Andhra Pradesh
Visakhapatnam-II
cc/172/2013
Adari Sanyasi Rao - Complainant(s)
Versus
The General Manager, Birla Sun Life Insurance Company Limited - Opp.Party(s)
Adari Apparao
05 Feb 2015
ORDER
Date of Registration of the Complaint:05-07.2013
Date of Order:05-02-2015
BEFORE THE DISTRICT CONSUMERS FORUM-II AT
VISAKHAPATNAM
P r e s e n t:
1. Sri H. Ananda Rao, M.A., L.L.B.,
President
2. Smt K. Saroja, M.A. B.L.,
Lady Member
3. Sri C.V. Rao, M.A., B.L.,
Male Member
Thursday, the 5th day of February, 2015.
CONSUMER CASE No.172/2013
Between:-
Sri Adari Sanyasi Rao, S/o Tatarao, Hindu,
aged 31 years, Moolapeta Village, Thotada
Post, Munagapaka Mandal, Visakhapatnam
District, Pin:531 002.
….. Complainant
And:-
1.The General Manager, Birla Sun Life
Insurance Company Limited, One Indiabulls
Centre, Tower 1, 16th Floor, Jupiter Mill
Compound, 841, Senapati Bapat Marg,
Elphinstone Road, Mumbai-400013.
2.The Branch Manager, Birla Sun Life Insurance
Company Limited, 1st Floor, Eswar Paradise,
Dwarakanagar Main Road, Visakhapatnam-530016.
… Opposite Parties
This case coming on 21.01.2015 for final hearing before us in the presence of Sri Adari Appa Rao, Advocate for the Complainant and Sri Sanapala Karuna & Smt. Sanapala Sailaja, Advocates for the 1st Opposite Party and the 2nd Opposite Party being exparte and having stood over till this date for consideration, this Forum made the following:
ORDER
(As per Sri. H. Ananda Rao, Honourable President, on behalf of the Bench)
1. This consumer complaint is filed by the Complainant against the Opposite Parties directing them to pay an amount of Rs.12,00,000/- + Rs.6,50,000/- = Rs.18,50,000/- (Rupees Eighteen lakhs and fifty thousand only) with interest @ 24% p.a. from the date of claiming the amount till payment, Rs.50,000/- (Rupees Fifty thousand only) towards compensation with costs.
2. The case of the Complainant in brief is that the Complainant’s sister Smt. Prasanthi had taken two Life Insurance Policies from the Opposite Parties bearing Nos. 004790915 for an amount of Rs.12,00,000/- on 23.03.2011 and 004732912 for an amount of Rs.6,50,000/- on 28.02.2011 and his name was registered as a nominee in the said policies on 22.06.2011. His sister due to sustaining of abdominal pain at early hours in her father-in-law’s house at Bheemavaram she was immediately shifted to Anakapalle for treatment while going to Hospital she died on the way.
3. That in the first week of September, 2011 he came to know about the existence of the policies while he was searching for land documents and he came to know that he was appointed as nominee of the said deceased in the said policies and immediately approached the 2nd Opposite Party and intimated the death of his sister by name Prasanthi to the 2nd Opposite Party on 23.09.2011. The 2nd Opposite Party had issued claim forms and thereupon he submitted them to the 2nd Opposite Party dated 04.11.2011 along with Original Policy Bonds, Original Death Certificate and documents etc., and token of receipt the 2nd Opposite Party gave acknowledgement and there-after the Opposite Parties enquired about the death and on 31.01.2011 he received a repudiation letter from the Opposite Parties with false allegations. Hence, this Complaint.
4. The Case of the Opposite Parties is that they have issued two policies referred supra on 23.03.2011 and 25.02.2011 respectively wherein the Complainant is her nominee for sum of Rs.6,50,000/- and Rs.12,00,000/- respectively, and received a death claim intimation along with the Claimant’s Statement and Death Certificate of the Deceased Policy Holder. That upon received of the Death Claim by the Opposite Party during the course of the investigation, it was established that the DLI had submitted different identification and personal details in the Application from the 2nd Policy (Policy No. 479091). The first Policy bearing No. 004732912 in the name of Prasanthi Sharkam and applied another policy bearing No. 0047909152 in the name of Prasanthi Adari. Moreover, the nominee of both policies were different. Further under the Policy bearing No.004732912 the DLA have described herself as Agricultural Landlord for 3 years with an Annual Income of Rs.2,00,000/- whereas in the Policy bearing No. 0047090915, the DLA have described her occupation as Self Employed, Owner of Agri Products for 5 years with annual income of Rs.4,00,000/-. Moreover, the address for communication in the two Applications for insurance were different, so also the family particulars. It clearly reflects that DLA had applied both the policies with the different identities to mis-lead the company and extract monies from them. These material details affecting the decision of the insurer for the acceptance or rejection of the contract of the insurance were willfully suppressed by the DLI as the same was not disclosed by him at the time of signing the said Application in spite of the specific question asked in the Proposal Form therefore, the said claim was rightly repudiated the claim vide letter dated 31.12.2012.
5. The DLI was under the obligation was disclosed immediately treatment in the Proposal Form it was necessary to the answered, for the purpose of determining under the said policy intentionally answered in negative by DLI. The said policy was obtained by suppression and mis-representation of the facts. For these reasons, the claim of the Complainant is liable to be dismissed.
6. To prove the case on behalf of the Complainant, he filed his sworn affidavit and got marked Exs.A1 to A10. On the other hand, on behalf of the Opposite Parties their Authorized Representative filed his affidavit and got marked Exs.B1 to B4.
7. Ex.A1 is the photo copy of Policy Bond No.004790915 issued by the 2nd Opposite Party in favour of the Complainant dated 23.03.2011. Ex.A2 is the photo copy of Policy Bond No.004732912 issued by the 2nd Opposite Party in favour of the Complainant dated 28.02.2011. Ex.A3 is the attested photo copy of Death Certificate dated 23.06.2011 issued by the Panchayat Secretary, Bheemavaram, S. Rayavaram Mandalam. Ex.A4 is the Claim Intimation Letter addressed by the Complainant to the 2nd Opposite Party dated 23.09.2011. Ex.A5 is the two attested Policy Bond Copies details issued by the 2nd Opposite Party dated 04.11.2011. Ex.A6 is the attested copy of Voter Identity Card dated 05.06.2003. Ex. A7 is the Photo copy of Form of Transfer Certificate issued by the Zilla Parishad High School, Thoiada of Adari Prasanthi dated 03.09.2005. Ex.A8 is the Repudiation letter issued by the 1st Opposite Party to the Complainant dated 31.01.2012. Ex.A9 is the letter addressed by the Complainant to Deputy Director (IRDA) and copy to 1st Opposite Party dated 23.04.2012. Ex.A10 is the final Repudiation letter addressed by the 1st Opposite Party to the Complainant dated 09.07.2012.
8. Ex.B1 is the photo copy of Policy Application of the Complainant’s sister in the name of Smt. Prasanthi dated 23.02.2011. Ex.B2 is the photo copy of Death Certificate of the Complainant issued by the Grama Panchayat Secretary, Bheemavaram, S. Rayavaram Mandalam dated 23.06.2011. Ex.B3 is the photo copy of Repudiation letter issued by the 1st Opposite Party to the Complainant dated 31.01.2012. Ex.B4 is the photo copy of final Repudiation letter addressed by the 1st Opposite Party to the Complainant dated 09.07.2012.
9. Both parties are filed their respective written arguments.
10. Heard oral arguments from both sides.
11. Now the points that arise for determination is:-
Whether there is any deficiency in service on the part of the Opposite Parties and the Complainant is entitled for the reliefs of advance amount with interest, compensation and costs.
12. As seen from record, it is not in-dispute the Complainant’s sister Smt. Prasanthi had taken two Life Insurance Policies from the Opposite Parties bearing Nos. 004790915 for an amount of Rs.12,00,000/- on 23.03.2011 and bearing No. 004732912 for an amount of Rs.6,50,000/- on 28.02.2011 and the name was registered as her nominee in the said policies and after the death of Prasanthi in the month of September, 2011 the death was intimated to the 2nd Opposite Party and after issuing Claim Forms to him, after complying the conditions therein. The Complainant submitted the same to the 2nd Opposite Party on 04.11.2011 along with the Original Policy Bonds, Original Death Certificate and other all required documents and subsequently, after investigation, the claim of the Complainant was repudiated.
13. Exs.A1 and A2 shows that the Complainant was duly appointed as nominee of the deceased/insured. Ex.A3 Death Certificate issued by the Panchayat Secretary, Bheemavaram reveals that the insured died on 26.02.2011. The main contention of the Opposite Parties is that the insured had suppressed material facts at the time of demanding the policies vide Exs.A1 and A2 and obtained the policies by mis-representation of material facts at the time of making the proposal.
14. To prove the same they relied upon Exs.B1 to B4. Ex.B1 shows that the Complainant was duly appointed as nominee of the deceased/insured and taken two Life Insurance Policies from the Opposite Parties referred supra for Rs.12,00,000/- on 23.03.2011 and Rs.6,50,000/- on 28.02.2011 i.e., one policy while she was residing in her in-laws house by saying that she is carrying on Agricultural Products and earning annual income of Rs.4,00,000/- and another policy as landlord while she was residing in her parent’s house. The Opposite Parties have not filed any document to prove the insured was suppressed the material facts, at the time of issue of the insurance policies. As per Ex.A3 issued by the Panchayat Secretary, Bheemavaram, it is evident that the insured died on 22.06.2011. When the proposal is filled by the agent, it is his duty to elicit all the facts, a poor, illiterate women from remote village is not supposed to know all the technicalities of law. Therefore, in our considered view merely the deceased not stated all facts in the facts and circumstances of the case would not amount to suppression of facts as contended by the learned counsel for the Opposite Parties.
15. The record clearly goes to show on receipt of the necessary documents by the Complainant, the officials of the 2nd Opposite Party inspite of giving acknowledgement and made necessary enquiries about the death of the deceased failed to settle the claim, on the other hand, they repudiated the claim of the Complainant without assigning proper reasons. The non-payment of the insurance amount to the Complainant amounts to deficiency of service. For these reasons, we are of the considered view the Complainant is entitled for amounts of Rs.12,00,000/- + Rs.6,50,000/- together with interest from 23.04.2012. The deceased/insured is the sister of the Complainant having two children by names Sharkum Bhavani, aged 16 years and Sharkam Sankar Babu, aged 11 years. The Complainant filed affidavit stating that in the event of any amount being awarded, he has no objection to deposit the same in the names of the aforesaid legal heirs till they attaining majority. Taking into consideration of the affidavit averments filed by the Complainant instead of directing the Opposite Parties to pay the amount to the Complainant to safeguard the interests of the minor children’s of the insured/deceased, we are inclined to direct the Opposite Parties to deposit the amount of Rs.18,50,000/- in this Forum in order to meet the ends of justice.
16. The record clearly goes to show the Complainant approached the Opposite Parties demanding him to pay the insured amount with necessary documents, but they failed and finally on 23.04.2012 he approached higher authorities of the Opposite Parties to receive the claim but they have not considered, as a result, he approached this Forum, therefore, we are inclined to grant interest for the awarded amount from 23.04.2012 onwards for a sum of Rs.18,50,000/-. It appears as seen from record the Complainant herein is looking after the minor children of the insured. Probably it may be the cause to place the Complainant herein as the nominee of the deceased. In these circumstances, we feel that if the amounts granted are deposited in the name of the minor children’s, it would serve the purpose of their day to day maintenance till they attained majority. For all these reasons we are inclined to direct the Opposite Parties to deposit an amount of Rs.18,50,000/- along with compensation and interest of Rs.50,000/- in this Forum on such deposit an amount of Rs.9,50,000/- each shall be deposited by way of FDR in the name of the legal heirs of the deceased/insured i.e., Sharkum Bhavani and Sharkum Sankar Babu till they attain majority for a period of 3 years and 7 years respectively; by taking monthly interest accrued thereon may be withdrawn by the Complainant herein for their day to day maintenance.
17. Now the question that comes up for consideration, at this stages of our discussion what is the rate of interest for which the Complainant is entitled. The rate of interest claimed by the Complainant is 24% p.a. This rate of interest claimed by the Complainant appears to be excessive, of course, it is a fact that the transaction covered by Ex.B2 is in commercial in nature, but that does not and cannot mean to say that the Complainant is a licenced to claim interest @ 24% p.a. on Ex.B2. But at the same time, it is an imperative on our part to award a reasonable interest. Having regard to all these facts and circumstances, we sincerely feel having considered the case on hand awarding of interest @ 9% p.a. on Ex.B2 would better serve the ends of justice. Consequently, we proposed to fix at rate in question @ 9% p.a. on Ex.B2 in question. Accordingly interest is ordered.
18. Whether the Complainant is entitled for compensation of Rs.50,000/- is to be considered. It appears as seen from the evidence of PW-1 that the Complainant was compelled to approach the Opposite Party and therefore experienced a lot of physical strain besides mental agony and financial loss. It is un-dispute fact that the Opposite Party did not refund the amount subscribed by the Complainant. Naturally that made have put the Complainant to suffer some mental agony besides physical stress and strain. In this view of the matter, we sincerely feel that it is a fit case to award compensation. Having regard to all these facts and circumstances, we are of the considered opinion, award of compensation of 50,000/- would serve the ends of justice. We therefore, proposed to award compensation of Rs.50,000 /-, in the circumstances of the case on hand. Accordingly this point is answered.
19. Before parting our discussion, it is incumbent and imperative on our part to consider the costs of litigation. The Complainant ought not have to approach this Forum had his claim for refund of the sum of Rs.18,50,000/- or reliefs sought for have been honored by the Opposite Parties within a reasonable time and in view of the matter, the Complainant’s claim for claims for cost deserves to be allowed. In our considered and unanimous opinion awarding a sum of Rs. 2,500/- as costs would appropriate and reasonable. Accordingly costs are awarded.
20. In the result, this Forum is directing the Opposite Parties to deposit an amount of Rs.12,00,000/- + Rs.6,50,000/- = Rs.18,50,000/- (Rupees Eighteen lakhs and fifty thousand only) in this Forum with interest @ 9% p.a. from 23.04.2012 till the date of realization, along with a compensation of Rs.50,000/- (Rupees Fifty thousand only). On such deposit, an amount of Rs.9,50,000/- (Rupees nine lakhs and fifty thousand only) each shall be deposited by way of FDR in the name of the Legal Heirs of the deceased/insured i.e., Sharkum Bhavani and Sharkum Sankar Babu till they attain majority, for a period of 3 years and 7 years respectively. It is further directed that monthly interest accrued thereon may be withdrawn by the Complainant herein for their day to day maintenance. Costs of Rs.2,500/- (Rupees Two thousand and five hundred only) granted to the Complainant. Time for compliance, one month. Accordingly, the complaint is allowed.
Dictated to the Steno, transcribed by him, corrected and pronounced by us in the Open Forum, this the 5th day of February, 2015.
Sd/- Sd/- Sd/-
Male Member Lady Member President
APPENDIX OF EVIDENCE
For the Complainant:-
NO. | DATE | DESCRIPTIONOFTHEDOCUMENTS | REMARKS |
Ex.A01 | 23.03.2011 | Policy Bond No.004790915 issued by the 2nd Op in favour of the Complainant | Photo copy |
Ex.A02 | 28.02.2011 | Policy Bond No.004732912 issued by the 2nd OP in favour of the Complainant | Photo copy |
Ex.A03 | 23.06.2011 | Death Certificate issued by the Panchayat Secretary, Bheemavaram, S. Rayavaram Mandalam | Attested copy |
Ex.A04 | 23.09.2011 | Claim Intimation letter addressed by the Complainant to the 2nd Op | Original |
Ex.A05 | 04.11.2011 | Policy Bond copies details issued by the 2nd OP in favour of the Complainant | Attested copy |
Ex.A06 | 05.06.2003 | Voter Identity Card | Attested copy |
Ex.A07 | 03.09.2005 | Form of Transfer Certificate issued by the Zilla Parishad High School, Thoiada of Adari Prasanthi | Photo copy |
Ex.A08 | 31.01.2012 | Repudiation letter issued by the 1st OP to the Complainant | Original |
Ex.A09 | 23.04.2012 | Letter addressed by the Complainant to Deputy Director (IRDA) and copy to 1st OP | Original |
Ex.A10 | 09.07.2012 | Final Repudiation letter addressed by the 1st OP to the Complainant | Original |
For the Opposite Parties:-
No. | DATE | DESCRIPTIONOFTHEDOCUMENTS | REMARKS |
Ex.B1 | 23.02.2011 | Policy Application of the Complainant’s sister in the name of Smt. Prasanthi | Photo coy |
Ex.B2 | 23.06.2011 | Death Certificate of the Complainant issued by the Panchyat Secretary, Bheemavaram, S. Rayavaram Mandalam | Photo copy |
Ex.B3 | 31.01.2012 | Letter issued by the 1st OP to the Complainant | Photo copy |
Ex.B4 | 09.07.2012 | Final Repudiation letter addressed by the 1st OP to the Complainant | Photo copy |
Sd/- Sd/- Sd/-
Male Member Lady Member President
Consumer Court Lawyer
Best Law Firm for all your Consumer Court related cases.
Bhanu Pratap
Highly recommended!
5.0 (615)
Bhanu Pratap
Featured RecomendedHighly recommended!
Experties
Consumer Court | Cheque Bounce | Civil Cases | Criminal Cases | Matrimonial Disputes
Phone Number
7982270319
Dedicated team of best lawyers for all your legal queries. Our lawyers can help you for you Consumer Court related cases at very affordable fee.