State Consumer Disputes Redressal Commission
Life Insurance Corporation Of India,, ... vs Smt.Bontha Madhavi, W/O.Late ... on 9 February, 2010
FA `BEFORE THE A.P STATE CONSUMER DISPUTES REDRESSAL COMMISSION AT HYDERABAD. FA.No.568/2008 AGAINST C.C.No.1/2007 DISTRICT FORUM, KHAMMAM Between: 1. Life Insurance Corporation of India, Rep. by its Branch Manager, Branch Office, D.No.8-2-163, Wyra Road, Khammam. 2. Life Insurance Corporation of India, Rep. by its Divl.Manager, Divl. Office, Warangal. Appellants/ Opp.parties. And Smt.Bontha Madhavi, W/o.late B.Ramaiah R/o.Medepalli Village, Mudigonda Mandal, Khammam District. Respondent/ Complainant Counsel for the Appellants:Mr.Srinivasa Karra Counsel for the Respondent:M/s Sreenivasa Rao. QUORUM: THE HONBLE JUSTICE SRI D.APPA RAO, PRESIDENT. SMT.M.SHREESHA, MEMBER
& SRI K.SATYANAND, MEMBER .
TUESDAY, THE NINTH DAY OF FEBRUARY, TWO THOUSAND TEN (Typed to the dictation of Sri K.Satyanand,Honble Member) *** This is an appeal filed by the opposite parties, insurance company, assailing the order of the District Forum.
The facts of the case are briefly as follows:
The complainant is the wife of the insured, Bontha Ramaiah, who worked as Senior Assistant in U.P.S.Yerragadda, M.P.Tirumalayapalem, Khammam District and died on 5-10-2005 while in service and during his life time obtained a policy bearing No.681765054 for an assured sum of Rs.25,000/- on 14-6-1999 with maturity date being 15-6-2014. The insured also obtained another policy bearing No.686615098 for an assured sum of Rs.1,00,000/- on 13-12-2004 from opposite party No.1 and died on 5-10-2005. After the death of the insured, the complainant preferred a claim along with the relevant documents and the opposite parties postponed the settlement of the claim and on 18-3-2006 sent a letter stating that the insured committed suicide within one year from the date of the policy and that the policy became null and void and therefore repudiated the policy bearing No.686615098.
It is the case of the complainant that the death of the insured was normal and that the insurance company have settled one claim and repudiated the other and submitted that there was no criminal case registered about the alleged committing of suicide and no postmortem done.
She, therefore, got issued a legal notice on 28-11-2006 demanding the opposite parties to settle the claim under policy No. 686615098 and though they received the notice, they failed to pay the amount. Hence the complaint for a direction to the opposite parties to pay Rs.1,00,000/- towards the claim under policy No. 686615098 together with damages of Rs.50,000/-.
Opposite parties filed written statement admitting that the insured had taken a policy under Jeevan Anand with a premium of Rs.483/- per month for a period of 20 years from opposite party No.1 on 13-12-2004 for Rs.1,00,000/- and that they received premiums upto August, 2005 and the insured died within one year of the commencement of the policy. The complainant, who was the nominee made a claim for payment of the amount due under the policy and therefore they conducted an enquiry and it came to light that the insured died on 5-10-2005 and it was a suicide by consuming pesticide Endosulphan at 10.30 p.m. on 4-10-2005 at his residence. After getting discharged from Kinnera Super Speciality Hospital, Khammam where he was initially treated for better treatment at a higher center vide out patient card No.86585 dated 5-10-2005 he was admitted at Kinnera Super Speciality hospital. The treatment did not save him. Hence they repudiated the claim as per clause 6 of the conditions and privileges of the policy and prayed for dismissal of the complaint.
In support of her claim, the complainant relied upon documents marked as Exs.A1 to A9 and on the other hand, the opposite parties relied on Exs.B1 to B4.
On a consideration of the evidence adduced on either side, the District Forum came to the conclusion that there was no evidence filed by the opposite parties to show that the insured committed suicide and accordingly allowed the complaint directing the opposite parties to pay Rs.1,00,000/- covered under policy bearing No. 686615098 with interest at 9% p.a. from the date of death of the insured i.e. 5-10-2005 till the date of realization together with costs of Rs.2,000/-.
Aggrieved by the said order, the insurance company filed the present appeal insisting, as its ground, that the District Forum erred in granting relief in spite of the evidence adduced by it that the death was not natural and on the other hand it was a case of suicide.
Heard both sides.
The points that arise for consideration are:
1) whether the insurance company was justified in repudiating the claim of the complainant that her husband committed suicide and the death was therefore not natural.
2) Whether there are any good grounds to interfere with the order of the District Forum?
This is a peculiar case in which the insurance company repudiated the claim branding the death of the insured as suicide relying upon Ex.B4, the alleged medical transcripts of a hospital that allegedly treated the insured on the eve of his death. The insurance company relied upon a stray reference to the suspected consumption of poison by the insured mentioned in Ex.B4. It is pertinent to point out that the said reference to poisoning found in Ex.B4 was ascribed to the information given by the complainant herself and there is absolutely no evidence authenticating such statement attributed to the complainant by examining the author of the said Ex.B4. On the other hand in the claim put forth by the complainant marked as Ex.B3, the complainant clearly stated that her husband died of heart attack. While the version attributed to the complainant in Ex.B3 is first hand, the version found in Ex.B4 attributed to the complainant is clearly second hand and in any view of the matter, it was not corroborated by the affidavit by the person who authored Ex.B4. The District Forum rightly taken the same view thus the repudiation urged by the insurance company has no strength. In other words, the repudiation is not justified as rightly held by the District Forum.
As we do not see any flaw in the order of the District Forum, there is absolutely no occasion to interfere with the order under appeal. Accordingly the appeal is dismissed with costs of Rs.1,000/-. The appellants shall comply with the order of the District Forum as also the order of this Commission within six weeks from the date of receipt of this order.
Sd/-PRESIDENT.
Sd/-MEMBER.
Sd/-MEMBER.
Dt.09-2-2010