BEFORE THE DISTRICT FORUM: KURNOOL
Present: Sri K.V.H.Prasad, B.A., LL.B., President
Smt C.Preethi, M.A., LL.B., Member
Sri R.Ramachandra Reddy, B.Com., LL.B., Member
Thursday the 8th day of December, 2005
CD 53/2005
Smt. B. Vengamma,
W/o. Late B. Krishna Reddy,
R/o. Tangutur (P),
Banaganapalli (M),
Kurnool Dist. . . . Complainant
-Vs-
1. The Divisional Manager,
LIC of India,
Cuddapah.
2. The Branch Manager,
LIC of India, Kurnool Branch,
Kurnool. . . . Opposite parties
This complaint coming on 7.12.2005 for arguments in the presence of Sri A. Rama Subba Reddy, Advocate, Kurnool for complainant and Sri S. Viswanatha Reddy, Advocate, Kurnool for opposite party and stood over for consideration, till this day, the Forum made the following.
O R D E R
(As per Smt. C.Preethi, Hon’ble Member)
1. The CD complaint of the complainant is filed under section 12 CP Act 1986 seeking a direction on the opposite parties to pay insured amount of Rs.5,00,000/- with 24% interest from the date of death, Rs.10,000/- as compensation, cost of the complainant and any such other relief or relief’s which the complainant is entitled in the circumstances of the case.
2. The brief facts of the complainant’s case is that the complainant’s husband late B. Krishna Reddy insured his life with opposite parties under five policies bearing No.s 651599425, 651604318, 651609029, 652357378, and 652679792. On 25-2-2002 the complainant’s husband was admitted in R.R.Super Speciality Hospital with complaint of Jaundice and died on 26-2-2002. The complainant as nominee intimated death of the policy holder and submitted claim form on
5-8-2002 and complied all formalities. The opposite parities settled the first four policies and repudiated the fifth policy through their communication dated 8-7-2003 on the ground that the policy holder was suffering from Gross Anemia and chronic jaundice and consulted a medical man and has taken treatment from a hospital prior to date of proposal of last policy. And the policy holder did not disclose the true facts in the proposal form.
3. But the complainant submits that the policy holder did not suffer from any ailments such as Jaundice, Anemia or any other disease and all the statements in the proposal form are correct. There is deficiency of service on part of opposite parties in repudiating the said claim.
4. In support of her case the complainant relied on the following documents Viz. (1) Repudiation letter dated 8-7-2003 addressed by opposite party No.1 to the complainant, besides to the sworn affidavit of the complainant in reiteration of her complainant averments and the above document is marked as exhibit A1 for its appreciation in this case. The complainant also relied on the third party affidavit of Dr. A.Nagaraju and caused interrogatories to the opposite party No.1 and the complainant and the third party suitabely replied to the interrogatories caused by opposite party No.1.
5. In pursuance to the notice of this Forum as to this case of the complainant the opposite parties appeared through their standing counsel and contested the case by filing written version. The opposite party No.1 filed his written version and opposite party No.2 adopted the written version of opposite party No.1.
5. The written version of opposite parties admits that the complainant’s husband B. Krishna Reddy has taken a policy bearing No.652679792 on his life for assured sum of Rs.5,00,000/- and nominated the complainant as his nominee. The complainant informed that the policy holder died on 26-2-2002 and preferred claim. As a claim aroused within one year from the date of the commencement of policy investigation was conducted, which revealed that the diseased was suffering from jaundice, pain in abdomen and Diahrea since 25-2-2001 i.e. prior to date of commencement of said policy and the said Jaundice was not cured as the diseased was very irregular in taking medicine and treatment as per the statement of Dr. A.Nagaraju who treated the policy holder. It further submits that the diseased gave negative answers to the question No.11 (i) in the personal history statement. As per condition No.5 of the policy if the policy holder gave any untrue statement in the proposal form or in the personal statement or any material information, then all the moneys that have been paid in consequences there of shall belong to the corporation. As the policy holder executed untrue statement in his proposal form the contract was declared null and avoid through their speaking order dated 8-7-2003. Hence, the repudiation by Opposite Parties was made on justifiable grounds and after due application of mind and seeks for the dismissal of complaint with costs.
6. In substantiation of its case the opposite parties relied on the following documents Viz. (1) Letter dated 20-10-2002 by Dr. A.Nagaraju to Opposite Party No.2 (Attested by notary) (2) Proposal form of the diseased B.Krishna Reddy (3) Policy bond bearing No.652679792 and (4) Questionnaire completed by medical practitioner Dr. A.Nagaraju (Attested by notary), besides to the sworn affidavit of the opposite party No.1 in reiteration of its written version. The above documents are marked as Ex. B1 to B4 for its appreciation in this case and caused interrogatories to the complainant and third party and suitabely replied to the interrogatories caused by complainant. The opposite party relied on the deposition of RW1 G.Md.Habeebur Rahiman.
7. Hence, the point for consideration is to what relief the complainant is entitled alleging deficiency of service on part of opposite parties:?
8. It is not in dispute that the deceased by name B. Krishna Reddy has taken five policies by submitting claim forms and on the death of the policy holder on 26.2.2002, the complainant/ nominee put forth the claims for assured amounts for the said five policies, the opposite parties settled the claims for the first four policies and repudiated the last policy vide Ex A.1. The said Ex A.1 dt 8.7.2003 envisages, the repudiation of claim of the policy bearing NO. 652679792 of the deceased B. Krishna Reddy on the reason that the said policy holder suffered from Gross Anemia and Chronic Jaundice and consulted a medical man and taken treatment and the policy holder suppressed the above facts relating to his health in the proposal form.
9. The Ex B.1 is the letter dt 20.10.2002 of Dr A.Nagaraju addressed to Branch Manager, LIC of India, Kurnool, the said Doctor’s submits that the insured Bana Krishna Reddy had taken treatment for Jaundice and diaharea on 20th May 2001 and concluded that the insured was very irregular in taking medicines since 20th May, 2001 and collapsed on 26.2.2002 in R.R. Super Speciality Hospital, Kurnool. But the said Dr A. Naga Raju in his sworn affidavit averments discredits the contents of Ex B.1 stating that he did not treat Bana Krishna Reddy on 20-5-2001 and he has seen the said Bana Krishna Reddy during the period of admission for five days in RR Hospital in February, 2002, and no treatment was given by him for any other disease prior to February, 2002. He further states that the opposite party No.2 approached him with Xerox copies of out-patient chits of one Krishna Reddy, who has taken treatment in the month of May 2001 and June 2001 for Jaundice believing the words of opposite party No.2 that Krishna Reddy is none other than Bana Krishna Reddy the said certificate in Ex B.1 was issued. But after verification from Tagutur (V) he came to know that G. Krishna Reddy was treated on 20.5.2001 and not B. Krishna Reddy and lastly stated that the opposite parties by misleading him obtained the said certificate and the contents there of in Ex B.1 are incorrect. Further from the perusal of Ex B.1, which has been signed by Notary/ Advocate, the said signature of Notary/ Advocate certifies the said Dr A. Naga Raju has signed before him. The said Notary/ Advocate in his deposition as RW1 stated he has not obtained signatures of the executant in the National Register maintained in Form No. XV, and further there is no reference of the said Ex B.1 transaction in the said Notarial Register maintained by him. Hence, the said signature of Notary/ Advocate obtained in the Ex B.1 is merely a signature and not speaking what he has attested. Hence, the said Ex B.1 bears no binding force for being acted upon by the opposite parties, especially, when the said certificate is denied by the executant himself and no credence can be given to the signature of Notary/ Advocate as the said transaction has no reference in the Notarial Register maintained by him in form No. XV under rule 11 (2) of Notaries Act, which is mandatory as per Notaries Act and no other material is placed by opposite parties to substantiate alleged Jaundice and Gross Anemia of the policy holder. Therefore, when the Ex B.1 is not carrying any force the repudiation of opposite parties being on said Ex B.1 remain not justifiable.
10. The other allegation of the opposite parties is that the deceased B. Krishna Reddy suppressed material information regarding his health condition prior to date of proposal. There is no doubt that the burden heavily lies on the opposite parties to establish that the policy holder suppressed material facts of his health. In the absence of any cogent supporting material in support of its contentions, the contentions of the opposite parties stands without any proof. Therefore, the opposite parties failed to discharge the burden of proving actual suppression of material facts by the policy holder B. Krishna Reddy before taking the said policy.
11. The Ex B.2 is the proposal form submitted by the policy holder to opposite parties, the Ex B.3 is Policy Bond bearing No. 652679792 of the deceased policy holder B. Krishna Reddy and the Ex B.4 is questionnaire completed by Dr A. Naga Raju, the contents of Ex B.4 says that, the policy holder was first seen on 24.2.2002 at RR Hospital and was suffering from Gross Anemia, loss of Appetite, pain in Abdoman, Jaundice, since last 5 years. But the sworn affidavit of said Dr A.Naga Raju which is on oath says that he has not given treatment to the policy holder Bana Krishna Reddy prior to February 2002 and he has seen policy holder Bana Krishna Reddy only for five days in February, 2002 at RR Hospital. Hence, the said Ex B.4 does not inspire any confidence about its contents which can be acted upon.
12. The complainant in support of its contentions relied on the following citation, LIC of India Vs Smt Promila Malhotra, reported in 2003 (2) ALT Pg 11 (NC), wherein, it was held that onus of proving the concealed material facts at the time of taking policies lies on the insurer and when the said contentions are not proved, the insurance is liable to pay assured amount.
13. Hence, in the circumstances discussed above and following the afore mentioned citation of (National Commission), the burden is upon the opposite parties to show that there is suppression of material facts and the opposite parties miserably failed to prove that there was really any suppression and the opposite parties cannot rely on said Ex B.1 to discharge its liability.
14. Having regard to over all consideration there is no hesitation to hold opposite parties have miserably failed to substantiate that the deceased suppressed material facts about his health condition before taking the said policy. Therefore, in the said circumstances the repudiation of claim by opposite parties is wholly arbitrary and unjust and amounts to deficiency of service on their part.
15. In the result, the complaint is allowed directing the opposite parties to pay to the complainant, the assured amount as per the policy of the deceased Bana Krishna Reddy bearing No. 652679792 with interest at the rate of 12% per annum from the date of demise of the deceased till realization along with costs of Rs.5,000/- within a month of the receipt of this order.
Dictation to Stenographer, transcriber by her, corrected and pronounced in the open court this the 8th day of December, 2005.
PRESIDENT
MEMBER MEMBER
APPENDIX OF EVIDENCE
Witnesses Examined
For the complainant: Nil For the opposite parties
R.W.1 Sri G.Md. Habeebur Rahiman
List of Exhibits Marked for the complainant:
Ex A.1 Repudiation letter dt 8.7.2003 written by opposite party No.1 to
the complainant.
List of Exhibits Marked for the opposite parties:-
Ex B.1 Letter, dt 20.10.2002 issued by Dr A. Naga Raju to opposite party
No.2.
Ex B.2 Original proposal for Insurance on Own life.
Ex B.3 Original copy of policy bond bearing No. 652679792.
Ex B.4 Questionaire completed by Dr A. Naga Raju.
PRESIDENT
MEMBER MEMBER
Copy to:-
1. Sri A. Rama Subba Reddy, Advocate, Kurnool..
2. Sri S. Viswanatha Reddy, Advocate, Kurnool..
Copy was made ready on:
Copy was dispatched on:
Copy was delivered to parties on:
