Karnataka

Chitradurga

CC/3/2021

Manjula w/o Late Veeranna - Complainant(s)

Versus

The General Manager Max Life Insurance company ltd. - Opp.Party(s)

Sri.Ashok

16 Aug 2022

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, CHITRADURGA.

CC.NO:03/2021

DATED: 16^th AUGUST 2022

PRESENT: -     Sri. M.I.SHIGLI. B.A., LL.M.,       PRESIDENT

                       

                        Sri. G. SREEPATHI, B.COM., LL.B., MEMBER         

                                      

                        Smt. B.H. YASHODA.    B.A., LL.B., LADY MEMBER

 

                    

……COMPLAINANT/S	. Smt. Manjula w/o Late Sri. Veeranna. r/o Jadekunte village,Kaparahalli post,Challkere taluk,Chitradurga Dist.Karnataka state.   Smt. Roja w/o Vinay D/o Late Sri. Veeranna Aged about 23 years,r o Jadekunte village,Kaparahalli post,Challkere taluk,Chitradurga dist.Karnataka state (Rep by Advocate Sri. Ashok)
V/S
.….OPPOSITE PARTY/S	1 . The General Manager       Max Life Insurance company Ltd., Plot No.90 A, Sector-18,Udyogi vihar, Gurugram, Haryana-122015 (Rep by Advocate H.B. Devi Prasad)     2 . The Manager, Axis Bank, Bangalore Road,Challkere Town,Chitradurga dist. (Exparte)

:ORDER:

 

Sri. M.I.SHIGLI. B.A., LL.M., PRESIDENT

 

       The Complainant has filed this compliant against the OPs U/s 35 of CP Act 2019.

        The Complainant has sought for direction to OPs to pay the assured amount of Rs.8,40,643/- and Rs.1,00,000/- towards mental shock pain and suffering with interest @ 18% p.a. and such other ancillary reliefs.

 

BRIEF FACTS OF THE CASE:

 

1. The complainant No.1 has asserted that, she is the wife of one Sri. Veeranna and complainant No.2 is his daughter. The said Sri. Veeranna died on 04/03/2020, and it was natural death at his home.

It is said that during the life time of said Sri. Veeranna had purchased a policy called Max Life Savings Advantage Plan bearing its Policy No.312751472, on 03/07/2019 from OP No.1. The premium frequency was annual at Rs.74,999.88/- and the term of plan was 5 years.

 

2. It’s stated that, from the date of purchase i.e. from 03/07/2019 the risk is commenced. It’s further stated that, the said plan was comprising guaranteed and non-guaranteed death benefits payable on the death and for the 1^st years assured amount was Rs.8,40,643/-.

It’s stated that, after the death of the said Sri. Veeranna the complainants are said to have approached the OPs for settlement of policy claim, which went in vain. It’s further asserted that, the OPs have further offered another policy under disguise of settlement for Rs.50,000/-. As the OP No.1 failed to settle the claim, a legal notice came to issued against OPs which is said to have fallen on the deaf ears of OPs for which the present complaint.

 

3. After registering this complaint, Notice to OPs is ordered to be issued which in turn the OP No.1 has appeared through its counsel whereas OP No.2 remained Ex-parte.

 

4. The OP No.1 has filed its lengthy version traversing all the contents of the complaint, and have specifically contended in para No.22 of the version that, the claim is turned down on the
ground that …

“Investigation has revealed that the Life Assured has concealed the fact that he was diagnosed with chronic Pancreatitis Carcinoma of head of Pancreas, mild hepatomegaly with fatty liver chronic calcific Pancreas.”

“…..Therefore it is appropriate to repudiate the claim on the ground for non-disclosure of material information at the time of proposal for insurance”.

 

5. Though the version of OP No.1 runs into pages, but the crux of it’s defense is as stated above. And the OP No.1 has produced documents at Annexures 1 to 5 in support of its version.

 

6. As the matter was set for leading evidence of parties, the complainant No.1 has chosen to examine herself as PW-1 and got marked documents at Ex.A-1 to A-7 and closed her side. Whereas OP No.1 though files its version, has not turned up to examine any witness nor got marked any documents on its side, as OP No.2 is placed Ex-parte.

 

7. The complainant filed her written arguments and submitted oral submissions too.

In the backdrop of the circumstances, this commission is confronted with the following points for consideration, viz.

1. Whether the complainants prove that they are consumers of the OPs.
2. Whether the complainants prove any deficiency of service on the part of OPs.
3. Consequently what order?

    8. We have heard the submission of counsel for complainant, perused the materials placed on record, and our findings on the above points are as under.

1. Point No.1: In the affirmative
2. Point No.2: In the affirmative
3. Point No.3: As per the final order for the following.

 

:REASONS:  

        9. The specific assertion of complaint and chief examination that, they are only legal heirs of deceased Sri. Veeranna is not disputed by the OP No.1, as OP No.1 in its version on page No.13 at para 25 states… “The contents of para No.1 to 3 needs no reply”.

This could drive us to infer that, the complainant are the legal heirs of deceased Sri. Veeranna, who held the policy and they consequently are the consumers of the OP No.1.

        10. Another interesting fact, revealed by the complainants is, that in the pretext of settling the claim as above mentioned, the OP No.1 has issued another similar policy bearing No.337392906 for Assured sum of Rs.7,11,339.00/- on 21/03/2020.

        11. It’s astonishing to take note that, the complainants have submitted the claim form No.‘A’ on 18/03/2020, as per Annexure 2 produced by the OP No.1, in respect of Policy No.312751472, and said to have put her signature on it in her vernacular language. But how could there be chance of purchase of another similar policy bearing No.337392906 on 21/03/2020.

        12. We have given our conscious attention to this fact, where PW-1 in her chief examination has deposed that at para No.5 stating that…
       “ £Á£ÀÄ £À£Àß UÀAqÀ£À ¥Á°¹ ºÀt PÉüÀ®Ä JzÀÄgÀÄzÁgÀgÀ §½ ºÉÆÃzÁUÀ, CªÀjUÉ §gÀ¨ÉÃPÁzÀ ºÀt ¤ÃqÀÄvÉÛêÉ. FUÀ ¤Ã£ÀÄ ¸ÀºÀ §AzÀÄ ¥Á°¹ ¥ÀqÉzÀÄPÉÆà JAzÀÄ ºÉý £À£Àß UÀAqÀ£À ªÀÄgÀt £ÀAvÀgÀ CAzÀgÉ ¢£ÁAPÀ:21/03/2020gÀAzÀÄ (£À£Àß UÀAqÀ ªÀÄgÀtºÉÆA¢zÀ 17 ¢£ÀPÉÌ) 2£Éà JzÀÄgÀÄzÁgÀgÀ ªÀÄÄSÁAvÀgÀ 1£Éà JzÀÄgÀÄzÁgÀgÀÄ £À£Àß ºÉ¸ÀjUÉ MAzÀÄ ¥Á°¹AiÀÄ£ÀÄß ¥Á°¹ £ÀA.337392906 JAzÀÄ 2£Éà JzÀÄgÀÄzÁgÀgÀ ¨ÁåAPï SÁvÉ £ÀA.9180100643024406 gÀ ªÀÄÄSÁAvÀgÀ gÀÆ.50,000/-UÀ¼À£ÀÄß £À£ÀUÉ UÉÆwÛ®èzÀAvÉ ªÀÄvÉÛ £À£ÀUÉ ªÉÆøÀªÀiÁqÀĪÀ GzÉÝñÀ¢AzÀ MAzÀÄ ¥Á°¹AiÀÄ£ÀÄß ¤ÃrgÀÄvÁÛgÉ. F jÃw ªÀiÁrgÀĪÀÅzÀÄ £À£ÀUÉ JzÀÄgÀÄzÁgÀgÀÄ ªÀiÁrgÀĪÀ ¸ÉêÁ£ÀÆå£ÀvÉAiÀiÁVgÀÄvÀÛzÉ. £À£Àß ¥Á°¹ vÉUÉzÀÄPÉÆAqÀgÀÄ ¸ÀºÀ £À£Àß UÀAqÀ£À ªÀÄgÀt¢AzÀ §gÀ¨ÉÃPÁzÀ ¥Á°¹ ªÉÆvÀÛªÀ£ÀÄß ¤ÃrgÀĪÀÅ¢®è.

     This deposition is the reiteration of her say in her complaint on Page No.3 in para No.5.

        13. What is to be seriously looked into, is, OP No.1 except filing its version has not come foreword to challenge the evidence of complainant by cross examination/interrogatories. As such, this part of evidence has gone unchallenged. This conduct of the OP No. l compells us draw an inference that, it is engaged in unfair trade practice.

        Non settlement of policy is not supported with genuine ground, which is unjust and unfair. No evidence is let in by the OP No.1 to substantiate its stand by leading evidence. The analysis of the above facts do point towards the fact that, the complainants are the consumer of OP No.1, wherefore we answer Point No.1 in affirmative.

        14. Despite these facts, we have observed that, the original claim form A is submitted on 18/03/2020 whereas, the second policy is said to have been purchased by the complainant No.1 as per Ex.A-2 Repudiation of the policy without assigning good reasons itself is deficiency of service. Hence there cannot be any hesitation to answer Point No.2 in affirmative and is answered accordingly.

        15. Though the OP No.1 has taken specific contention that, it has conducted its investigation, nothing is placed on record by examination of any witness to this effect.

        The apex Court of our land, has time and again ordained, that, there shall not repudiation of policy claims on flimsy grounds. We have authorities to this effect, viz.

Gurumel Singh V/s National Insurance Company 2022 (2) CPR390(S.C). Wherein it is observed “…..in many cases, it is found that insurance companies are refusing claim on flimsy grounds and/or technical grounds…..” And in 2008CTJ917SC the SC has held similarly.

Shorn of unnecessary details, what one can infer from the facts narrated, is the fact that, the OP No.1 is unjust and unfair in repudiating the claim of the complainants, for which we have to come with heavy hands.

For the foregoing reasons we proceed to pass the following.

::ORDER::

        The complaint filed by the complainants U/s 35 of CP Act 2019 is hereby allowed in part, it is ordered that…

1. The OP No.1 shall settle the claim of the complainant to the tune of Rs.8,40,643/-

 

 

2. The OP No.1 shall pay Rs.50,000/- towards mental agony /pain/suffering.

 

3. The OP No.1 shall also be liable to pay Rs.5,000/- towards litigation costs.

The aggregate amount shall be paid by the OP No.1 within a period of 30 days from the date of this order. Failure of same shall carry interest at the rate of 12% p.a. from the date of petition till its realization.

Communicate the order to the parties.

(Typed directly on the computer to the dictation given to stenographer, the transcript corrected, revised and then pronounced by us on 16^th August 2022.)

 

 

 

     LADY MEMBER             MEMBER                    PRESIDENT

 

 

 

-:ANNEXURES:-

Witnesses examined on behalf of Complainant:

1. Smt. Manjula w/o Late Sri. Veeranna

 

Witnesses examined on behalf of Opponents:

Nil

 

Documents marked on behalf of Complainant:

01	Ex-A-1:-	Max Life Insurance policy copy
02	Ex-A-2:-	Max Life Insurance policy copy
03	Ex-A-3:-	Legal Notice Xerox copy dated 24/10/2020
04	Ex-A-4&5:-	Postal Track Consignment copy
05	Ex-A-6:-	Postal receipt
06	Ex-A-7:-	Postal Acknowledgement

 

Documents marked on behalf of opponents:

 

Nil

 

 

 

LADY MEMBER                   MEMBER                    PRESIDENT

 

 

GM