State Consumer Disputes Redressal Commission
Raj Kaur vs B.M Bajaj Allianz Life Insurance ... on 23 November, 2015
CHHATTISGARH STATE
CONSUMER DISPUTES REDRESSAL COMMISSION
PANDRI, RAIPUR (C.G.)
Appeal No.FA/15/116
Instituted on : 24.03.2015
Raj Kaur, Age 48 years,
W/o Bachan Singh,
R/o : Quarter No. M/56,
Old Mines Colony, Bhatgaon Colliery,
District Surajpur (C.G.) ... Appellant
Vs.
Branch Manager,
Bajaj Allianz Life Insurance Company Limited,
Manendragarh Road, Ambedkar Chowk,
Ambikapur, District Surguja (C.G.) .... Respondent
PRESENT: -
HON'BLE JUSTICE SHRI R.S. SHARMA, PRESIDENT
HON'BLE MISS HEENA THAKKAR, MEMBER
HON'BLE SHRI D.K. PODDAR, MEMBER
HON'BLE SHRI NARENDRA GUPTA, MEMBER
COUNSEL FOR THE PARTIES :-
Shri R.K. Bhawnani, for appellant.
Shri S. Pandya, for respondent.
ORDER
Dated : /11/2015 PER: - HON'BLE JUSTICE SHRI R.S. SHARMA, PRESIDENT This appeal is directed against the order dated 22.01.2015, passed by the District Consumer Disputes Redressal Forum, Surguja, Ambikapur (C.G.) (henceforth "District Forum" for short), in Complaint Case No.C.C./2014/07. By the impugned order, learned District Forum, has partly allowed the complaint of the appellant (complainant) and directed the respondent (O.P.) to pay within a period of 45 days a sum of Rs.1,80,000/-, which is sum assured and // 2 // also pay a sum of Rs.5,000/- towards compensation for mental agony along with interest @ 6% p.a. from 09.01.2014 till realisation. The respondent (O.P.) has further been directed to pay a sum of Rs.2,000/- to the appellant (complainant) as cost of litigation in which advocate fees is also included.
2. Briefly stated, the facts of the complaint are that the husband of the appellant (complainant) Late Bachan Singh, during his lifetime on 28.03.2008 obtained insurance policy No.94533448 from the respondent (O.P.) through its agent Devendra Singh. The said insurance policy was valid for the period from 28.03.2008 to 28.03.2023 i.e. for 15 years and annual premium amount to the tune of Rs.12,000/- was being regularly paid by the insured Late Bachan Singh. During the subsistence of the insurance, on 05.06.2009, the insured Bachan Singh died, but thereafter as per terms and conditions of the insurance policy, the respondent (O.P.) is not making payment of the sum assured Rs.1,80,000/- to the appellant (complainant). The respondent (O.P.) committed deficiency in service by not making payment of the sum assured under the insurance policy to the appellant (complainant) after death of her husband Late Bachan Singh. The appellant (complainant) several time orally requested to the respondent (O.P.) for payment of the sum assured under the insurance policy and also sent notice through advocate on 10.09.2013, but the // 3 // respondent (O.P.) did not make payment of the sum assured under the insurance policy to her. Hence, the appellant (complainant) filed consumer complaint before the District Forum, and prayed for granting reliefs as mentioned in the relief clause of the complaint.
3. The respondent (O.P.) filed its written statement and averred that the departmental claim case was repudiated vide order dated 12.02.2010 and intimation regarding the same was given to the appellant (complainant) in the month of March, 2010. The appellant (complainant) was not ill during lifetime of his husband and she did not become seriously ill due to sudden death of her husband. The appellant (complainant) is taking continuously treatment since 2009 till present. After improvement in her health, the appellant (complainant) and her counsel did not make efforts in the month of September, 2013. The respondent (O.P.) repudiated the departmental claim case vide order dated 12.02.2010 on justified grounds and intimation regarding the same was given to the appellant (complainant) in the month of March, 2010, but the appellant (complainant) did not challenge the above order within prescribed period i.e. two years before the competent court and after lapse of the prescribed period, the appellant (complainant) has filed consumer complaint on false and frivolous ground, which is prima facie liable to be dismissed as time barred. The husband of the appellant (complainant) Late Bachan Singh has // 4 // suppressed the fact in the proposal form that he was suffering from high blood pressure and diabetes type -2 prior to one year from the date of making proposal for the insurance i.e. July, 2007 and his died due to serious disease. The respondent repudiated the claim of the appellant (complainant) on 12.02.2010 and intimated her regarding the same and thereafter file was closed and as per rules vide letter dated 05.12.2012 Policy and Fund Value amount of Rs.23,898/- which was deposited in the account of Late Bachan Singh, provided to the appellant (complainant) through cheque no.64864 dated 22.11.2013. The appellant (complainant) is not entitled to get any amount from the respondent (O.P.).
4. The appellant (complainant) has filed complaint against the Branch Manager, Bajaj Allianz Life Insurance Company Limited, Manendragarh Road, Ambedkar Chowk, Ambikapur, District Surguja (C.G.) (O.P.No.1) , and Earnestine Consultant Private Limited, Indira Nagar Bangalore (O.P.No.2), but vide order dated 17.11.2014, the name of the O.P.No.2 was deleted from the array of the O.P.
5. Learned District Forum, after having considered the material placed before it by the parties, has partly allowed the complaint and directed the respondent (O.P.) to pay compensation to the appellant (complainant), as mentioned in para 1 of this order.
// 5 //
6. The appellant (complainant) filed documents. The documents are Schedule issued by the respondent (O.P.), Initial Unit Statement, First Premium Receipt, Policy Deposit Renewal Premium Receipt, Death Certificate of Bachan Singh issued by Registrar (Birth & Death),, letter sent by the appellant (complainant) to Claim Review Committee, Bajaj Allianz Life Insurance Company Limited, letter dated 19.02.2010 sent by the respondent (O.P.) to the appellant (complainant), letter dated 30.08.2010 sent by the respondent (O.P.) to the appellant (complainant), copy of Medical Service Card, Report dated 09.07.2009 issued by Thyrocare Technologies Limited in respect of Smt. Raj Kaur, Complete Hemogram Report dated 09.07.2009 in respect of Smt. Raj Kaur issued by Thyrocare Technologies Limited, Report dated 25.10.2009 in respect of Smt. Raj Kaur, issued by Thyrocare Technologies Limited, Report dated 25.10.2009 in respect of Smt. Raj Kaur, issued by Thyrocare Technologies Limited, report dated 23.12.2010 in respect of Smt. Raj Kaur issued by Thyrocare Technologies Limited, Report dated 30.10.2011 in respect of Smt. Raj Kaur, issued by Thyrocare Technologies Limited, Report dated 28.12.2012 in respect of Smt. Raj Kaur issued by Thyrocare Technologies Limited, Report dated 19.02.2012 in respect of Smt. Raj Kaur issued by Thyrocare Technologies Limited, Report dated 19.02.2012 in respect of Smt. Raj Kaur, issued by Thyrocare Technologies Limited, Report dated 19.02.2012 in respect of Smt. Raj // 6 // Kaur, issued by Thyrocare Technologies Limited, Report dated 10.02.2012 in respect of Smt. Raj Kaur issued by Thyrocare Technologies Limited, treatment paper of Tata Main Hospital, Jamshedpur in respect of Smt. Raj Kaur, Discharge Summary of Tata Main Hospital, Jamshedpur in respect of Smt. Raj Kaur, legal notice dated 10.09.2013 sent by Shri Neelratan Jaiswal, Advocate on behalf of the appellant (complainant) to Bajaj Allianz Life Insurance Company Limited, Branch Office Ambikapur (C.G.) and Earnestine Consultant Private Limited, Bangalore (Karnataka), acknowledgement, the envelope which was returned back to the sender, copy of demand draft, dated 22.11.2013 for Rs.23,897/-, letter dated 05.12.2013 sent by the respondent (O.P.) to the appellant (complainant).
7. The respondent (O.P.) has also filed documents. The documents are prescription dated 21.07.2007 issued by Dr. R.N. Gupta in respect of Bachan Singh, copy of statement of Shri Devendra Singh, copy of Medical Report provided by Medical Officer Dr. Narendra Singh, Medical Certificate provided by Dr. Maheshwar Singh, Medical Officer, Medical Attendant's Certificate, Proposal Form for Life Insurance, copy of cheque No.006875 dated 12.02.2015 and receipt given by Smt. Raj Kaur.
8. Shri R.K. Bhawnani, learned counsel appearing for the appellant (complainant) has argued that the intimation regarding the death of // 7 // the insured Bachan Singh, was immediately given to the respondent (O.P.) but the respondent (O.P.) deliberately caused delay in deciding the claim of the appellant (complainant). The District Forum has directed the respondent (O.P.) to pay within 45 of the date of the order the sum assured Rs.1,80,000/- along with interest @ 6% p.a. from the date of filing of the complaint i.e. 09.01.2014 till realisation. The insured Bachan Singh died on 05.06.2009, therefore, the appellant (complainant) is entitled to get interest on the awarded amount from the date of death of the insured Bachan Singh, but the learned District Forum, has awarded interest on the awarded amount @ 6% p.a. from the date of filing of the complaint i.e. 09.01.2014 till realisation, which is on lower side. The appellant (complainant) is entitled to get interest @ 18% p.a. on the awarded amount from the date of death of the insured Bachan Singh, instead of 6% p.a., as directed by the District Forum. He further argued that learned District Forum has wrongly given direction to the respondent (O.P.) for payment of Rs.5,000/- towards compensation for mental agony, which is also on lower side and the appellant (complainant) is entitled to get a sum of Rs.1,00,000/- towards compensation for mental agony. Therefore, the impugned order passed by the District Forum, be modified and accordingly the appellant (complainant) is entitled to get interest @ 18% p.a. on the awarded amount from 05.06.2009 i.e. the date of death of the insured Bachan Singh till realisation and is also entitled to get a sum of // 8 // Rs.1,00,000/- towards compensation for mental agony instead of a sum of Rs.5,000/- as awarded by the District Forum.
9. Shri S. Pandya, learned counsel appearing for the respondent (O.P.) has argued that the appellant (complainant) is not entitled to get interest @ 18% p.a. from the date of death of the insured Bachan Singh. The interest and compensation awarded by the District Forum to the appellant (complainant) is just and proper and does not need any modification, therefore, the appeal is liable to be dismissed.
10. We have heard learned counsel for the parties and have also perused the record of the District Forum.
11. It is not disputed that the deceased Bachan Singh had taken insurance policy no.94533448 from the respondent (O.P.) and the same was effective for the period from 28.03.2008 to 28.03.2023 i.e. for 15 years. It is also not disputed that Bachan Singh had died on 05.06.2009. The respondent (O.P.) had repudiated the claim of the appellant (complainant) on the ground that the deceased was suffering from high blood pressure and diabetes type - 2 prior to one year from the date of making proposal for the insurance i.e. July, 2007. On the basis of suppression of material fact, the claim of the appellant (complainant) was repudiated by the appellant (complainant). The respondent (O.P.) repudiated the claim of the appellant (complainant) on 19.02.2010 and // 9 // sent intimation regarding the same to the appellant (complainant). The learned District Forum, awarded a sum of Rs.1,80,000/- the sum assured and also awarded a sum of Rs.5,000/- towards compensation for mental agony. In addition to it the District Forum has also awarded interest @ 6% p.a. from the date of filing of the complaint i.e. 09.01.2014 till realisation onRs.1,80,000/- .
12. Looking to the facts and circumstances of the case and the grounds taken by the respondent (O.P.) for repudiation of claim of the appellant (complainant), we find that the compensation awarded by the District Forum to the appellant (complainant) towards mental agony and allowing interest @ 6% p.a. on Rs.1,80,000/- from the date of filing of the complaint i.e. 09.01.2014 till realisaiton, is just and proper. The impugned order dated 22.01.2015, passed by the learned District Forum, does not suffer from any infirmity and illegality, hence does not call for any interference by this Commission.
13. Hence, the appeal filed by the appellant (complainant) being devoid of any merits, deserves to be and is hereby dismissed. No order as to the cost of this appeal.
(Justice R.S. Sharma) (Ms. Heena Thakkar) (D.K. Poddar) (NarendraGupta) President Member Member Member /11/2015 /11/2015 /11/2015 /11/2015