THE KARNATAKA STATE CONSUMER DISPUTES

REDRESSAL COMMISSION, BANGALORE. (ADDL. BENCH)

DATED THIS THE 29^th DAY OF JULY, 2022

PRESENT

SRI RAVI SHANKAR – JUDICIAL MEMBER

SMT. SUNITA C.BAGEWADI – MEMBER

APPEAL NO. 1706/2014

Sri.Muralidhar Venkatesh Revankar,

Aged about 48 years,

Occupation Auto Driver,

Residing at Church Road,

Yellapur, Uttar Kannada

District    

….Appellant/s.

(By Sri/Smt.Manjunath.G.Kandekar,   Adv.,)

-Versus-

1.         The Karnataka Bank Ltd,

            Near Bus Stand, Yellapur,

            Represented by its Manager,

2.         Bajaj Allianz Life Insurance

            Company Ltd.,

            West Hub, 2^nd Floor, Bajaj Finserve,

            Survey No.208/1-B, Behind Weikfiled

            IT building, Vaman Nagar, Nagar Road,

Pune, Maharashtra-411 014

……….. Respondent/s

(Respondent No.1-by Sriharsha.R.Londhe, Adv.,)

(Respondent No.2-by J.R.Jagadish, Adv.,)

: ORDERS:

BY SRI RAVI SHANKAR – JUDICIAL MEMBER

The complainant in complaint No.164/2013 has filed this appeal against the order passed by the District Consumer Commission, Uttar Kannada at Karawar which dismissed the complaint holding that there is no deficiency of service on the part of the Opposite Party Nos.1 and 2.  

2.         Brief facts of the complaint is that, the complainant’s sister one Shobha Venkatesh Revankar had obtained “SARVE SHAKTI SURAKSHA POLICY” from the 1^st Opposite Party for a sum assured of Rs.3,00,000-00 by paying annual premium of Rs.12,000-00 and accordingly the policy was issued on 26-2-2013 and this complainant is the nominee to the said policy. Such being the case on 14-4-2013, the sister of complainant/insured died and being a nominee, the complainant claimed for assured amount as per the policy. After receipt of the claim, the 2^nd Opposite Party has offered to pay only Rs.7,889-00 which the complainant rejected and demanded for payment of assured amount but the 2^nd Opposite Party repudiated the claim without any reasons. Hence, the complainant alleged the deficiency of service and filed this complaint before the District Commission.  

3.         After trial, the District Commission dismissed the complaint holding that the insured suppressed her health condition prior to taking policy, hence violated the terms and conditions of the policy and repudiated the claim and the District Commission considered the said defence and dismissed the complaint against which complainant/appellant before this Commission and submits to set aside the order passed by the District Commission and allow the complaint. Further the complainant submits that cause of death is not due any of previous diseases she had opted the said insurance policy at the time of borrowing housing loan to the tune of Rs.8,00,000-00 from the 1^st Opposite Party bank and the 1^st Opposite Party bank have insisted this insured to pay the premium hence prayed for payment of assured amount by allowing the complaint.

4.         On going through the certified copy of the order passed by the District Commission and memorandum of appeal, we noticed here that the 2^nd Opposite Party has issued the police called “SARVE SHAKTI SURAKSHA POLICY” on 26-2-2013. After issuance of the policy, they received the claim form from the complainant, who was the nominee to the policy issued to one Shobha Venkatesh Revankar after receiving the said claim, they verified and scrutinized and noticed that the insured prior to taking the policy was hospitalized at SDM College of Medical Science and Hospital, Sattur, Dharwad for “Chronic Kidney Disease and during the hospitalization, the said hospital have advised for dialysis. Basing the said treatment the 2^nd Opposite Party Company repudiated the claim as the insured has not expressed that she had taken treatment prior to taking policy, hence repudiated the claim. The District Commission also noticed that, the documents produced by the Opposite Parties i.e. Ex.R1 which categorically goes to shows that, the sister of the complainant had been taken treatment for chronic kidney diseases and she was advised for dialysis the said facts also known to the complainant. In this regard, the complainant also made declaration to the hospital and given consent. Thus the insured had taken treatment from 17-10-2012 to 22-10-2012 for chronic kidney disease and renal failure and subsequently on 26-2-2013 the policy was obtained but the insured fail to disclose the said material facts with respect to the health condition at the time of proposal.  We consider it is clear case of suppression of material facts by the insured. The policy has to be obtained on good faith. Since claim was within one year, the 1^st Opposite Party have offered for refund of premium amount after deduction of surrender value. We found there is no any deficiency of service on the part of the 2^nd Opposite Party in not settling the claim, for the reasons of suppression of material facts. The complainant is not entitled to any compensation as claimed except the amount offered by the 2^nd Opposite Party company. The District Commission has righty dismissed the complaint considering the materials placed before the commission. We found there is no merit in the appeal as such the order passed by the District Commission does not requires any interference hence, the appeal is also dismissed.  Accordingly, we proceed to pass the following:-

:ORDER:

The appeal is dismissed.  No costs.

Send a copy of this order to both parties as well as Concerned District Commission.

Member.                                                                    Judicial Member.