Legal Document View

Unlock Advanced Research with PRISMAI

- Know your Kanoon - Doc Gen Hub - Counter Argument - Case Predict AI - Talk with IK Doc - ...
Upgrade to Premium
[Cites 10, Cited by 0]

State Consumer Disputes Redressal Commission

Smt. Phooleshwari Dhekwar vs Icici Prudential Life Insurance Co.Ltd ... on 3 December, 2014

                CHHATTISGARH STATE
       CONSUMER DISPUTES REDRESSAL COMMISSION,
                 PANDRI, RAIPUR (C.G.)

                                          Complaint Case No.CC/14/01
                                             Instituted on : 11.02.2014

Smt. Phooleshwari Dhekwar,
W/o Shri Sewak Ram Dhekwar,
D/o : Late Shri Ramji Lilhare,
Permanent Address : Ward No.7, Village - Pauni,
Post - Karamsara, District Balaghat (M.P.),
Present address : C/o Kushal Tyres, G.E. Road,
Tatibandh, Raipur (C.G.).                            ...   Complainant.

    Vs.

1. I.C.I.C.I. Prudential Life Insurance Co. Ltd.,
Through : Manager / Competent Officer,
I.C.I.C.I. Prudential Towers,
1089, Appasaheb Marathe Marg, Prabha Devi,
Mumbai - 400025

2. I.C.I.C.I. Prudential Life Insurance Co. Ltd.,
Through - Manager / Competent Officer,
Jain Tower, Second Floor, Napier Town, Rassal Chowk,
Jabalpur (C.G.).

3. I.C.I.C.I. Prudential Life Insurance Co. Ltd.,
Through : Manager / Competent Officer,
S. Global Complex, Telibandha,
Raipur (C.G.)
                                                    ... Opposite Parties
PRESENT: -

HON'BLE SHRI JUSTICE R.S. SHARMA, PRESIDENT
HON'BLE MS. HEENA THAKKAR, MEMBER
HON'BLE SHRI D.K. PODDAR, MEMBER

COUNSEL FOR THE PARTIES:

Shri Rajesh Pandey, for the complainant.
Shri Alok Saraswat, for the opposite parties.
                                    // 2 //


                                 ORDER

Dated : 03/12/2014 PER :- HON'BLE SHRI JUSTICE R.S. SHARMA, PRESIDENT. The complainant filed this consumer complaint under Section 17 of the Consumer Protection Act, 1986 against the OPs seeking relief as under :-

(i). To direct the OPs to pay remaining sum assured amount under the insurance policies i.e. Rs.22,25,300/- along with other benefits along with interest @ 12% p.a.
(ii). To direct the OPs to pay a sum of Rs.2,00,000/- to the complainant towards compensation for deficiency in service, professional mis-conduct.
(iii). To direct the OPs to pay a sum of Rs.2,00,000/- to the complainant towards compensation for deficiency in service, professional and mental agony suffered by her.
(iv). To direct the OPs to pay a sum of Rs.50,000/- towards cost of litigation and other miscellaneous expenditure.

Any other relief which deem fit and reasonable in the facts and circumstances of the case.

2. Brief facts of the complaint are that : the complainant is daughter of Late Shri Ramji Lilhare. Shri Ramji Lalhare was having good health. During his life time, he purchased six different insurance // 3 // policies from the OPs between 13.03.2011 to 30.03.2012. He purchased ICICI Pru Guaranteed Savings Insurance Policy No.1529077 dated 13.03.2011 for the period from 13.03.2011 to 13.03.2026 and its annual premium was Rs.50,000/- and the sum assured was Rs.3,50,000/-. He again purchased I.C.I.C.I. Pru Whole Life Policy No.15280420 dated 29.03.2011 for the period from 29.03.2011 to 29.03.2020 and its annual premium was Rs.49,735/- and the sum assured was Rs.3,15,000/-. He also purchased ICICI Pru Guarantee Savings Insurance Policy No.15600628 dated 07.06.2011, for the period from 07.06.2011 to 07.06.2017 and its annual premium was Rs.29,500/- and the sum assured was Rs.2,06,500/-. He also purchased ICICI Pru Guaranteed Savings Insurance Policy No.15742093 dated 26.07.2011, for the period from 26.07.2011 to 26.07.2026 and its annual premium was Rs.98,400/- and the sum assured was Rs.6,88,800/-. He purchased ICI Pru Life Stage Wealth II Unit Link Insurance Product Policy No.15870047 dated 26.08.2011, for the period from 26.08.2011 to 26.08.2021 and its annual premium was Rs.1,00,000/- and the sum assured was Rs.7,00,000/-. He also purchased ICICI Pru Pinnacle Super - LP Insurance Policy NO.16497438, for the period from 30.03.2012 to 30.03.2022 and its annual premium was Rs.50,000/- and the sum assured was Rs.5,00,000/-. The insured Shri Ramji Lilhare nominated the complainant as his nominee in all the above insurance policies. Shri Ramji Lilhare purchased the above insurance policies during his life // 4 // time and at that time his health was good and after his health check up, and after satisfaction of the doctor, the above insurance policies were issued by the OPs. Shri Ramji Lilhare, had duly renewed the above insurance policies and he paid a total sum of Rs.7,10,000/- as premium of the aforesaid insurance policies to the OPs. In the month of November, 2013 , all of a sudden the life assured Shri Ramji Lal fell ill and died on 07.11.2012. After the death of the life assured, the complainant submitted claim form in respect of all the insurance policies before the OPs in the month of December, 2012 along with all relevant documents i.e. original policy document, title deed (LokfeRo izek.k i=), death certificate and other documents. After submitting claim form, the complainant contacted the OPs several times for settlement of her claim at the earliest, but the OPs did not settle the claim. The OPs continuously gave assurance that her genuine claim will be settled at the earliest. In the meantime, the time was passing. Period of two years has lapsed but the OPs continued to keep pending the claim of the complainant unnecessarily. Vide letter dated 05.01.2013 the OPs intimated the complainant that the claim in respect of Policy No.15209077 has been accepted and the amount of Rs.1,07,863.62 will be deposited within 6 days in the account of the complainant. Vide letter dated 23.02.2013 the OPs repudiated the claim of the complainant in respect of insurance policy no.15870047 on imaginary ground that at the time of obtaining insurance policy the // 5 // father of the complainant had suppressed material facts. After repudiation of her claim the complainant again requested the Ops to reconsider their claim by which her claim of repudiated reply to the OPs sent letter dated 11.07.2013 to the complainant and acknowledged the representation in respect of policy No.15870047 and 16497438. The OPs sent letter dated 23.07.2013 and informed that no amount is payable in respect of her claim against policy no.15870047 and 15280420 and intimated for payment of sum of Rs.1,75,247/- towards ex-gratia payment. For sum assured under the six insurance policies i.e. Rs.27,60,300/- the father of the complainant paid a sum of Rs.7,10,000/- to OPs as premium, but till today the OPs have paid only a sum of Rs.5,35,000/- to the complainant and have not paid the remaining sum assured Rs.22,15,300/- and other benefit till today and thus committed deficiency in service and professional misconduct. Hence this complaint.

3. The OPs filed their written statement and pleaded that the complaint is false, frivolous, and vexatious and abuse of the process of this Commission and therefore the same is liable to be dismissed under Section 26 of the Consumer Protection Act, 1986. The complainant has not disclosed any cause of action to proceedings against the OPs. The present dispute is not a consumer dispute and is not maintainable. The policy forming the subject matter of the complaint is void-ab-initio, invalid, unoperative and unenforceable in law and therefore, the // 6 // complaint is liable to be dismissed. The OPs further pleaded that the policy holder did not disclose all material fact relating to his health at the time of purchasing the insurance policies. After death of the policy holder, on careful examination of the medical records, it was revealed that the life assured was hospitalized on July 18, 2012 and was diagnosed of "Myocardial Infraction with Hypertension" and was under treatment for the same. It is noted that the Life Assured was diagnosed case of "Left Hemiplegia", but the Life Assured did not disclosed the above facts in the proposal form and he suppressed material facts. Proposal forms were sent to the OPs by the policy holder and he never gave any information that details given in the proposal form are incorrect in any aspect. The life assured had not disclosed the true facts regarding his medical history, therefore, the complainant is not entitled to get any amount on the basis of insurance policies and complaint is liable to be dismissed.

4. On the basis of averments of both the parties, the points for determination are :-

1. Whether the complainant is consumer ?
2. Whether the policy holder Shri Ramji Lilhare suppressed material facts regarding his health and after suppressing material facts he obtained insurance policies ?

// 7 //

3. Whether the complainant is entitled to get the reliefs as mentioned in the relief clause of the complaint ?

5. Shri Rajesh Pandey, learned counsel appearing for the complainant argued that the deceased Shri Ramji Lilhare had purchased the insurance policies from the OPs and premium and the OPs were under obligation to give the insured amount on maturity to the insured or his nominee, therefore, the OPs failed to discharge their duty and committed deficiency in service. The complainant is a consumer and OPs is service provider. The life assured was having good health at the time of purchasing insurance policies. He never suppressed any material fact regarding his health. In reply to the question that Have you ever undergone or been advised any tests or investigations in last 5 years the life assured replied in negative (No). According to the OPs, Shri Ramji Lilhare fell ill in the month of February, 2002. The OPs have not filed any document to show that the life assured Shri Ramji Lilhare was ill or suffering from the diseases as mentioned in the personal of life assured 5 years before obtaining insurance policies. According to the OPs, the medical report of Shri Ramji Lilhare was of the year 2002 i.e. near about 9 years prior to the date of purchase of the insurance policies which is not relevant, therefore, it cannot be said that deceased Shri Ramji Lilhare has suppressed material fact regarding his health, hence the denial by the OPs to given benefit under the insurance policies is not justified.

// 8 //

6. Shri Alok Saraswat, learned counsel appearing for the OPs has argued that the complainant is not a consumer and dispute is not a consumer dispute. The complainant has not disclosed any cause of action to proceedings against the OPs. The present dispute is not a consumer dispute and is not maintainable. The policy forming the subject matter of the complaint is void-ab-initio, invalid, unoperative and unenforceable in law and therefore, the complaint is liable to be dismissed. He further argued that the policy holder did not disclose all material fact relating to his health at the time of purchasing the insurance policies. After death of the policy holder, on careful examination of the medical records, it was revealed that the life assured was hospitalized on July 18, 2012 and was diagnosed of "Myocardial Infraction with Hypertension" and was under treatment for the same. It is noted that the Life Assured was diagnosed case of "Left Hemiplegia", but the Life Assured did not disclose the above facts in the proposal form and he suppressed material facts. Proposal forms were sent to the OPs by the policy holder and he never gave any information that details given in the proposal form are incorrect in any aspect. The life assured had not disclosed the true facts regarding his medical history, therefore, the complainant is not entitled to get any amount on the basis of insurance policies and complaint is liable to be dismissed.

// 9 //

7. The complainant filed document. Document Annexure - 1 is copy of policy No.15209077, Annexure - 2 is copy of policy no.15280420, Annexure 3 is copy of policy No.15600628, Annexure - 4 is copy of policy No.15742093, Annexure 5 is copy of policy No.15870047, Annexure 6 is policy no.16497438, Annexure 7 is death certificate, Annexure 8 is letter dated 05.01.2013 sent by the OPs to the complainant , Annexure 9 is letter dated 23.02.2013 sent by the OPs to the complainant, Annexure 10 is letter dated 11.07.2013 sent by the OPs to the complainant, Annexure 11 letter dated 23.07.2013 sent by the OPs to the complainant, Annexure 12 is letter dated 11.07.2013 sent by the OPs to the complainant, Annexure 13 is premium deposit receipt, Annexure 14 is application sent by the complainant to the Operation Head, Death Claim Department, Jabalpur, Annexure 15 is account statement of the complainant, Annexure 16 is account statement of Shri Sevakram Dhekwar, Annexure 17 is original letter dated 03.04.2014 sent by the OPs to the complainant, Annexure 18 is Discharge Voucher, Annexure 19 is Account Statement.

8. The OPs have also filed documents. Annexure R-1 are proposal form of the insurance, Annexure R-2 is prescription slip issued by Shri Sai Kripa Chaturmohta Hospital, Balaghat (M.P.). etc., Annexure R-3 is letter dated February 22, 2013 sent by the OPs to the complainant, Annexure R-4 is letter dated February 23, 2013 sent by the OPs to the complainant, Annexure R-5 is letter dated February 23, 2013 sent by // 10 // the OPs to the complainant, Annexure 6 is letter dated September 2, 2013.

Discussions and its conclusion :-

Point No.1. Whether the complainant is consumer ?

9. Firstly we shall consider whether the complainant is a consumer ?

10. Section 2(1)(d) of the Consumer Protection Act, 1986 runs thus :-

"(d) "consumer" means any person who,-
(i) buys any goods for a consideration which has been paid or promised or partly paid and partly promised, or under any system of deferred payment and includes any user of such goods other than the person who buys such goods for consideration paid or promised or partly paid or partly promised, or under any system of deferred payment, when such use is made with the approval of such person, but does not include a person who obtains such goods for resale or for any commercial purpose; or
(ii) [hires or avails of] any services for a consideration which has been paid or promised or partly paid and partly promised, or under any system of deferred payment and includes any beneficiary of such services other than the person who [hires or avails of] the services for consideration paid or promised, or partly paid and partly promised, or under any system of deferred payment, when such services are availed of with the approval of the first mentioned person [but does not include a person who avails of such services for any commercial purpose];"

Explanation:- For the purposes of this clause, "commercial purpose" does not include use by a person of goods bought and used by him and services availed by him exclusively for the purposes of earning his livelihood by means of self-employment;"

11. Section 2(1)(o) of the Consumer Protection Act, 1986 runs thus :-

// 11 // "(o) " "service" means service of any description which is made available to potential [users and includes, but not limited to the, provision of] facilities in connection with banking, financing insurance, transport, processing, supply of electrical or other energy, board or lodging or both, [housing construction,] entertainment, amusement or the purveying of news or other information, but does not include the rendering of any service free of charge or under a contract of personal service;"

12. In the instant case, Shri Ramji Lilhare, the father of the complainant obtained insurance policies from the OPs and paid premium thereof. The contract of insurance is contract of indemnity and therefore, obtaining insurance policy is not covered within purview of commercial transaction and insurance policy is for indemnifying the loss and insured who takes insurance policy cannot carry on any commercial activity with regard to the insurance policy taken by him.

13. In The Divisional Manager, L.I.C. vs. Shri Bhavanam Srinivas Reddy, 1991 (2) CPR 144 (NC), Hon'ble National Commission, observed thus :-

"3. The first point of objection raised by the Insurance Company before the State Commission and reiterated before us namely is that no dispute arising out of a contract of insurance can be made subject matter of adjudication under the Consumer Protection Act. This contention cannot be sustained in view of decision of this Commission dated July 28, 1989 in Shri Umedilal Aggarwal v. United India Assurance Company Ltd., F.A. Nos.3 and 4 of 1989 (Reported in I // 12 // (1991) CPJ-3, 1991 (1) CPR 217 (NC), wherein we have held as follows :-
"We find no merit in the contention put forward by the insurance company that a complaint relating to the failure on the part of the insurer to settle the claim of the insured within a reasonable time and the prayer for the grant of compensation in respect of such delay will not fall within the jurisdiction of the Redressal Forums constituted under the Consumer Protection Act. The provision of facilities in connection with insurance has been specifically included within the scope of the express 'service' by the definition of the said word contained in Section 2(i)(o) of the Act. Our attention was invited by Mr. Malhotra, learned counsel for the Insurance Company to the decision of the Queen's Bench in National Transit Insurance Company Ltd. vs. Customs and Central Excise Commissioner, (1975) (1) all England Reports Page 303) The observations contained in the said judgment relating to the scope of the expression 'insurance' occurring the schedule of the enactment referred to therein are of no assistance at all to us in this case because the context in which the expression is used in the English enactment considered in the case is entirely different. Having regard to the philosophy of the Consumer Protection Act and its avowed object of providing cheap and speedy redressal to consumers affected by the failure on the part of persons providing "service" for a consideration, we do not find it possible to hold that the settlement of insurance claims will not be covered by the expression "insurance" occurring in Section 2(1)(d). Whenever there is a default or negligence in regard to such settlement of an insurance claim that will constitute a 'deficiency' in the service on the part of the Insurance company and it will be perfectly open to the concerned aggrieved // 13 // consumer to approach the Redressal Forums under the Act seeking appropriate relief. We, accordingly over the objection raised by the Insurance Company regarding the jurisdiction of the State Commission to adjudicate upon the complaint.

14. In The Divisional Manager, L.I.C. vs. Uma Devi, 1991 (1) CPR 662 (NC), Hon'ble National Commission, observed thus :-

"8. The very fact that the Insurance Act provides for a machinery for remedy for grievances arising out of repudiation of a claim under section 45 leads to show that the Corporation has to satisfy a Court that the repudiation was justified. Accordingly, it is for the consumer to choose a forum convenient to him to seek remedy for the loss suffered because of deficiency in service. As the provisions of this Act are in addition to and not in derogation of any other law for the time being in force, the State Commission has the jurisdiction to entertain the complaint and to investigate whether the repudiation was justified or not and to grant such relief as deems fit if it is satisfied that there was deficiency in service. We therefore, cannot uphold this contention in view of the decision of this Commission in Revision Petition No.12 of 1990 (New India Assurance Co. Ltd. v. Vipro Electronics Pvt. Ltd., 1991 (1) C.P.R. (NC) 531, where the identical point has been elaborately discussed".

15. In The New India Assurance Co. Ltd. vs. M/s Vipro Electronics Pvt. Ltd., 1991 (1) C.P.R. (N.C.) 531, the Hon'ble National Commission, observed thus :

"We are not impressed with the contention raised by Shri S.K. Paul, learned counsel appearing on behalf of the Petitioner that merely because of Insurer had totally repudiated his liability in respect of the claim, no proceedings could be validly initiated under the Consumer // 14 // Protection Act by the insurer. This contention squarely falls within the ruling given by this Commission in Ummedilal Agrawal v. United India Assurance Co. Ltd. (O.P.No.3 & 4 of 1989, decided on 28.7.1989". In that decision this Commission has observed that it is not possible to hold that settlement of a disputed insurance claim will not be covered by the expression "service" occurring in Section 2(d) of the Act. It was laid down that whenever there is default or negligence in regard to service that will constitute "deficiency in service" on the part of the insurer and it is perfectly open to the aggrieved party for seeking appropriate relief under the Act.
In the result, the Revision Petition has no merits and it is accordingly dismissed".

16. In M/s. Harsolia Motors vs. M/s. National Insurance Co. Ltd. & Ors. 2005 (1) CPR 1 (NC), Hon'ble National Commission, has observed thus :-

"13. In Halabury's Laws of England Vol. 25, 4th Edition, the origin and common principles of insurance is discussed and in paragraph 3 it has been discussed and in paragraph 3 it has been mentioned that it is based on principle of indemnity. Thereafter, relevant discussion is to the effect that most of contract of insurance belong to general category of contracts of indemnity. In the sense that insurers' liability is limited to the actual loss which is , in fact, proved. The contract is one of indemnity and, therefore, insured can recover the actual amount of loss and no more.
14. In this view of the matter, taking of the insurance policy is for protection of the interest of the assured in the articles or goods and not for making any profit or trading for carrying on commercial purpose.
16. We would refer to few relevant judgments :
// 15 // In Regional Provident Fund Commissioner vs. Shiv Kumar Joshi, (2000) 1 SCC 98, the Court elaborately considered the provisions of Sections 2(1)(d) and 2(1)(o) as well as earlier decisions and held that :-
"The combined reading of the definitions of 'consumer' and 'service' under the Act and looking at the aims and object for which the Act was enacted, it is imperative that the words "consumer" and "service" as defined under the Act should be construed to comprehend consumer and services of commercial and trade-oriented nature only. Thus any person who is found to have hired services for consideration shall 'be deemed to be a consumer notwithstanding that the services were in connection with any goods or their user. Such services may be for any connected commercial activity and may also relate to the services as indicated in Section 2(1)(o) of the Act."

The aforesaid ratio makes it abundantly clear that the services may be for any connected commercial activity, yet it would be within the purview of the Act."

17. The insurance policies were taken by the life assured Shri Ramji Lilhare for protection of the interest of himself or his nominee and not for making any profit, therefore, the complainant is a consumer and dispute between the parties comes within purview of consumer dispute.

Point No.2 & 3. Whether the policy holder Shri Ramji Lilhare suppressed material facts regarding his health and after suppressing material facts he obtained insurance policies ? & Whether the // 16 // complainant is entitled to get the reliefs as mentioned in the relief clause of the complaint ?

18. In the instant case, the answers given by the life assured Shri Ramji Lilhare for Policy No.16497438 the proposal for insurance received by OPs on March 20, 2012, relevant questions were answered as follows :-

Q.No.    Question.                                                    Answer

VIII     Personal details of the Life to be Assured.

         (5) Health details of the Life to be Assured.

c) Have you undergone or been advised to undergo any tests or investigations in last 5 years ?

No.

d) Have you ever undergone or been advised any surgery or hospitalized for observation or treatment in the past ?

No.

e) Did you have any ailment / injury / accident requiring treatment / medication for more than a week or have you availed leave for more than 5 days on medical grounds in No the last two years ?

f) Have you ever suffered or been diagnosed or been treated for any of the following ?

(i) Diabetes or High Blood sugar, high blood pressure, chest pain, palpitations, heart murmur, heart attack, shortness of breath, any other heart related disorder or undergone angioplasty, bypass surgery, heart surgery or any blood disorders like anemia, thalassemia etc. or No respiratory disorders like asthma, bronchitis, Tuberculosis.

iv) Nervous system disorders, ailments related to brain, medical / psychiatric ailments, stroke, paralysis, epilepsy or musculoskeletal disorders like arthritis any disorder of joints, spine limbs or any disorder of any of eye, nose or No throat.

// 17 //

19. The complainant filed photocopy of the insurance policies. The details of the insurance policies are thus :-

Policy No. Sum assured Premium amount. Effective (Annual) Date 15209077 Rs.3,50,000/- Rs.50,000/- 13.03.2011 to 13.03.2026 15280420 Rs.3,15,000/- Rs.49,735/- 29.03.2011 to 29.03.2020 15600628 Rs.2,06,500/- Rs.29,500/- 07.06.2011 to 07.06.2026 15742093 Rs.6,88,800/- Rs.98,400/- 26.07.2011 to 26.07.2026 15870047 Rs.7,00,000/- Rs.1,00,000/- 26.08.2011 to 26.08.2021 16497438 Rs.5,00,000/- Rs. 50,000/- 30.03.2012 to 30.03.2022

20. The OPs repudiated the claim of complainant on the ground that the life assured was suffering from Hypertension and Myocardial Infraction with Hypertension and Left Hemiplegia. Prior to filling proposal form for the insurance and had suppressed material facts regarding his health. The OPs filed prescription of Shri Sai Kripa Chaturmohta Hospital, Balaghat (M.P.) and report of Dr. Praveen Singh. From perusal of the Medical Report of Shri Sai Kripa Chaturmohta Hospital, Balaghat (M.P.), it is clear that the deceased was admitted in that hospital on 18.07.2002 till 26.07.2002. Looking to the // 18 // said documents it is established that deceased was admitted there in the month of July, 2002 for his treatment.

21. The insurance policies were obtained by the life assured on 13.03.2011, 29.03.2011, 07.06.2011, 26.07.2011, 26.08.2011 and 30.03.2012. It appears that the deceased was suffering from above diseases prior to 9 years from the date of obtaining insurance policies. In the proposal form in reply to question asked Have you ever undergone or been advised any tests or investigations in last 5 years the life assured replied in negative (No). The OPs did not file any document which indicates or shows that deceased was continuously suffering from the diseases as mentioned in the question asked in the proposal form from 2002 till obtaining insurance policies. The OPs have not been able to prove that the deceased was suffering from diseases as mentioned in the medical report during last five years from the obtaining insurance policies. The OPs did not produce any evidence to prove that deceased was continuously suffering from the diseases as mentioned in the medical report of Shri Praveen Singh.

22. People can live for month or even years together without knowing that they have suffered heart disease or hypertension and heart disease is often discovered accidentally after routine medical checkup. The burden to prove that the insured was suffering from the diseases as mentioned in the report of Dr. Praveen Singh, within period of preceding 5 years and he fraudulently suppressed the same was on // 19 // the insurer and mere production of documents of Shri Sai Kripa Chaturmohta Hospital, Balaghat (M.P., is not sufficient to prove suppression of material facts by the insured. The burden of proof establishing pre-existing disease and the life assured was having knowledge regarding the disease, is on insurer. The documents filed by the OPs is not sufficient to prove the pre-existing disease of the life assured / deceased, therefore, repudiation of the claim of the complainant on the ground of not disclosing the material information is erroneous and thus the OPs (Insurance Corporation) has committed deficiency in service by repudiating the claim on the ground of suppression of material facts is not justified.

23. The complainant prayed for Rs.2,00,000/- towards compensation for mental agony and Rs.2,00,000/- towards compensation for profession mis-conduct. The complainant is not entitled for any compensation for professional mis-conduct, but so far the compensation for mental agony is concerned, the complainant pleaded that she submitted her claim before the OPs but OPs did not take any action on her claim for a period of 2 years and yet they did not decided her claim and had taken time of near about 2 years. Looking the facts of the case and time taken by the OPs, it is just and proper to award a sum of Rs.20,000/- to the complainant towards compensation for mental agony.

// 20 //

24. Therefore, we allow the complaint and direct the OPs to pay a sum of Rs.22,25,300/- (Rs. Twenty Two Lakhs Twenty Five Thousand and Three Hundred only) to the complainant and also pay a sum of Rs.20,000/- (Rs. Twenty Thousand only) towards compensation for mental agony within 2 months form the date of this order and also pay interest on the said amount @ 9% p.a. from the date of filing of the complaint till date of payment. The OPs will also pay a sum of Rs.5,000/- (Rs. Five Thousand only) to the complainant towards cost of litigation.




(Justice R.S. Sharma)     (Ms. Heena Thakkar)       (D.K. Poddar)
     President                  Member                 Member
          /12/2014                /12/2014               /12/2014