OFFICE OF THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, ANGUL
PRESENT:- SRI DURGA CHARAN MISHRA.
PRESIDENT
A N D
Smt.Sunanda Mallick & Sri K.K.Mohanty,
MEMBERS .
Consumer Complaint No. 64 of 2018
Date of Filling : -23.07.2018.
Date of Order :- 21 .12.2019.
Sukanti Bhoi,W/O.Late Dhulia Bhoi,
Vill.Aradhia,P.O.Nuakheta,P.S.Bantala,
Dist.Angul.Odisha.
_______________________Complainant.
Vrs.
- The Chairman,Reliance Nippon Life Insurance Company Ltd.,
Reliance Centre Off Western Express Highway,
Sntacruz (East),Mumbai- 400055.
- The Branch Manager, Reliance Nippon Life Insurance Company Ltd.,
Angul Branch,At-Sankar Cinema Road,P.O/P.S/Dist.Angul-759122.
________________________Opp. parties.
For the complainant :- Sri Sri S.C.Mishra & associates(Advs.)
For the opp.parties :- Sri D.Singh & associates(Advs.)
: J U D G E M E N T :
Sri K.K.Mohanty,Member.
The complainant has filed this case with prayer to direct the opp.parties to pay the assured sum of Rs. 1,88.624.00 along with suitable interest, cost of litigation and compensation towards mental agony and harassment.
2. The complainant’s case runs thus :-
That, Dhulia Bhoi the husband of the present petitioner had taken an insurance policy bearing No. 52464593 from the opp.parties on 15.12.2015 by paying half yearly premium of Rs. 12,435.00 only. After due verification of the proposal form by the sales manager and the advisor of the company (opp.parties). The proposal was accepted and the contract was completed. The insurance was valid commencing from 15.12.2015 to till 15 years. The present petitioner is the wife, legal hair and nominee of the insured Dhulia Bhoi . During valid insurance period, the insured Dhulia Bhoi died on 01.04.2016 due to snake bite and to that effect the Birth & Death Registrar has issued death certificate No. 329/20.4.2016 of the insured. After death, the present complainant being wife and nominee of the deceased filed death claim before the opp.parties but the opp.parties repudiated the claim stating falls and unnecessary grounds. So she has filed this case.
3. The opp.parties have contested the case by filing joint written version with prayer to dismiss the case of the petitioner with costs. They have pleaded that, as this is an early claim they thoroughly enquired in to the matter and came to know that on the date of filing or acceptance of the proposal the insured was not alive as because he had already died on 11.10.2015.So they repudiated the claim.
4. In view of the viral pleadings of the parties the following issues arise for adjudication:-
: I S S U E S :
- Whether there is any cause of action to file this case and the case is maintainable or not?
- Whether the case is barred by law of limitation or any other law ?
- Whether there is consumer and service provider relationship between the parties ?
- Whether the repudiation of the claim of complaint is justified or she is entitled to get the reliefs claimed ?
- To what reliefs the parties are entitled to ?
: F I N D I N G S :
Issue No.(i),(ii) & (iii):- The husband of the complainant had taken insurance policy No. 52464593 by paying cash of Rs. 12,435.00 for which definitely the complainant being the wife of the late insured is a consumer and the insurance officials are the service providers.
As the opp. parties being the service providers, unduly repudiated the claim, the complainant has cause of action to the case.
Nothing has been shown by the opp. parties to come to a conclusion that this case is not maintainable.
The case has been filed with a petition for condonation of delay. The complainant has filed medical certificate (Annexure-I) showing that she was bed-ridden. Further, the complainant is an widow and a village rustic lady. The opp. parties have not disputed the medical certificate. So the sight delay is condoned.
Issue No.(iv):- The opp.parties have taken the stand that after filing of the claim they enquired into the matter and ascertained from the local Anganwadi workers and co-villagers that prior to availing the insurance policy the insured was dead since 11.10.2015. On the other hand the complainant has filed the death certificate of the insured issued by the Registrar of Birth and Death which reveals that the insured died on 01.04. 2016. This certificate has been issued by the public official with reference to Govt. record. The statement if any recorded by the opp.parties from any body can not be accepted as because they have no authority or capacity to do so. If they could know that a fradulent policy has been taken by the insured , they could have approached the proper court for cancellation of the contract of the insurance by due procedure of law. But instead of doing that, the opp.parties have themselves taken the decision that the insured though dead but wrongly the policy was issued.
In the proposal form, the sales manager has very clearly mentioned hat he had seen and met the life assured, he did not notice any disability and mental or physical deformities with the insured and the life assured was in good health and this fact has been ratified by the advisor of the insurance company. When such statement of the opp.parties is clearly available in the proposal form, they are estoped from going away from their previous statement. Further, the statements recorded by the opp.parties can not be accepted in law. Therefore the plea of the opp.parties that a fraudulent policy was obtained can not be accepted and it can not be said that the policy taken by insured was void one.
The opp. Parties have relied on a decision reported in Vikram Greentech India Ltd and another Vrs. New India Assurance Company Ltd. (2009) 5 SCC,599, the Hon’ble Supreme Court has held that:-
“ an insurance policy is to be construed strictly as per the terms and conditions of the policy document which is a binding contract between the parties and nothing can be added or subtracted by giving a different meaning to the words mentioned therein”.
They have also relied on many other decisions which are of equal spirit with the above cited case. In all the above cases it has been held that, one policy bond is issued it is a valid contract and no body can add or delete any words in it. After long time of issuance of policy the opp. parties are trying to prove it is a void policy which can not be allowed.
Issue No.(v):- In view of the discussions made above in issue numbers 1 to 4, the complainant is entitled to get the death claim of her late husband (Insured late Dhulia Bhoi in policy No. 52464593).Also she is entitled to get litigation charges and compensation towards mental agony and harassment for loosing interest on the claim amount. Since the case has been filed in late this forum feels that awarding a sum of Rs. 45,000.00 towards interest, mental agony and harassment and a sum of Rs. 5,000.00 towards cost of litigation will be just and proper in this case and will meet the ends of justice .
- Hence the order:-
: O R D E R :
The case is disposed of on contest by both the parties .The opp.parties are jointly and severally liable to pay the awarded amount. The opp.parties shall pay the assured the sum of Rs. 1,88,624.00 9Rupees One Lakh Eighty-Eight Thousand Six Hundred Twenty-Forty) only, along with Rs. 5,000.00 (Rupee Five Thousand) towards cost of litigation and Rs. 45,000.00 (rupees Forty-Five Thousand) towards interest , harassment and mental agony to the complainant within 30 days of getting this order. It is made clear that in case of any deviation of this order the opp.parties shall pay 12% quarterly compoundable interest to the complainant on the awarded amount of Rs.2,38,624.00 (Rupees Two Lakh Thirty-Eight Thousand Six Hundred Twenty-Four) {Rs. 1,88,624.00 + Rs.5000.00+ Rs.45,000.00}from the 31st day of getting this order till actual payment is made besides other penalties prescribed in C.P.Act,1986 .
Order delivered in the open forum today the 21th December,2019 with hand and seal of this Forum.
Typed to my dictation
and corrected by me Sd/-
(Sri D. C. Mishra)
Sd/- President.
(Sri K.K.Mohanty )
Member.
Sd/- (Smt.S.Mallick)
Member.
