BEFORE THE DISTRICT FORUM: KURNOOL
Present: Sri K.V.H.Prasad, B.A., LL.B., President
and
Smt C.Preethi, M.A., LL.B., Member
Sri R.Ramachandra Reddy, B.Com., LL.B., Member
Thursday the 15th day of September, 2005
CD No. 86/2005
C.Rama Chandrudu,
S/o. Late Gurappa,
R/o. U.Kothapalli (V),
Dhone(M),
Kurnool Dist. . . . Complainant
Vs
1. The Divisional Manager,
LIC of India,
Kadapa.
2. The Branch Manager,
LIC of India,
Dhone Branch,
Kurnool Dist. . . . Opposite parties
This complaint coming on 14.09.2005 for arguments in the presence of Sri A.Rama Subba Reddy, Advocate for complainant and Sri A.S. Ummer Javid Ali, Advocate for opposite parties No.1 and 2 and stood over for consideration till this day the Form made the following.
O R D E R
(As per Smt C. Preethi, Member)
1. This CD complaint of complainant is filed under section 11&12 of C.P. Act, 1986, seeking a direction on the opposite parties to pay to the complainant policy amount of Rs.75,000/ with 24percent interest per annum, Rs. 10,000/ towards compensation, costs of the complaint and any such other relief or reliefs which the complainant is entitled in the circumstances of the case.
2. The brief facts of the complainant s case is that the complainant is the nominee of deceased policy holder C. Gurappa who insured his life with opposite parties under the policy bearing No. 653300342 for RS.75,000/ and the policy holder died due to chest pain within three months after taking policy. As the nominee under the above said policy, the complainant putforth a claim for policy amount before the opposite parties. But the opposite parties did not pay the policy amount, therefore, the complainant got issued legal notice dt 14.3.2005 demanding the payment of policy amount and the opposite parties replied dt 3.3.2005, falsely stating that complainant had relinquished all his rights and also addressed another letter dated 16.3.2005 to complainant s counsel. But the complainant denies that he had relinquished his rights under the said policy. Hence, non settlement of the claim of the complainant by opposite parties constrained the complainant to seek redressal in this Forum.
3. In substantiation of his case the complainant relied on the following documents Viz (1) office copy of legal notice issued by complainant s counsel to opposite party No.2, dated 14.3.2005 (2) courier receipt dt 14.3.2005 for sending legal notice (Ex A.1) (3) Reply to Ex A.2 given by the opposite party No.2 addressed to complainant s counsel ,dated 16.3.2005 and (4) Letter dt 3.3.2005 issued by Senior, Divisional Manager, Cuddapah to the complainant, besides to the sworn affidavit of complainant in reiteration of his complaint averments and the above documents are marked as Ex A.1 to A.4 for its appreciation in this case, the complainant suitably replied to the interrogatories caused by the opposite parties and caused interrogatories to the opposite parties
4. 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 filling written version of opposite party No.1 and opposite party No.2 adopted the written version of opposite party No.1.
5. The written version of opposite parties questions the maintainability of complainant s case either in law or on facts, and admits the deceased C. Gurrappa insured his life under the above said policy for Rs. 75,000/ . On the demise of said C. Gurrappa on 26.8.2001 due to Chest pain, the complainant putforth a claim for insured amount. As the death aroused within 2 years of taking policy investigation was conducted, which revealed that the age furnished by the deceased was not correct and gave under statement of 20 years and was not keeping good health, prior to taking the above said policy and the deceased suppressed the facts of his ill health and has taken the above said policy. When the above facts were brought before the notice of the complainant, he voluntarily admitted and submitted a disclaimer on 24.2.2005 stating that there was suppression of material facts about the health of deceased and also agreed for relinquishment of his claim under the above said policy, the said disclaimer/ relinquishment letter is duly attested by the Notary. It lastly submits that the deceased suppressed material information, hence the policy became null and void and the complainant is not entitle to the policy amount of the deceased. Hence, there is no deficiency of service on part of opposite parties 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) Original proposal of the deceased C.Gurrappa No. 11067, dated 18.3.2004 (2) declaration of age in original dt 10.3.2004 submitted by the deceased life assured (3) Original policy bond of the deceased C.Gurrappa bearing No. 653300342 (4) Original Form of Declaration Relinquishing claim under policy No. 653300342 by the complainant and (5) office copy of the letter dated 3.3.2005 addressed to the complainant by the opposite party No.1, besides to sworn affidavit of opposite party No.1 in reiteration of his written version as defence and the above documents are marked as Ex B.1 to B.5 for its appreciation in this case. The opposite party No.1 suitablely replied to the interrogatories caused by the complainant and caused interrogatories to the complainant.
7. Hence, the point for consideration is to what relief the complainant is remaining entitled alleging deficiency of service and deficient conduct on part of opposite parties:
8. It may be stated at the outset that the dispute involved in this case centers round the claim of the complainant for insured amounts of Rs. 75,000/ under policy bearing No.653300342 and the dispute of the same is raised by the opposite parties by simply putting the complainant to strictly prove the material allegations of the complaint averments. The material facts that emerge from the averments, the contents of documents are that the complainant is the nominee of the deceased C.Gurrappa, who insured his life with opposite parties under the above said policy. The deceased C. Gurrappa died on 18.9.2004 due to chest pain. The complainant informed the death of deceased to the opposite parties and submitted claim form to the opposite parties for assured amount. But the opposite parties rejected the claim of the complainant vide Ex A.4/B.5. It dates to 3.3.2005. It rejects the claim made by the complainant for the above said policy on the reason that the deceased policy holder suppressed material information regarding his health prior to submitting the proposal form in Ex B.1. There is no doubt that the onus is on the opposite parties to prove that the deceased C.Gurrappa suppressed material information but no material or any direct evidence showing that the deceased actually taken treatment for any decease has been put on the record by the opposite parties. In the absence of any documents, any evidence produced on record primary or secondary regarding the treatment of the deceased before the submission of proposal form, it cannot be said that the opposite parties has proved on the record that the policy holder was suffering from any decease and suppressed material in formation prior to submitting proposal form. Therefore, the opposite parties have miserablely failed to prove the case by placing any original documents or by placing on record the certified copies of its original, which has not been done. Therefore, in these circumstances the rejection of claim by opposite parties is wholly arbitrary, unreasonable unjust and amounts to deficiency of service.
9. The opposite parties relied in support of their case on Ex B.4 i.e DISCLAIMER/ relinquishing claim form dt 24.2.2005, alleged to have been submitted by the complainant, who has relinquished the claims under the above said policy by executing it on 24.2.2005, the proforma in which Ex B.4 was prepared from its columns requires to be taken in the presence of Magistrate, Notary of an officer empowered to administrator oath. The said relinquishing form in Ex B.4 alleged to have been signed by the complainant on 24.2.2005, but the complainant disputes the said Ex B.4 as not signed by him before any Notary and further submits that he never ever signed on oath any disclaimer/ relinquishing claim form and submitted to the opposite parties. Further, from the contents of Ex B.4, it appears to be an obligatory one, as to a certificate to the extent that the contents of said declaration were explained by its certifying officer in vernacular to the person, who has given the said declaratory statement. As the said column is blank, the Ex B.4 statement is remaining devoid of merit on that aspect also, and no other material is placed by the opposite parties in support of Ex B.4, when the said exhibit is disputed by the complainant, hence from there it appears that the Ex B.4 relied by the opposite parties does not inspire any confidence about the contents of the said exhibit which can be acted upon. Moreover, the opposite parties in rejecting the claim of the complainant vide Ex A.4/B.5, stated that the deceased suppressed material information but the opposite parties failed to substantiate the said contention by placing any relevant cogent material on record. Hence, it appears that it is an after thought of the opposite parties to disclaim the valid claim of the complainant. Hence, the said Ex B.4 bears no binding force for being acted upon by the opposite parties, especially when the said declaration was denied by the complainant and no other material is placed by the opposite parties to substantiate the alleged suppression of material facts by the deceased policy holder. Therefore, when the Ex B.4 is not carrying any force, the opposite parties in not paying the policy amounts to the complainant basing on the said Ex B.4 remains not justifiable.
10. Hence, in the circumstances discussed above 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 when there is no suppression there is no necessity for the complainant to submit disclaimer/ relinquishing form to the opposite parties, disclaiming his entitleness to the policy amount. Hence, the opposite parties cannot rely on the said Ex B.4 to discharge its liability. Therefore, what follows is that there was no suppression of material information by the deceased and hence, the rejection by the opposite parties is arbitrary, untenable and unreasonable.
11. Having regard to over all consideration there is no hesitation to hold opposite parties have miserablely failed to substantiate that the deceased suppressed material facts about his health condition before taking the policy and that the complainant submitted disclaimer knowing fully aware of the consequences arising there of signed the disclaimer. 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 and the complainant is perfectly remaining entitled to the insured amount.
12. In the result, the complaint is allowed directing the opposite parties to pay to the complainant the assured amount under policy bearing No. 653300342 with 12percent interest per annum from the date of demise of deceased till realization along with Rs. 3,000/ as costs within a month of receipt of this order.
Dictated to the Stenographer, Typed to the dictation corrected by us, pronounced in the Open Court this the 15th day of September, 2005.
PRESIDENT
MEMBER MEMBER
APPENDIX OF EVIDNCE
Witness Examined
For the Complainant For the opposite parties
Nil Nil
List of Exhibits Mrked for the complainant: s
Ex A.1 Office copy of legal notice issued by complainant s counsel to opposite
Party No.2, dated 14.3.2005.
Ex A.2 Courier receipt dated 14.3.2005 for sending legal notice (Ex A.1).
Ex A.3 Reply to Ex A.2 given by the opposite party No.2 addressed to
Complainant s counsel dated 16.3.2005.
Ex A.4 Letter dated 3.3.2005 issued by Senior, Divisional Manager, Cuddaph.
List of Exhibits Marked for the opposite parties:
Ex B.1 Original proposal of the deceased C. Gurrappa No. 11067, dated 18.3.04.
Ex B.2 Declaration of age in original dt 10.3.2004 submitted by the deceased
Life assured.
Ex B.3 Original policy bond of the deceased C.Gurrappa bearing
No. 653300342.
Ex B.4 Original Form of Declaration Relinquishing claim under policy
No. 653300342 by the complainant.
Ex B.5 Office copy of the letter dated 3.3.2005 addressed to the complainant by
the opposite party No.1
PRESIDENT
MEMBER MEMBER
Copy to:
1 Sri A.Prma Subba Reddy, Advocate, Kurnool.
2. Sri A.S.Ummer Javid Ali, Advocate, Kurnool.
Copy was made ready on:
Copy was dispatched on:
Copy was delivered to parties:
APPENDIX OF EVIDENCE
Witnesses Examined
For the complainant For the opposite parties
Nil Nil
List of Exhibits marked for the complainant:
Ex A.1 Repudiation letter dt 31.3.2003 addressed to the complainant.
Ex A.2 Death certificate issued by register of Births and deaths, dated
5.10.2001.
Ex A.3 Certified copy of policy bearing No. 652678911 dated 19.7.2001.
Ex A.4 Certified copy of policy bearing No. 652679426 dated 6.8.2001.
Ex A.5 certified copy of policy bearing No. 652679249 dated 6.8.2001.
List of Exhibits marked for the opposite parties:
Ex B.1 Proposal Form dated 29.6.2001.
Ex B.2 Proposal Form dated 12.7.2001.
Ex B.3 Proposal Form dated 22.7.2001.
Ex B.4 Policy bond bearing No. 652678911 for sum assured of Rs.50,000/
Ex B.5 Policy bond bearing No. 652679426 for sum assured of RS.50,000/ .
Ex B.6 Policy bond bearing No. 652679249 for sum assured of Rs.50,000/ .
Ex B.7 Repudiation letter dt 31.3.2003 addressed to the complainant
Ex B.8 Relinquishing claim form dated 3.4.2003.
PRESIDENT
MEMBER MEMBER
Copy to:
1. Sri P.Sivasudarshan, Advocate, Kurnool for complainant.
2. Sri P.Sivaprasada Reddy, Advocate, Kurnool for opposite party 1 and 2
Copy was made ready on :
Copy was dispatched on :
Copy was delivered to parties:
