BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM RAICHUR.
COMPLAINT NO. (DCFR) CC. 19/2012.
THIS THE 31st DAY OF MAY 2012.
P R E S E N T
1. Sri. Pampapathi B.sc.B.Lib. LLB PRESIDENT.
2. Sri. Gururaj, B.com.LLB. (Spl) MEMBER.
3. Smt. Pratibha Rani Hiremath,M.A. (Sanskrit) MEMBER.
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COMPLAINANT :- Smt. Padmavathi W/o. Late Amaresh Patil, Major,
Occ: Agriculture & Household, R/o.
Neermanvi village, Tq. Manvi, Dist: Raichur.
//VERSUS//
OPPOSITE PARTY :- The Divisional Manager, LIC of India,
Divisional Office, Station Road, Raichur.
CLAIM : For direct the opposites LIC of India to pay
an amount of Rs. 50,000/- towards LIC Policy bearing No. 664439381 and Rs. 2,50,000/- towards policy bearing No. 665020500 with interest and damages with cost.
Date of institution :- 03-03-12.
Notice served :- 21-03-12.
Date of disposal :- 31-05-12.
Complainant represented by Sri. Mallangouda, Advocate.
Opposite Nos. 1 & 2 represented by Sri. Basavaraj Sakri, Advocate.
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This case coming for final disposal before us, the Forum on considering the entire material and evidence placed on record by the parties passed the following.
JUDGEMENT
By Sri. Pampapathi President:-
This is a complaint filed by complainant Smt. Padamavathi W/o. Amaresh Patil against the Divisional Manager, LIC of India, Raichur U/sec. 12 of Consumer Protection Act for to direct the opposites LIC of India to pay an amount of Rs. 50,000/- towards LIC Policy bearing No. 664439381 and Rs. 2,50,000/- towards policy bearing No. 665020500 with interest and damages with cost.
2. The brief facts of the complainant’s case are that, one late Amaresh Patil subscribed two Insurance Policies bearing No. 664439381 for assured sum of Rs. 50,000/- for a period of ten years and another policy bearing No. 665020500 for assured sum of Rs. 2,50,000/- for a period of fifteen years. Premiums of two policies regularly paid, the said Amaresh Patil was working in BSF at Srinagar (Jammu & Kashmir). Unfortunately, he died on 18-02-2011 leaving behind complainant as his wife, who is also a nominee under the two policies, thereafter this complainant filed claim petition with all necessary records, but opposite LIC repudiated the claim of complainant on untenable grounds. It shown its negligence in settling her claim towards the said two policies, hence, she filed this complaint for the reliefs as noted in it among other grounds.
3. The opposite LIC appeared in this case through its Advocate, filed written version by contending that, Amaresh Patil had suffered Bipolar Affective Dis-order since 2007 which is prior to issuance of policy, he intentionally not disclosed such disease in his proposal form. Hence claim of complainant was repudiated on the ground of suppression of material facts, accordingly, it prayed for to dismiss the complaint among other grounds.
4. In-view of the pleadings of the parties. Now the points that arise for our consideration and determination are that:
1. Whether the complainant proves that, her husband late Amaresh Patil subscribed two LIC policies bearing No. 664439381 for assured sum of Rs. 50,000/- and another LIC policy bearing No. 665020500 for assured sum of Rs. 2,50,000/- from opposite LIC. Her husband died on 18-02-2011 and thereafter she filed claim petition before LIC of India Raichur, but opposite shown its negligence in settling her claim and thereby opposite found guilty under deficiency in its service.?
2. Whether complainant is entitled for the reliefs as prayed in her complaint.?
3. What order?
5. Our findings on the above points are as under:-
(1) In the affirmative
(2) As discussed in the body of this judgement and as noted in the final order.
(3) In-view of the findings on Point Nos. 1 & 2, we proceed
to pass the final order for the following :
REASONS
POINT NO.1 :-
6. To prove the facts involved in these two points, affidavit-evidence of the complainant was filed, she was noted as PW-1. The documents Ex.P-1 to Ex.P-12 are marked. On the other hand affidavit-evidence of Officer of the opposite LIC was filed, who is noted as RW-1. The documents Ex.R-1 to Ex.R-4 are marked.
7. In the instant case, it is undisputed fact that, the present complainant Padmavathi is the wife of late Amaresh Patil and a nominee under the said two LIC policies.
It is undisputed fact that, the premiums of the said two policies was regularly paid.
Further it is undisputed fact that, late Amaresh Patil died on 18-02-2011 while he was in service.
As per the contention of opposite LIC of India the claim of the said two policies were repudiated by it, on the ground of suppression of material facts regarding the health of late Amaresh Patil, she was suffering from Bipolar Affective Dis-order since 2007. This fact was not disclosed by him, in the month of April 2008 and in the month of Janury-2009 while he was filing proposal form, therefore it rightly repudiated the claim of complainant and there was no deficiency in service on its part.
8. Now, it is a settled principles of law is that, when opposite LIC took contention of suppression of material fact regarding health condition by late Amaresh Patil while giving proposal form, then the burden of proving it is on the LIC of India. Initial burden is on the complainant however the burden of proving such suppression of material facts regarding his health condition is on the shoulder of LIC OF India.
9. If, LIC of India succeeds in establishing the fact of suppression of material facts, by late Amaresh Pail in his proposal forms then complainant has no case against LIC of India. If opposite not established the said fact then, complainant has got a case against LIC of India.
10. To prove the suppression of material facts regarding the health of Amaresh Patil while submitting his proposal form, it is submitted that, he was suffering from Bipolar Affective Dis-order since 2007. In support of this contention the LIC of India relied on document Ex.R-1 to Ex.R-3 among them material document is Ex.R-3 which is a letter issued by CMO 173 BN BSF Aizawl. This letter is dt. 30-08-2011 but Amaresh Patil died on 18-02-2011 that means to say that, this letter obtained by LIC of India round about (6) months after the death of Amaresh Patil. But the endorsement made by the Department of Psychiatric, Civil Hospital with the date on the said letter, we can easily understood that, the Department of Psychiatric, Civil Hospital concocted the date of receipt of the said letter by it as on 20-07-2011, that means, it received Ex.R-3 prior to the date of the letter Ex.R-3. It is highly impossible case, as such we have not relied on Ex.R-3.
11. Now, the question remains for our consideration is with regard to facts noted in document Ex.R-1 Medical Attendance Certificate and Ex.R-2 the certificate of hospital of treatment, Ex.R-2 discloses that, he was suffering from Bipolar Affective Dis-order disease, Ex.R-1 discloses that, the death of Amaresh Patil was due to Cardio Pulmonary Arrest, exact cause of death was suspected to be heart attack. Apart from it, it is noted as it is a known case of Bipolar Affective Dis-order since 2007.
12. If, we compare the reasons for his death as noted in Ex.R-1 and as noted Ex.R-2, we are of the view that, Bipolar Affective Dis-order not causes death of any person or there cannot be any threat to his life. Apart from it. We have not believed Ex.R-3. If really Amaresh Patil was suffering from Bipolar Affective Dis-order, then how he was serving in BSF in (Jammu & Kashmir), how the authority has retained him in service till his death. No person will work in BSF, if really he was suffering from Bipolar Affective Dis-order disease. As such, we are of the clear view that, the reasons stated for repudiating the claim of the complainant under the said two LIC policies are not proper, sufficient and good grounds. Hence, it committed deficiency in its service, accordingly we came to a conclusion that, complainant has discharged her burden of proving part of her case by filing affidavit-evidence and other documents with the support of the principles of the following rulings:
(1) KCCR 2007 (1) Page 478.
(2) KCCR 2004 (4) 471.
(3) 2003 111- CPJ- 30 NC
(4) 2003- CPR-1 38 NC
(5) 2001 (2) SCC Page 160
(6) 1998 (1) CPR Page 37
(7) API Text book of Medicine Vol. 9th edition.
Opposite not discharged its burden in proving its contention, as such we answered Point No-1 in affirmative.
13. Admittedly the first LIC policy bearing No. 664439381 is for assured sum of Rs. 50,000/-, the second LIC policy bearing No. 665020500 is for assured sum of Rs. 2,50,000/-, as such, the complainant is entitled for assured sum of Rs. 50,000/- under the first policy and Rs. 2,50,000/- under the second policy. Considering the nature of the deficiency in service committed by LIC of India, we have awarded a lumpsum amount of Rs. 3,000/- under the said head and also we have awarded an amount of Rs. 2,000/- towards cost of this litigation. Hence the complainant totally entitled to recover Rs. 3,05,000/- from the opposite. Further complainant is entitled to recover future interest at the rate of 9% p.a. on Rs. 3,05,000/- from the date of this complaint till realization of the full amount, accordingly we answered Point No-2.
POINT NO.3:-
14. In view of our findings on Point Nos-1 & 2, we proceed to pass the following order:
ORDER
The complaint filed by the complainant is partly allowed with cost.
The complainant is entitled to recover a total amount of Rs. 3,05,000/- from opposite towards said two policies.
The complainant is also entitled to recover future interest at the rate of 9% p.a. on the above total sum of Rs. 3,05,000/- from the date of the complaint till realization of the full amount.
One month time is granted to opposite LIC of India to make the above said sum to the complainant from the date of this judgment.
Intimate the parties accordingly.
(Dictated to the Stenographer, typed, corrected and then pronounced in the open Forum on 31-05-12)
Smt.Pratibha Rani Hiremath, Sri. Gururaj Sri. Pampapathi,
Member. Member. President,
District Consumer Forum Raichur. District Consumer Forum Raichur. District Consumer Forum Raichur.
