This C.C coming on before us for final hearing, on 5-12-2008 in the presence of Sri.Y.Srinivasa Rao, Advocate for Complainant, and in the presence of Sri. K.Prabhakar Rao, Advocate for the opposite party No-1 to 3 ; upon perusing the material papers on record; upon hearing arguments, and having stood over for consideration, this Forum passed the following:-
ORDER
(Per Sri.K.V.Kaladhar, Member )
1. This complaint is filed under section 12-A of the Consumer Protection Act, 1986.
2. The brief facts of the complaint are that the complainant No-1 is the wife , complainant No-2 is the mother of the deceased G.Narasimha Rao, who is working as U.D.C., O/o. C.E.K.T.P.S.Palvoncha, during his life time he was joined a policy offered by the opposite parties vide policy bearing No.AP/225274 and monthly premium Rs.983/-by deducting the salary from the deceased. The Accounts Officer, O & M., K.T.P.S.Palvoncha had deducted salary of the deceased Narsimha Rao, till his death for the payment of above said policy. The said Narasimha Rao died on 3-1-2007. The opposite parties issued a bond in favour of Late Narasimha Rao on 29-3-2007 for Rs.1,50,000/- towards the above said policy.
3. After the death of the Late Narasimha Rao the complainant No-1 approached opposite party No-1 and informed the death of her husband and requesting to pay the insured amount to them, as per the terms of policy issued by the opposite parties. After receiving claim form and other relevant documents the opposite parties have not at all granted the insured amount and repudiated the claim on the ground that the said Narasimha Rao was applied for the medical leave in the year, 2003 and this fact was not intimated to the opposite parties. At the time of joining the policy, said Narasimha Rao, was hale and healthy and submitted a certificate from the doctor and after seeing the said certificate and satisfying themselves by the opposite parties and issued policy in favour of the deceased Narasimha Rao, and now the opposite parties are with an intention to avoid the payment and shown that the deceased has violated the Rule 7 of POIF rules and suppression of facts. Hence this complaint to direct the opposite parties to pay policy amount of Rs.1,50,000/- with interest accrued thereon, and pay the damages of Rs.2,00,000/- to grant any other relief or reliefs.
4. The complainant No-1 filed her affidavit along with the following documents:
Ex A1: Repudiation letter issued by opposite parties, dated29-6-2007. Ex A2: xerox copy of PLI Premium recovery particulars of G.Narasimha Rao, dated 16-3-2007.Ex A3: xerox copy of leave particulars of G.Narasimha Rao, issued by Account Officer-II, O & M/KTPS/Paloncha, dated 3-5-2007. ExA4: A letter issued by inspector post, Bhadrachalam, to the Accounts Officer-II, O & M/KTPS/Palvoncha, dated 13-6-07.Ex A5: A letter issued by opposite party No-2, Account Offier, KTPS/Palvoncha, dated 9-3-2007.Ex A6: Medical certificate for leave of G.Narasimha Rao, dated 6-8-2003. Ex A7: A letter issued to G.Narasimha Rao by opposite parties dated 29-3-05 along with postal receipts. Ex A8: Death Certificate of G.Narasimha Rao, dated 26-3-07. Ex A9:Legal Heir Certificate of complainant issued by MRO, Paloncha, dated 13-2-07.
5. Opposite parties filed the following counter:
It is true that G.Narasimha Rao had obtained the Life Insurance Policy from the opposite parties is fact. But the opposite parties subsequently enquired into the health condition of the deceased and found that he died on 3-1-2007 due to Diabetes Mellitus with Hepatitis. It is further established in domestic enquiry that the deceased had been suffering with the said disease much prior to obtaining the life Insurance policy from the opposite parties i.e., prior to 29-3-2005. As such the opposite parties informed to the Legal heirs and nominee about the suppression of the facts by the deceased about his health condition and fraudulent act of deceased in obtaining the policy, therefore the opposite parties have got no liability to pay the damages to the complainants. It is established in enquiry that the deceased had availed 26 days commuted leave on medical grounds for the period from 6-8-2003 to 31-8-2003 producing the medical certificate issued by Civil Surgeon, K.T.P.S.Hospital, Paloncha. The said Medical certificate revealed that deceased was suffering from Diabetes Mellitus with Hepatitis at that time. The deceased willfully concealed his health condition and furnished the incorrect information in column No.16 of P.L.I. proposed form and obtained policy. This act of suppression of facts the contract is null and void as per Rule-7 of POIF Rules.
Hence, it is prayed that the Hon’ble Forum may be pleased to dismiss the claim of complainants.
6. The opposite parties filed the following documents:
ExB1: A letter issued by opposite parties to complainant, dated 29-6-07. Ex B2: A Letter issued by opposite parties to Account Officer, KTPS,Palvoncha, dated 9-3-07. Ex B3:PLI Premium recovery particulars of G.Narasimha Rao, dated 9-3-07.Ex B4:A letter issued by Inspector of post to the Account Officer, O &M KTPS/Palvoncha, dated 13-6-07. Ex B5: A letter issued by Account Officer, O &M , KTPS, Palvoncha to Inspector to post, Bhadrachalam, dated 3-5-07. Ex B6: Medical Leave certificate of G.Narasimha Rao Ex B7: Policy particulars of G.Narasimha Rao Ex B8: Death certificate of G.Narasimha Rao, dated 26-3-07.Ex B9:Legal heir certificate issued by MRO, Palvoncha, dated 13-2-07.
7. Both parties filed written arguments and also advanced oral arguments.
8. The complainant No-1 filed chief affidavit.
9. The point for consideration is whether the complainants are entitled to the claim as prayed for?
10. The contention of the complainants is that the husband of the complainant No-1 joined the policy vide policy bearing No.AP/225274 for a monthly premium Rs.983/- and policy amount was Rs.1,50,000/- on 29-3-05. Since then the Account Officer, O & M KTPS/Paloncha deducted the policy amount from the salary of the deceased Narasimha Rao till his death i.e., on 3-1-2007. After the death of the late Narasimha Rao the complainants have approached opposite party No-1 and informed the death of said Narasimha Rao and requesting to pay the insured amount to them but repudiated the claim on the ground that the said Narasimha Rao suppressed his health condition and obtained this policy. At the time of joining the policy the said Narasimha Rao was hale and healthy and submitted a certificate from the Doctor and after seeing the said certificate and satisfying themselves they issued the policy infavour of deceased Narasimha Rao and now the opposite parties are with an intention to avoid the payment and showed the above said reason. Hence this complaint.
11. For this the opposite parties contention is that the complainant died on 3-1-07 due to Diabetes Mellitus with Hypatities and their domestic enquiry revealed that the deceased had been suffering from the said disease much prior to obtaining the policy. In their enquiry it is revealed the deceased had obtained 26 days commuted leave on medical ground for the period from 6-8-03 to 31-8-03. The medical certificate revealed that deceased was suffering from Diabetes Mellitus Hypatities at that time. The deceased willfully concealed his health condition and furnished the incorrect information at column No.16 of PLI Proposed form. Hence the contract is null and void. Hence they need not pay anything to the complainant.
12. The only contention raised by the opposite parties is that the deceased Narasimha Rao had availed 26 days commuted leave on medical ground for the period from 6-8-03 to 31-8-03 as from the medical certificate issued by Civil Surgeon, KTPS, Hospital, Palvoncha. The said medical certificate revealed that deceased was suffering from diabetes Mellitus with Hypothesis at that time. Even if it is true that the deceased has suffered Diabetes and Jandis in the year 2003 but the deceased joined in the policy on 29-3-05. If the deceased has got ill intention why he did not join the above said policy in the year 2003 itself. It is also the contention of the complainants that at the time of joining policy the said Narasimha Rao was hale and healthy and submitted a certifictge from the Doctor and after seeing the said certificate satisfying themselves. The opposite parties issued policy infavour of the deceased Narasimha Rao.
13. Hence, we are of the opinion that even if the deceased suffered with Diabetes ,the Diabetes itself is not at all a disease and the deceased did not obtain the above said policy immediately after the sufferance of the above said disease. Hence the deceased has no ill intention in obtaining the above said policy. The opposite parties did not file any medical record to show that the deceased had suffered with Diabetes and Jandis at the time of death except medical leave certificate which was issued on 6-8-2003. Hence the opposite parties are liable to pay the above said policy.
14. Hence, we direct the opposite parties to pay an amount of Rs.1,50,000/- with 9% interest P.A. from the date of complaint i.e., 15-10-07 till the date of realization. However, we are not awarding any damages to the complainants. Accordingly this C.C. is allowed. The complainant No-1 is entitled Rs.1,00,000/- with interest and complainant No-2 is entitled Rs.50,000/- with accrued interest thereon. Accordingly this C.C. is allowed with no costs.
Dictated to the Stenographer, Corrected and pronounced by us, in this Forum on this 16th day of December, 2008.
President Member Member
District Consumers Forum, Khammam
APPENDIX OF EVIDENCE
WITNESS EXAMINED FOR
Complainant Opposite parties
Nil Nil
DOCUMENTS MARKED FOR
Complainant
Ex A1: Repudiation letter issued by opposite parties, dated29-6-2007.
Ex A2: xerox copy of PLI Premium recovery particulars of G.Narasimha Rao, dated 16-3-2007.
Ex A3: xerox copy of leave particulars of G.Narasimha Rao, issued by Account Officer-II, O & M/KTPS/Paloncha, dated 3-5-2007.
ExA4: A letter issued by inspector post, Bhadrachalam, to the Accounts Officer-II, O & M/KTPS/Palvoncha, dated 13-6-07
.Ex A5: A letter issued by opposite party No-2, Account Offier, KTPS/Palvoncha, dated 9-3-2007.
Ex A6: Medical certificate for leave of G.Narasimha Rao, dated 6-8-2003.
Ex A7: A letter issued to G.Narasimha Rao by opposite parties dated 29-3-05 along with postal receipts.
Ex A8: Death Certificate of G.Narasimha Rao, dated 26-3-07.
Ex A9:Legal Heir Certificate of complainant issued by MRO, Paloncha, dated 13-2-07.
Opposite parties
ExB1: A letter issued by opposite parties to complainant, dated 29-6-07.
Ex B2: A Letter issued by opposite parties to Account Officer, KTPS,Palvoncha, dated 9-3-07.
Ex B3:PLI Premium recovery particulars of G.Narasimha Rao, dated 9-3-07.
Ex B4:A letter issued by Inspector of post to the Account Officer, O &M KTPS/Palvoncha, dated 13-6-07.
Ex B5: A letter issued by Account Officer, Bhadrachalam, dated 3-5-07.
Ex B6: Medical Leave certificate of G.Narasimha Rao
Ex B7: Policy particulars of G.Narasimha Rao
Ex B8: Death certificate of G.Narasimha Rao, dated 26-3-07.
Ex B9:Legal heir certificate issued by MRO, Palvoncha, dated 13-2-07.
President Member Member
District Consumers Forum, Khammam
