State Consumer Disputes Redressal Commission
The Divisional Manager Lic Opf India. vs Smt. Baby Bai Surna. on 28 July, 2022
Daily Order BEFORE THE KARNATAKA STATE CONSUMER DISPUTES REDRESSAL COMMISSION, BANGALORE DATED THIS THE 28TH DAY OF JULY 2022 PRESENT SRI. RAVI SHANKAR : JUDICIAL MEMBER SMT. SUNITA C. BAGEWADI : MEMBER Appeal Nos. 910 & 911 of 2015 1. The Divisional Manager LIC Of India, Divisional Office P.B. No.43, Jeevan Prakash Station Road, Raichur-584120. 2. The Branch Manager LIC Of India Branch Office No. 63, Koganti Complex, Kottal Road, Kampli Hospet Tq., Bellary District. Both are Rep. by Authorized Representative Sri. K. Bheemasena Rao, Manager (Legal& HPF) LIC Of India, Divisional Office No.1, J.C. Road, Bangalore-02. Appellants are common in both cases. (By Sri. Rohith B.J.) V/s ....Appellants Smt. Baby Bai Surna, W/o. Mangilal Surana Aged 65 years, R/o. Near SVN School Opp Chandrakala Talkies, Sathyanarayanpet,Kampli-583132. Hospet Tq Bellary District. Respondent is common in both cases. (By Sri. Sam George) .....Respondent O R D E R
BY SRI RAVISHANKAR, JUDICIAL MEMBER As the facts involved and parties to these appeals are one and the same they are clubbed together for the purpose of common order.
The appellant/OP before District Consumer Disputes Redressal Forum, Bellary in C.C.Nos.178/2014 and 177/2014 respectively preferred these appeals against the order dated 07.08.2015 in which District Commission directed the appellant/ OP to pay assured amount of Rs.5.00 lakhs in C.C.No.177/2014 and Rs.2.00 lakhs in C.C.No.178/2014 along with other directions and submits that the complainant filed complaint before District Commission alleging deficiency in service in not settling the claim towards death of the assured and after issuance of notice this appellant appeared before the District Commission and contended that policy holder/ insured died on 26.07.2013 at Haveri when he had been to attend natural call and slipped and fell down which caused severe injuries and succumbed to death. After that complainants haven given police complaint where it was mentioned that said insured was a person of unsound mind and unable to control himself due to which he fell down and succumbed to injuries. Basing on that they repudiated the claim for the reason of suppression of material facts, but, the District Commission without considering the said contention have allowed the complaint and directed them to pay above said amounts to the complainants against which they preferred these appeals and prays for setting aside of the impugned order.
Heard from both parties.
On going through the orders passed in C.C.Nos.178/2014 and 177/2014 it is noticed that OPs have issued two policies i.e., in C.C.No.178/2014 issued policy bearing No.665334817 dated 15.07.2010 for an assured amount of Rs.2.00 lakhs and premium payable is Rs.16,645/- per year. In C.C.No.177/2014 OP has issued a policy bearing No.665335087 dated 25.08.2010 for an assured amount of Rs.5.00 lakhs and amount of premium payable is Rs.40,863/- per year. Such being the case on 26.07.2013 the son of the complainant i.e., insured at Haveri when he had been to attend natural call and slipped down which caused severe head injuries and succumbed to injuries. After receiving the information complainant and family members rushed to Haveri and registered police complaint under UDR No. 16/2013 and police have taken statements in Kannada language which the complainant and her family members have no knowledge about writing and reading of kannada. There afterwards, being beneficiary to the policies complainant claimed assured amount, but, OP repudiated the claim basing on the statement found in the police complaint No. UDR No.16/2013 where it was mentioned that said deceased was person of unsound mind against which they preferred complaints.
We noticed here that OPs have repudiated the claim merely basing on the statement in UDR No.16/2013. Except the statement the OPs have not produced any document to show that deceased/ insured was of unsound mind prior to taking policies. They have not produced any materials before the District Commission to establish that the insured was suffering unsoundness. We observed here that the deceased / insured had obtained policy way back in the year 2010, whereas he died on 26.07.2013 after lapse of three years. The OP cannot contend that deceased had unsoundness prior to taking of policies. In is only a presumption by OP basing on the statement given in UDR No.16/2013. Mere presumption of facts cannot be a ground for repudiation of the genuine claim and the OP failed to establish that insured had unsoundness prior to taking of policies. The order passed by the District Commission is in accordance with law and we found there is no irregularity in the order passed by the District Commission. As such appeal also fails and accordingly, appeal is dismissed.
Amount in deposit is directed to be transmitted to the District Commission for disbursement to respondent/complainant.
Keep the original of this order in Appeal No.910/2015 and copy thereon in connected file.
MEMBER JUDICIAL MEMBER CV*