Karnataka

Chitradurga

CC/91/2017

Suresh.H.M S/o Shadasksharaiha - Complainant(s)

Versus

The Manager - Opp.Party(s)

Sri.K.B.Chandrappa

24 Mar 2018

ORDER

COMPLAINT FILED ON:13/09/2017

DISPOSED      ON:24/03/2018

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, CHITRADURGA.

 

CC.NO: 91/2017

 

DATED:  24^th MARCH 2018

PRESENT: - SRI. T.N. SREENIVASAIAH  : PRESIDENT                                   B.A., LL.B.,

                   SRI.N. THIPPESWAMY        : MEMBER

                          B.A., LL.B., PGDCLP  

……COMPLAINANT/S	Suresh H.M S/o Shadaksharaiah H.M, Major, R/o Bilesanuru Village, Harihara Taluk, Davanagere District.   (Rep by Sri. K.B. Chandrappa, Advocate)
V/S
…..OPPOSITE PARTIES	1. The Manager, Reliance Life Insurance Co. Ltd., C/S/C Office, Bangalore Road, Challakere.   2. The Manager, Reliance Life Insurance Co. Ltd., No.44, BSC Avenue, 2nd Floor, Akkamahadevi Road, P.J. Extension, Opp: Chetan Hotel, Davanagere Town.   (Rep by Sri. B.S.Shivamurthy, Advocate)

ORDER

SRI. T.N. SREENIVASAIAH:   PRESIDENT

The above complaint has been filed by the complainant u/Sec.12 of the C. P Act, 1986 for the relief to direct the OPs to pay    Rs.3,32,732/-, the policy amount and other benefits with cost  and such others reliefs.

2.      The brief facts of the case of the above complainant are that, one Anasuyamma W/o Shadaksharaiah, who is the mother of complainant has obtained two policies i.e., first policy bearing No.52277618 and the second policy bearing No.52418796.  The premium for the second policy was Rs.15,525/- i.e., half yearly premium for the period of 15 years and the policy holder has to pay the premium only for 10 years.  Sum assured under the policy was Rs.3,32,732/-.  On 10.11.2015, the said Anasuyamma was died due to severe heart attack at the house of complainant situated at Bilisanur, Harihara Taluk, Davanagere.  After the death of her mother, the complainant has intimated the same to the OPs.  OPs have settled the policy claim bearing policy No.52277618 on 06.04.2017 but the policy bearing No.52418796 has not been settled and transfer the premium amount to the account of deceased Anasuyamma.  The complainant questioned the OPs with regard to the same and the OPs have given arrogant answer and after that the complainant wrote a letter to the OP and requested them to settle the second policy claim but, the OPs have neglected to settle the claim.  The OPs have return the premium amount and mentioned the old date 26.11.2015 in the cheque and request letter issued on 05.04.20174 which the policy was issued to Smt. Anasuyamma was died on 10.11.2015 and OPs have not paid the full and final settlement amount of the assured amount.   The cause of action for this complaint arose when the deceased Anasuyamma was paid the amount through authorized agent at Challakere, the amount has been transferred from Challakere branch, which is within the jurisdiction of this Forum and hence, prayed for allow this complaint.           

3.      After issuance of notice to the OPs, OPs appeared through Sri. B.S. Shivamurthy, Advocate and filed version.  According to the OPs, the complaint filed by the complainant is not maintainable either in law or on facts and the same is liable to be dismissed in limine.  The complainant has filed this case without having any jurisdiction.  The OPs have issued policies from Davanagere jurisdiction and hence, this Forum has no jurisdiction to entertain this complaint because the policies were issued within the jurisdiction of Davanagere District Forum.  It is further submitted that, the allegations made in para 2 to 5 are denied as false, the complainant is put to strict proof of the same.  The OP Company was in receipt of one duly filed and signed proposal form from one Ms. Anasuyamma or issuance of insurance policy on her life.  As per underwriting norms of company policy No.52277618 was issued to her on 07.07.2015.  On 01.10.2015, the officials of OP Company were in receipt of a mail the operation term regarding changes in the underwriting guidelines which will be effective from 05.10.2015.  As per the revised guidelines single name policy will be issued only if it meets the criterion mentioned in the guidelines.  Hence, policy No.53418796 was rejected and the premium paid under the policy was refunded to the life assured vide cheque No.350170 for an amount of Rs.15,525/- dated 26.11.2015 dispatched by speed post vide Pod EM865508329IN.  However since policy No.52277618 was issued prior to issuance of revised guidelines and hence, policy No.52277618 continued.  After receipt of the death claim intimation from the complainant, regarding death of life assured, the OP Company duly investigated the case and paid the death benefit under policy No.52277618 i.e., an amount of Rs.4,64,573 vide RTGS Ref. No.703310739689 and UTR No. HDFCR52017040393120676 dated 31.03.2017 from RLIC Bank A/c No.145415.  However, since policy No.53418796 was rejected since inception no amount was payable under the policy as same was never in existence at the time of death of Life assured.  Further, the allegations of the complainant as to unfair trade practice are wrong and hence denied.  The OP Company rendered all services as per terms and conditions of the subject policy and hence, there is no deficiency in service on the part of OP company and hence, no cause of action to file the present complaint.  Further this Forum does not have territorial jurisdiction to entertain this complaint as none of the cause of action arose in the jurisdiction of this Forum.  It is stated that, admittedly, the policy was issued from the branch of the OP company at Davanagere i.e., OP No.2 which comes within the jurisdiction of Davanagere District Forum.  Hence, the complaint should be dismissed for want of territorial jurisdiction and hence prayed for dismissal of the complaint.          

4.      Complainant has examined as PW-1 by filing affidavit evidence and the documents Ex.A-1 to A-6 were got marked and closed his side. On behalf of OPs, one Sri. Chinna Rangaswamy, the Sr. Territory Manager of OPs has examined as DW-1 by filing the affidavit evidence Ex.B-1 to B-5 documents have been got marked and closed their side.  

5.      Arguments of both sides heard.

6.      Now the points that arise for our consideration for decision of above complaints are that;

 

1. Whether the complainant proves that, this Forum has got territorial jurisdiction to entertain this complaint?

 

2. Whether the complainant proves that, the OPs have committed deficiency in service and unfair trade practice in settling the claim under Policy No.53418796 and entitled for the reliefs as prayed for in the complaint?

              (2) What order?

          7.      Our findings on the above points are as follows:-

                    Point No.1:- Affirmative.

                   Point No.2: Partly Affirmative.

 

                    Point No.3:- As per final order.

 

REASONS

8.      Point No.1:- It is the case of the complainant that, the mother of the complainant Smt. Anasuyamma W/o Shadaksharaiah has obtained two insurance policies from the OPs by paying requisite premium.  The term of the policies was for 15 years.  The first policy bearing No.5227618 for Rs.4,64,573/- was obtained on 30.10.2015 and second policy No.52418796 for Rs.3,32,732/- obtained on 098.11.2015.  The OP Company has accepted two policies from the said Anasuyamma.  On 10.11.2015, the said Anasuyamma was died due to severe heart attack at Bilisanuru village, Harihara taluk.  After the death of her mother, the complainant intimated the same to OP Company.  The OP Company asked to produce all the necessary documents from the complainant.  After that, the complainant has produced all the necessary documents for settlement of the claim.  OP after receiving the necessary documents from the complainant, settled the first claim under policy No.52277618 for Rs.4,64,573/- vide RTGS Ref. No.703310739689 and UTR No. HDFCR52017040393120676 dated 31.03.2017 from RLIC Bank A/c No.145415.   But the policy No.53418796 was rejected.  The OP Company have taken a main contention that, the mother of the complainant deceased Anasuyamma has obtained insurance policies from the OP No.2 within the jurisdiction of Davanagere District Forum and this Forum has no jurisdiction to entertain this complaint.  But the mother of the complainant has obtained policy from Challakere Branch office, Chitradurga.  When the deceased Anasuyamma has obtained policy through Challakere Branch, this Forum has got jurisdiction to entertain this complaint. Accordingly, Point No.1 is answered in affirmative.    

9.      Point No.2:- The deceased Anasuyamma W/o Shadaksharaiah has obtained two insurance policies from the OP company on 30.10.2015 by paying premium and after that, the OP company has issued the bond on 09.11.2015 bearing Policy No.52418796 in the name and style as Reliance Fixed Savings for half yearly mode premium of Rs.15,525/- for a term of 15 years.  The policy holder has to pay the premium only for 10 years and remaining five years, she is not due to pay the premium amount as per the terms and conditions of the policy for a sum assured amount of Rs.3,32,732/-.  The policy covered in case of natural death or accidental death.  The policy holder Smt. Anasuyamma W/o Shadaksharaiah was died on 10.11.2015 due to severe heart attack at Bilisanur village, Harihara Taluk.  After the death of the her mother, the complainant informed the same to the OP and the OP issued claim form and the complainant submitted all the relevant documents and claim form to the OP along with original policy.  On perusal of the said claim form and all the relevant documents, the OP appointed investigator for proper investigation and who submitted report.  OP has settled the policy amount under Policy No.52277618 on 31.03.2017 but policy No.53418796 has not been settled and transferred the premium amount after the death of policy holder to her account.  The complainant questioned the same, the OPs have given arrogant answer to the complainant.  As per the documents produced by the complainant, it clearly goes to show that, the mother of the complainant deceased Smt. Anasuyamma has obtained two insurance policies from the OP No.2 and in the said two policies there is nothing mentioned on record that, one person cannot obtain two policies.  But the OPs have taken a contention in the version that, one person cannot obtain two policies in his name.  In this case also, the deceased Anasuyamma has obtained two policies in her name.  The OP No.2 has received the premium amount under the second policy, such being the case, the OP cannot repudiate the claim made under the policy. 

10.    We have gone through the entire documents filed by the complainant and OPs.  The exhibits produced by the complainant i.e., Ex.A-1 to A-6 clearly shows that, the mother of the complainant has obtained two insurance policies from the OP No.2.  The OPs have settled the claim in first policy but, failed to settle the claim made by the complainant in second policy and in turn the premium amount of Rs.15,525/- collected by the OPs has been returned to the account of policy holder stating that, single person cannot obtain two policies in her name.  In this case also, the mother of the complainant has taken two policies in her name but, the OP No.2 has admitted the mother of the complainant has obtain two insurance policies.  At the time of issuing the insurance policies, the OPs never questioned the policy holder about the policy holder or never stated anywhere in their policy that, one person cannot obtain two policies and moreover, the OP No.2 has send the premium amount to the account of the mother of the complainant i.e., deceased insured person on 26.11.2015 who died on 10.11.2015.  If really the OPs have not admitted the second policy they could have send the amount before the death of policy holder.  In this case, the complainant has submitted all the documents to the OPs and intimated the death of his mother.  After the information received by the OPs, they have remitted the premium amount to the account of the policy holder.  Therefore, we come to the conclusion that, the OPs have committed deficiency in service in settling the claim made by the complainant under the policy bearing No.52418796 obtained by his mother and hence, this Point No.2 is held as partly affirmative to the complainant.          

            11.     Point No.3:- As discussed on the above points and for the reasons stated therein we pass the following:-

ORDER

            The complaint filed by the complainant U/s 12 of CP Act 1986 is partly allowed.

            It is ordered that the OPs are hereby directed to pay a sum of Rs.3,32,732/-, the sum assured amount under the policy bearing No.52418796 to the complainant along with interest @ 9% p.a from the date of collecting the premium amount from the deceases Smt. Anasuyamma till realization.

            It is further ordered that, the OPs are hereby directed to pay Rs.10,000/- towards mental agony and Rs.5,000/- towards cost of the proceedings to the complainant. 

            It is further ordered that, the OPs are hereby directed to comply the above order within 30 days from the date of this order.

             (This order is made with the consent of Member after the correction of the draft on 03/03/2018 and it is pronounced in the open Court after our signatures)

           

 

                                     

 MEMBER                                                   PRESIDENT

-:ANNEXURES:-

Witnesses examined on behalf of Complainant:

PW-1:  Complainant by way of affidavit evidence.

Witnesses examined on behalf of OP:

DW-1:  Sri. Chinna Rangaswamy, the Sr. Territory Manager of OPs by way of affidavit evidence. 

Documents marked on behalf of Complainant:

01	Ex-A-1:-	Original letter dated 06.04.2017 by the OP
02	Ex-A-2:-	Letter by the complainant to OP
03	Ex-A-3 & 4:-	Postal receipt and acknowledgement letter
04	Ex-A-5:-	Original cheque dated 26.11.2015
05	Ex-A-6:-	Original policy book

 

Documents marked on behalf of OPs:

01	Ex-B-1:-	Proposal Form
02	Ex-B-2:-	Nominee details
03	Ex-B-3:-	Pan card
04	Ex-B-4:-	Adhar card
05	Ex-B-5:-	Vernacular declaration form

 

 

 

MEMBER                                                            PRESIDENT

Rhr**