that, the deceased policy holder has failed to declare correct age and he acted against doctrine of good faith by suppressing material facts.  The life assured has violated the terms and conditions of the policy, for which the OPs have repudiated the claim of the complainant.  Non-disclosure of material facts is violation of terms and condition of the policy and therefore, there is no deficiency of service on the part of OP.               

11.    In support of its contention, the OP No.1 has filed affidavit evidence of one Sri. Kumar. B.G, Asst. Manager, Legal has examined as DW-1 by filing affidavit evidence and reiterated the contents of version and relied on the documents like copy of electronic proposal form marked as Ex.B-1, letter dated 28.10.2015 written by the Director of Sarvasiddantha Service Pvt. Ltd., marked as Ex.B-2, Death Certificate of Sri. Rudrachari @ Rudrappa marked as Ex.B-3.

12.   On hearing the rival contentions of both the parties and on perusal of the documents including the affidavit and documentary evidence, it clearly made out that, the OP himself has admitted the deceased Rudrachari @ Rudrappa S/o Hanumanthappa has taken a HDFC Life Click Protect policy bearing No.16195057.  According to him, the life assured amount of Rs.14,50,000/- but, the OP has taken only a contention that, the father of the complainant has suppressed the age as per the ID and Adhar Card.  Those documents are not the relevant documents to say the age of the person.  The complainant has produced death certificate of his father, the same has marked as Ex.A-1.  It is clearly shows the said Rudrachari was died on 03.09.2014.  The OP has failed to disprove the case of the complainant.  The complainant has claimed a sum of Rs.9,50,000/-.  But, the OP himself admits the policy was covered a sum of Rs.14,50,000/-.  The claim of the complainant is very less.  So, as per the claim of the complainant we allow the case in part and sanctioned a sum of Rs.9,50,000/- to the complainant.  The OP never produced any admissible documents to disprove the case of the complainant.  Hence, the OP has committed a deficiency of service and unfair trade practice.  Accordingly, this Point No.1 is held as partly affirmative to the complainant.          

            13.     Point No.2:- As discussed on the above point and for the reasons stated therein we pass the following:-

ORDER

The complaint filed by the complainant U/s 12 of CP Act 1986 is partly allowed.

It is ordered that, the OPs are hereby directed to pay a sum of Rs.9,50,000/- to the complainant along with interest at the rate of 9% p.a from the date of policy till realization. 

It is further ordered that, the OPs are hereby directed to pay Rs.10,000/- towards mental agony and Rs.5,000/- towards costs of this proceeding.  

It is further ordered that, the OPs are hereby directed to comply the above order within 45 days from the date of this order.

 (This order is made with the consent of Member after the correction of the draft on 03/05/2017 and it is pronounced in the open Court after our signatures)         

 

                                     

 MEMBER                                                   PRESIDENT

-:ANNEXURES:-

Witnesses examined on behalf of Complainant:

PW-1:  Complainant by way of affidavit evidence.

Witnesses examined on behalf of OP:

DW-1:  Sri. Kumar. B.G, Assistant Manager, Legal  of OP by way of affidavit evidence. 

Documents marked on behalf of Complainant:

01	Ex-A-1:-	Death certificate of deceased Rudrachari @ Rudrappa
02	Ex-A-2:-	Office copy of the legal notice dated 08.09.2016
03	Ex-A-3:-	Reply notice dated 21.09.2016
04	Ex-A-4:-	Postal receipts
05	Ex-A-5:-	Served acknowledgement

 

Documents marked on behalf of OPs:

01	Ex-B-1:-	Electronic proposal form
02	Ex-B-2:-	Letter dated 28.10.2015 written by the Director of Sarvasiddantha Service Pvt. Ltd.,
03	Ex-B-3:-	Death Certificate of Sri. Rudrachari @ Rudrappa

 

 

 

MEMBER                                                            PRESIDENT

Rhr**