The complainant Udha Devi alias Usha Devi   has filed this complaint petition against Managing Director, PNB Met Life  Insurance company Ltd. 5 Vani Vilash Road, Basavangudi Banglore  and one  another (o.ps) for realization of Rs. 9,10,000/- for policy  21494215, against Rs. 9,10,000/- for policy No-21484320 (sum assured),  Rs. 51,000/- for mental agony and and physical harassment and Rs. 30,000/- as litigation cost. with 18 % p.a. interest since date of death of life assured  till date of final payment on the total sought amount.

The, brief, facts of the case is that complainant Udha Devi allies Usha Devi is nominee and  wife of L.A. person namely  Late- Bhola Ray. The further allegation is that the Husband of the complainant purchased two policies bearing Nos.- 21494215 and 21484320 for total sum assured amount of Rs. 18,20,000/- and paid  the premium amount against the policies. The further case is that the entire  proposal form were filledup by company’s agent in presence  of company’s  official and the L.A. Bhola Ray only put his  signature whereas the agent  and company official told him to do so in good faith  and trusting upon agent’s and company official knowledge and technicality about insurance policy. The further case is that after accepting the premium of above policies, the o.p company issued  premium receipts and bonds in the name of  L.A. person namely Bhola Ray and the companies supported  risk coverage  of life of Bhola Ray from 12-02-2015 against policy  No.- 21494215 and from 28-01-2015 against policy, No-21484320 respectively. The further case is that on               15-06-2015, Bhola Ray was going to met his  friend at Repura under Muzaffarpur District after getting down from the  Bus at Markon Chowk. As soon as he moved 200 m forward on N.H. from the Markan Chowk under vill-Repura P.S- Sakara District-Muzaffarpur at about 1:10 PM, Driver of the Motor cycle bearing registration No.- BR06AA-4240  came rashly and negligently by motorcycle from Muzaffapur site and dashed Bhola Ray from the back side.  Consequently,  Bhola Ray felll down on the road and fainted. He was brought before Dr Suman Kr. at Muzaffarpur for his treatment  who after doing some treatment declared that there is  Brain hemorrhage  and the patient needs brain surgery, so he referred   Bhola Ray PMCH Patna but unfortunately on the way to  PMCH Patna, Bhola Ray died. The further case is that for the occurrence, Sakara P.S. Case No.-271/2015 was lodged and after investigation police submitted charge sheet. Thereafter, the complainant filed death claim against the above policies before the insurance company with all relevant documents, but in spite of several demand and persistent request, the company repudiated the claim of the complainant on the ground that L.A. had consulted  a Dr. on 01-07-2013 for the treatment of tuberculosis  and also taken the policy of 66 lacks  before the assigned proposal form about which L.A. didn’t disclose to the company.

The complainant has filed the following documents with the complaint petition - photocopies of   first premium receipts  annexure-1&2, photocopy of death certificate of Bhola Ray -annexure- 3, photocopy of FIR of Sakara P.S. Case No. 271/2015 annexure-4-, photocopy  of  charge sheet of Sakara P.S. Case No. 271/2015 annexure-5-, photocopy of  prescription report of Dr. A.K.Suman in respect of Bhola Rai -annexure-6-, photocopy  of  certificate regarding death of Late Bhola Rai granted by Mukhiya of village Panchayat Raj Bhagwanpur Ratti. annexure-7-, photocopy of letter Death Certificate of  Late Bholat Rai granted by Aangan Bari Sevika of Bhagwanpur Ratti -annexure-8. photocopy of  I.T. return  of Bhola Ray for the year 2013-2014 & 2014-2015 annexure-9, photocopy of PAN card of Bhola Rai annexure-10, photocopy of   Death certificate of Late Bhola Rai granted by Sarpanch, gram Kachahari Bhagwanpur Ratti. annexure-11, photocopy of Death certificate of Late Bhola Rai granted by Member Ward No.-2  Panchayat raj Samiti Bhagawanpur Ratti annexure-12, photocopy of  death certificate of Late Bhola Rai granted by  Member of Panchayat  of Bhagawanpur ratti annexure-14, photocopy of repudiation letters annexure-15

On issuance of notices o.p  appeared but not filed their w.s. so they have been debarred from  filing w.s.   vide order dated 11-01-2019.

On behalf of complainant  AW-1 Udha Devi alias Usha Devi has been examined on affidavit.

No evidence either oral or documentary has been adduced on behalf of o.ps.

No argument has been advanced on behalf of o.p though three opportunities have been provided him to argue the case.

The complainant has filed repudiation letter as annexure-14 -15 which goes to show that the policies of Late Bhola Ray have been repudiated on the  ground that he was suffering from T.B. prior to issuance of policy and he has not disclosed the material facts that D.L.A was suffering from T.B. prior to the issuance of policy. The burden of proof to prove the above fact  is on o.ps who repudiated the claim on the above ground but no evidence has been adduced on their behalf to prove the above facts. On the other hand, the complainant has examined herself  as AW-1, and she has stated the facts of the case in her deposition. She has denied  in her deposition filed on affidavit that her husband neither suffered from T.B. nor consulted any Dr. for the treatment of  T.B.. She has also proved the annexure filed on her behalf as exhibit- 1 to 15 in her deposition. In the repudiation letter, filing of claim petition has been admitted. The complainant has filed photocopy of premium receipts as annexure1 & 2. She has also filed photocopy of death certificate as annexures- 3,7,8,11,12 and 13 to prove the death of her husband. She has also filed the photocopy of FIR of Sakara P.S. Case No.- 271/2015 and charge-sheet of the above P.S. Case as annexure-4 & 5 to prove her allegations

On the basis of above discussion we are of the opinion that the complainant  has been  able to established her case and the o.p companies have wrongly  repudiated the claim of the complainant and as such  there is deficiency in service of part of o.ps.

Accordingly, complaint petition is allowed and the o.ps are directed to pay Rs. 18,20,000/-   for policy Nos- 21494215 & 21484320 ( sum assured) to the complainant with 7 %  p.a. interest   from the date of  death of D.L.A.  i.e  15-06-2015 sRs. 20,000/- as mental agony and physical harassment and Rs. 10,000/- as litigation cost within two months  from the receipt of the copy of the order, on failure they shall be responsible for payment of aforesaid amount with 9 % interest p.a. till realization. Let a copy of this order be furnished to both the parties as per rule.