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
Wednesday the 6th day of April, 2011
C.C.No.105/10
BETWEEN:
Sanisetty Kotamma alias Kota Kotamma, W/o. late Venkateswarlu,
H.No.4-301, M.H.S. Road, Kurnool.
…Complainant
-Vs-
1. The Branch Manager,Life Insurance Corporation of India,
Railway Station Road, Nandyal - 518 501.
2. The Manager, Life Insurance Corporation of India, Divisional
Divisional Office, Kadapa.
.
…Opposite Parties
This complaint is coming on this day for orders in the presence of Sri S.V.Krishna Reddy, Advocate for complainant and Sri I.Anantha Rama Sastry, Advocate for opposite parties 1 and 2 upon perusing the material papers on record, the Forum made the following.
ORDER
(As per Sri. T.Sundara Ramaiah, President)
C.C. No. 105/10
1. This complaint is filed under section 11 and 12 of C. P. Act, 1986 praying:-
(a) To direct the opposite parties to pay the assured amount of Rs.3,00,000/- to the complainant;
(b) To award RS. 20,000/- for mental agony;
- To award interest from the date of submission of document from 26-11-2007 to till the date;
- To award costs to the complainant;
- To grant such other relief or reliefs as the Hon’ble Forum may deem fit and proper in the circumstance of the case.
2. The case of the complainant in brief is as under:- The deceased Kota Pitchaiah insured his Life with opposite party No.1. Opposite party No.1 issued policy bearing No. 654275562 dated 28-07-2006 in favour of the deceased Kota Pitchaiah. The policy is valid up to 28-07-2021. The complainant who is the daughter of insured Kota Pitchaiah is the nominee under the policy. The insured Kota Pitchaiah died on 29-10-2007 due to ill health. The complainant who is the nominee under the policy submitted relevant documents to opposite party No.1 and requested to pay assured amount of Rs.3,00,000/-. Opposite parties failed to pay the assured amount to the complainant inspite of several demands. On 08-03-2010 the complainant got issued legal notice demanding to pay the policy amount. Even after the receipt of the said notice opposite party No.1 did not choose to settle the claim of the complainant. Hence the complaint.
3. Opposite party No.2 filed written version and the same is adopted by opposite party No.1. It is stated in the written version of opposite party No.2 that the complaint is not maintainable. The assured took “JEEVAN ANAND” policy for RS.3,00,000/- from the opposite parties. The complainant is the nominee under the policy. The deceased was 70 years old by 2005. The deceased suppressed the material fact of correct age in the proposal. The contract of insurance is based on good faith. The deceased played fraud and produced fabricated school certificate to take the insurance policy. The deceased in order to have wrongful gain from the opposite parties went to the extent of fabricating the school certificate and committed breach. As per the House Hold Card the assured was 70 years old prior to the proposal. At the age of 70 years no policy will be issued by the insurance company. The deceased committed breach of conditions of the contract of insurance. The opposite parties are not liable to pay any amount to the complainant.
4. On behalf of the complainant Ex.A1 to A10 are marked and sworn affidavit of the complainant is filed. On behalf of the opposite parties Ex.B1 to B4 are marked and sworn affidavit of opposite party No.2 is filed.
5. Both sides filed written arguments.
6. The points that arise for consideration are:
- Whether there is deficiency of service on the part of the Opposite Parties?
- Whether the complainant is entitled to the reliefs as prayed for?
(c) To what relief?
7. POINT No.1 & 2 :- Admittedly the deceased Kota Pitchaiah obtained insurance policy Ex.A1 dated 28-07-2006 from the opposite parties for assured amount of Rs.3,00,000/-. The complainant is the nominee under the policy Ex.A1. The complainant to show that her father died on 14-11-2007 relied on a Ex.A2, death certificate issued by Registrar of Births and Deaths Nandyal Municipality, Nandyal. In Ex.A2 it is clearly mentioned that Kota Pitchaiah died on 29-10-2007. Admittedly after the death of Kota Pitchaiah the complainant who is the nominee under the policy submitted the claim to the opposite parties. The opposite parties failed to settle the claim of the complainant on the ground that the deceased obtained the policy by playing fraud. It is the case of the opposite parties that the deceased was 70 years old by the date of the proposal as per the House Hold Card issued by the M.R.O. and that the deceased suppressed the said fact regarding his age. The burden is the insurer to establish that the insured obtained the policy by playing fraud. It is mentioned in Ex.B1 proposal form that date of birth of insured was 10-04-1949 and that his age was 57 years as on the date of the proposal i.e.20-04-2006. In Ex.B2 policy issued by the opposite parties also it is stated that the date of birth of the deceased is 10-04-1949 and that his age was 57 years by 28-07-2006. It is also mentioned in Ex.B2 that the age of the insured was admitted as 57 years. It is mentioned in Ex.B3 record sheet of late Kota Pitchaiah that his date of birth is 10-04-1949. It is the contention of the opposite parties that the insured fabricated Ex.B3 and that Ex.B3 was not issued by M.P.P. Elementary School, Potlapadu. According to the complainant that his father was 57 years old by the date of the proposal. In support of her contention she filed Ex.A9 House Hold Card where in the age of Kota Pitchaiah (insured) is shown as 60 years by 05-01-2006. The complainant also filed Ex.A10 certificate issued by the Sarpanch of Potlapadu Village where in it is stated that the date of birth of the deceased is 10-04-1949. Though it is mentioned in the written version of the opposite parties that as per the House Hold Card issued by M.R.O. the age of the deceased was 70 years in the year 2005, the opposite parties have not chosen to file the said House Hold Card. On the other hand in the House Hold Card Ex.A9 filed by the complainant it is shown that the Kota Pitchaiah was 60 years old by 2006. There is no documentary evidence on record to show that the assured was 70 years old by the date of the proposal Ex.B1 dated 20-04-2006.
8. According to the opposite parties the insured fabricated Ex.B3 to show that he was 57 years old by the date of the proposal. The opposite parties got examined the Head Mistress of M.P.P. Elementary School on commission. It is stated by the witness that admission No.987 relates to Mallidi Chandra Sekhar and that his date of birth is 09-11-1971. In her cross examination she admitted that admission No.987 is not of the year 1957. It is mentioned in Ex.B3 that Kota Pitchaiah whose date of birth is mentioned as 10-04-1949 joined in the first class on 16-07-1957. The witness did not say that admission No.987 of the year 1957 does not relate to Kota Pitchaiah. Merely basing on the evidence of the witness examined on commission it cannot be concluded that Ex.B3 is fabricated. It is clearly mentioned in Ex.B3 that Kota Pitchaiah was born on 10-04-1949. The opposite parties failed to establish that the deceased was 70 years old by the date of proposal and Ex.B3 is fabricated. As seen from the evidence available on record it is very clear that the deceased was 57 years old by the date of the proposal and that his age was admitted by the opposite parties. At this stage it is not open to the opposite parties to with hold the claim of the complainant on the ground that the insured obtained the policy by playing fraud. The opposite parties have not settled the claim of the complainant with in time. It amounts to deficiency of service. The complainant who is the nominee under the policy is entitled for the assured amount.
9. In the result, the complaint is partly allowed directing the opposite parties jointly and severally to pay assured amount of Rs.3,00,000/- to the complainant, with interest at 9% from the date of the complaint i.e. 07-05-2010 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 day 6th of April, 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 Photo copy of Policy No.654275562, dated 28-07-2006 of Kota Pitchaiah.
Ex.A2. Certificate of Death of Kota Pitchaiah dated 14-01-2007.
Ex.A3 Photo copy of claim form.
Ex.A4 Photo copy of Claim Statement.
Ex.A5 Photo copy of Identity and Burial or Cremation.
Ex.A6 Photo copy of Certificate of Hospital Treatment.
Ex.A7 Office copy of legal notice dated 08-03-2010.
Ex.A8 Postal acknowledgement.
Ex.A9 Photo copy of House Hold Card.
Ex.A10 Certificate issued by Sarpanch, Reddycherla
Grama Panchayat, dated 16-08-2010.
List of exhibits marked for the opposite parties:-
Ex.B1 Proposal form dated 20-04-1006 of Kota Patchaiah.
Ex.B2 Policy No.654275562, dated 28-07-2006 of
Kota Patchaiah.
Ex.B3 Photo copy of record sheet by the Head Master of Potlapadu Village.
Ex.B4 Letter addressed by the Head Master of Potlapadu Village.
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 :
Copy was made ready on :
Copy was dispatched on :
