O R D E R

(By Sri D.Shankar Rao, Member)

1. The brief facts set-out in the complaint are that the complainant is the wife of policy holder Enugupatla Vittal who died in a Road accident on 24-05-2011 at Jakora Village of Varni Mandal, District Nizamabad.  During life time of Enugupatla Vittal, obtained four double accident benefit policies Nos.604248404 for sum assured Rs.2,50,000/-; 604246124 for sum assured Rs.3,00,000/-;  604233508 for sum assured Rs.2,00,000/- and 644146843 for sum assured Rs.1,00,000/- from opposite parties.  The complainant being wife & nominee of the policies, has claimed for payment of death claim.  The opposite parties have released only an amount of Rs.50,000/- in respect of the policy No.644146813 considering it as simple benefit.  The opposite party No.1 has repudiated the claim on 31-03-2012 under three policies on a ground that the deceased Enugupatla Vittal has suppressed his physical disability while executing proposal Forms.  The opposite parties 1 & 2 have considered only one claim but repudiated other claims is deficiency of service and they are also liable to pay the death claim of other three policies with interest & damages besides costs. 

2.       The opposite parties 1 & 2 have filed their counter and stated very briefly that Sri.Enugupatla Vittal during his life time has secured 4 policies from LIC of India as under:-

          The life assured Enugupatla Vittal died on 24-05-2011 in an accident.  On receipt of claim, the 4^th policy No.644146843 is settled and paid the amount of Rs.2,58,634/- to the nominee / complainant in full and final settlement.  The claim of other three policies are early as the death occurred within 3 years, accordingly inquired into bonafides.  It revealed that the life assured Enugupatla Vittal had physical deformity since his childhood and the same was suppressed at the time of proposal for policies.  Hence the opposite parties 1 & 2 have repudiated the claim of other three policies.  The opposite parties 1 & 2 have got indisputable proof that the life assured Enugupatla Vittal had deformity of his right lower limb since his childhood.  In Police final report and in PME report have clearly mentioned that the life assured Enugupatla Vittal while returning from the meeting of physically handicapped at Bodhan, was hit by APSRTC bus (No.AP-11Z-2209), sustained injuries & died on the spot.  The life assured Enugupatla Vittal had with held the material information relation to his deformity which was within his knowledge.  As such the contract between the life assured Enugupatla Vittal and the opposite parties 1 & 2 is void.  Hence the repudiation of claim of other three policies is justified. 

3.       During enquiry the complainant filed her evidence affidavit as PW1 and got marked exhibits A1 to A6 documents and closed her evidence.

          The opposite parties have filed the evidence affidavit of their Secunderabad Divisional Manager K.Madan Mohan Rao as RW1 and got marked exhibits B1 to B9 documents and closed their evidence.

4.       Heard Arguments.

5.       The points for consideration are:-

          1)  Whether there is any deficiency of Service on the part of opposite parties 1          & 2 in repudiation of the claim under three policies?

          2)  To what relief?

6.       POINT No.1 & 2: It is not in dispute that the husband of complainant Enugupatla Vittal had obtained 4 policies 1) 604248404 for sum assured Rs.2,50,000/-, 2) 604246124 for sum assured Rs.3,00,000/-, 3) 604233505 for sum assured Rs.2,00,000/- and 4) 644146843 for sum assured Rs.1,00,000/- during his life time from LIC of India.  The complainant being wife is the nominee for the 4 policies is also not in dispute.  The life assured Enugupatla Vittal died in a road accident on 24-05-2011 is also not in dispute.  Admittedly the death claim of the policy No.644146843 is settled and paid an amount of Rs.2,58,634/- to the nominee / complainant.   

          It is disputed that the life assured Enugupatla Vittal had with held material information regarding the deformity of his right lower limb since his childhood at the time of proposed for the policies. 

          In order to prove the case the complainant filed her evidence affidavit as PW1 and she relied upon exhibits A1 to A6 documents.

          The opposite parties 1 & 2 have also filed their Divisional Manager evidence affidavit of D.Madan Mohan Rao as RW1 and they relied upon exhibits B1 to B9 documents supporting to their contention. 

          Ex.A1 is the driving license of life assured Enugupatla Vittal valid from 31-01-2005 to 30-01-2025.  Ex.A2 is the claim repudiation letter dated 31-03-2012 under three policies.  Ex.A3 (B5) is the FIR No.105 of 2011 issued by Varni Police on 24-05-2011.  Ex.A4 (B7) is the inquest report dated 24-05-2011.  Ex.A5 (B6) is the post mortem examination report dated 24-05-2011.  Ex.A6 is the charge sheet dated 29-11-2011 filed by Varni Police.

          Ex.B1 is the claim payment voucher dated 17-07-2011 for the 4^th policy No.644146843 dated 28-03-2001.  Ex.B2 is the proposed form for policy No.604248404.  Ex.B3 is proposed Form for policy No.604233505.  Ex.B4 is the proposed Form for policy No.604246124.  Ex.B8 is the SSC certificate of life assured Enugupatla Vittal.  Ex.B9 is the photograph showing the life assured Enugupatla Vittal died in an accident on the spot.

          The plea taken by opposite parties 1 & 2 that the life assured Enugupatla Vittal had suppressed the material information regarding deformity of his right lower limb at the time of executing proposed forms for the policies and they repudiated the claim of other three policies as early claims.

          Admittedly the death claim of 4^th policy No.644146843 dated 28-03-2001 was settled and paid the amount as non-early claim.  Therefore the onus to prove the same by opposite parties 1 & 2.

          It is not the case of opposite parties 1 & 2 that the deformity lead to the death of life assured Enugupatla Vittal in an accident.  It is also not the case of opposite parties 1 & 2 that the life assured Enugupatla Vittal is not eligible for obtaining the policies since he had deformity from his childhood.  Only the case of opposite parties 1 & 2 is that the life assured Enugupatla Vittal knowingly had held material information regarding his deformity since his childhood.  No doubt the life assured Enugupatla Vittal had deformity of his right lower limb since his childhood as per material available on record but how far such deformity is nexus with the death of life assured on 24-05-2011 in a road accident.  The opposite parties 1 & 2 might have repudiated the death claim under three policies on a promise that the life assured Enugupatla Vittal had suppressed his deformity because they are early claims within 3 years.  If such deformity is really have nexus with the death of life assured Enugupatla Vittal in a road accident on 24-05-2011; or such deformity dis-entitles to get the policies.  The opposite parties 1 & 2 would have also repudiated the death claim of 4^th policy No.644146843 dated 28-03-2001 considering one policy claim as non-early claim and repudiation of claim under three policies as early claims is not at all a ground for repudiation unless proved as fraud and must have nexus with the cause of death of life assured.

          Therefore we are of the considered view that mere incorrect / wrong answer to questions which ultimately do not have bearing or connection with death of insured would not absolve insurer from its liability.  Insurer not justified in repudiating claim of other three policies; in the light of Hon’ble State Commission Rajasthan judgement between Shanthi Devi V/s LIC of India reported in CPJ 2006 Vol No.II SCDRC 357.

          In view of aforesaid discussions; findings and in the light of judgement stated supra, we are of the considered view that the opposite parties 1 and 2 are liable to pay the death claim of sum insured Rs.2,50,000/- plus Rs.3,00,000/- and plus Rs.2,00,000/- under the policy Nos.604248404, 604246124 and 604233505 respectively with interest and costs of the proceedings.  The complainant has not filed any evidence how she is entitled for damages. 

7.       IN THE RESULT, the complaint is allowed in part as under:-

1. The opposite parties 1 & 2 are directed to pay the death claim of sum insured Rs.2,50,000/- plus Rs.3,00,000/- and plus Rs.2,00,000/- under the policy Nos.604248404, 604246124 and 604233505 respectively with 9% interest P.A from the date of repudiation i.e. on 31-03-2012 till realisation to the complainant.

2. The opposite parties 1 and 2 are further directed to pay Rs.2,000/- to the complainant towards costs of the complaint.

          Typed to dictation, corrected and pronounced by the Member in Open Forum on this the 27^th day of November 2014.