DATE OF DISPOSAL: 13.06.2024.
PER: SRI SATISH KUMAR PANIGRAHI, PRESIDENT
The factual matrix of the case is that the complainant has filed this consumer complaint Under Section 12 of the Consumer Protection Act, 1986, alleging deficiency in service against the Opposite Parties (in short the O.Ps.) and for redressal of her grievance before this Commission.
2. The complainant is the nominee of the policy holder late Smt. A.Lalita Kumari Patra, who herself was self-employed through grocery shop at her residence and the annual income being Rs.1,80,000/-. To know the policy conditions of O.Ps the complainant opted for the policy signed on the standard proposal form and deposited Rs.12,454/- towards the annual subscription for total sum assured of Rs.1,21,000/- only for term of 15 years under TATA AIA Life Insurance Money Maxima. The said proposal was done on 19.12.2014. After deposit of Rs.12,454/- the O.P.No.1 issued the first premium receipt for the like amount. The Bond paper along with policy data and schedule of benefits were received by the policy holder from O.Ps. While the matter stood thus, the policy holder had been to Gandamunda, Tarini Basti, Bhubaneswar where he was subject death on 05.02.2015 due to sudden attack of stroke. The complainant obtained the death certificate bearing Registration No. 20.02.2015 issued by the Bhubaneswar Municipal Corporation, Bhubaneswar. The complainant filed the death claim to the O.Ps claiming Rs.1,21,000/- only as per condition of policy received on 04.03.2016 and the O.P;No.1 asked the documents along with advance discharge and receipt of total payment. The O.P.No.1 instead of making payment of the assured money of Rs.1,21,000/-, communicated its letter on dated 19.03.2016 by making NEFT of Rs.12,080.64 to the account of the complainant and instructed to contact the customer care cell, Thane. The complainant contacted the Customer care cell in letter dated 06.04.2016 requesting to settle the death claim amounts. The said authority without making any such query in presence of the complainant intimated in their letter dated 27.04.2016 making negative response. The facts and contents started above specify that the O.P. received this policy amount of Rs.12,454/- with policy assured of Rs.1,21,000/- but on claim says that the policy holder was under treatment of cancer though was never for any such treatment. The verifications made if any by the O.Ps are behind the back of the complainant, hence not lawful and justified. Alleging deficiency in service on the part of the O.Ps the complainant prayed to direct the O.Ps to pay Rs.1,21,000/-, compensation of Rs.15,000/- and costs of Rs.5000/- in the best interest of justice.
3. The Commission admitted the case and issued notice to the Opposite Parties.
4. The Opposite Parties filed written version through his advocates. It is stated that the instant complaint is false, malicious and incorrect and is nothing but an abuse of the process of law and it is an attempt to waste the precious time of the Hon’ble Forum and more over the case has been filed by the complaint just to avail under advantage. On 24.12.2014 Mrs A.Lailita Kumari Patra referred to as the Deceased Life Insured or DLI was issued with policy No. C042485997 under the Tata AIA life money maxima here-in-after referred to as the policy. As per the proposal form the DLI offered to pay yearly premium of Rs.12,081/- for an sum assured Rs.1,21,000/-. The said policy was issued to DLI on based on the representations made and declarations provided by her in the proposal form on 19.12.2014. Basing on such application along with the documents supplied by the DLI the policy was accepted by the underwriting and thus the policy was issued on 24.12.2014 after receipt of required premium. On or about 04.03.2016 O.Ps received notification of death claim in respect of the said policy along with death certificate, stating that DLI had died on 05.02.2015. The Opposite Parties conducted inquiry as authorized by the DLI in the proposal and during the course of enquiry it was ascertained that the DLI committed fraud with the company as she was a patient of cancer long before the proposal and she has undergone treatment in Hemalata hospital, Chandrasekharpur, Bhubaneswar as indoor patient vide Registration No. 2013000293 and date of admission being 15.04.2013. The insured was suffering from cancer of Cervix (squamous cell carcinoma) since 16th March 2013 and has undergone chemotherapy. Conclusively after careful investigation of all facts, documents submitted and circumstances in the given case, the claim of the complainant was repudiated on suppression of material facts. Thus the O.P. found the claim to be not a valid claim and rescinded the policy from its inception and accordingly the liability was limited to refund of premium and an amount of Rs.12,080.64 was paid through NEFT to the complainant with intimation to him vide the repudiation letter dated 09.04.2016. Hence the O.P.No.1 & 2 prayed to dismiss the case.
5. On the date of hearing the advocate for complainant is present. The Commission heard argument at length. The Commission perused the complaint petition, written version, evidence on affidavit, written argument and documents available in the case record.
The case in hand attracts the principle of clean hands. Thus, one who seeks the aid of equity must come into Court with clean hands. Hence a clear inference can be drawn from the evidences that, the complainant has not approached the Commission in clean hand.
This Commission by relying upon an authority passed by Hon’ble National Commission, New Delhi in Mahipal Singh versus S.D.O. OP City/Division 2012 (1) CPR 44 such as: - “Any person, who approaches court or judicial Forum with unclean hands and conceals material facts, is not entitled to relief under law”.
In view of the principle of law on “Unclean hand” laid down in Kishore Samrite versus State of U.P. and ors reported in AIR 2012 S.C. (Supp.) 699 the Commission dismissed the present complaint. No order as to cost.
This case is disposed of accordingly.
The Judgment be uploaded on the www.confonet.nic.in for the perusal of the parties.
A certified copy of this Judgment be provided to all the parties free of cost as mandated by the Consumer Protection Act, 2019 or they may download same from the www.confonet.nic.in to treat the same as if copy of the order received from this Commission.
The file is to be consigned to the record room along with a copy of this Judgment.
Pronounced on 13.06.2024.
