State Consumer Disputes Redressal Commission
Lic Nomura Mutual Fund Asset & Another vs Smt.Jyothi Sudhir on 15 September, 2011
BEFORE THE KARNATAKA STATE CONSUMER DISPUTES REDRESSAL COMMISSION, BANGALORE BEFORE THE KARNATAKA STATE CONSUMER DISPUTES REDRESSAL COMMISSION, BANGALORE. DATED THIS THE 15th DAY OF SEPTEMBER 2011 PRESENT HONBLE JUSTICE MR.K. RAMANNA : PRESIDENT SRI. A.M. BENNUR : MEMBER SMT. RAMA ANANTH : MEMBER Appeal No.1379/2011 1. LIC Nomura Mutual Fund Asset Management Company Ltd., Industrial Assurance Building, 4th Floor, Opp: Church gate Station, Mumbai-400020 2. The Area Manager LIC Nomura Mutual Fund Area Office, No.5, Ground Floor, Popular Building, K.S.Rao Road, Mangalore. (By Shri/Smt Rajesh Shetty Appellants Opposite Parties before the DF -Versus- Smt. Jyothi Sudhir W/o late K.Sudhir Kumar Jain, Aged about 46 years, R/a "Shri Bhagavathi Ashish", Near TVS Suzuki Show Room, 1st Cross, Neharu Nagar, Sagar-577401 (By Shri/Smt ) ..Respondent Complainant before the DF ORDER
SRI. A.M. BENNUR, MEMBER This is an appeal filed under Section 15 of the C.P Act of 1986 by the OP in Complaint No.95/2010 on the file of District Consumer Disputes Redressal Forum, Mangalore being aggrieved by the order dated 18-03-2011.
The brief facts of the case are as under :
2. The complainant and her husband have taken LIC mutual fund ULIS policy with the risk coverage of Rs.4,80,000/-. They are regularly making payment of monthly premium installments. Out of which, Rs.174.40 was being appropriated towards risk coverage/mortality charges and balance of Rs.3,825.60 was towards mutual fund units. The husband of the complainant died on 15/03/2009. As she being the nominee approached the Op to settle the claim. But Op repudiated the said claim, without substantial reason or cause. Hence, the complainant felt deficiency in service. Accordingly, filed the complaint.
3. On appearance, OP filed the version denying all the allegations made by the complainant in toto. According to the Op, there is a suppression of material facts with regard to the ailment of cancer to the liver. Those facts are not stated at the time of submitting the proposal. Hence, Op is justified in repudiating the said claim.
In addition to that there is a default in payment of the installments. At the time of the death of the policy holder, the policy was lapsed. It was not renewed well within the reasonable time. Hence, complainant is not entitled for the relief claimed. Accordingly, prayed for the dismissal of the complaint.
4. Then the litigating parties lead their evidence and after hearing the arguments DF was pleased to allow the said complaint vide its order dated 18-03-2011. Being aggrieved by the same, now the OP has come up with this appeal on the following grounds:
That the DF failed to appreciate the facts and circumstances of the case in a proper perspective manner. The conclusion arrived at, inferences drawn, findings recorded, reasons assigned are opposed to law, facts and probability of the case. By suppressing the material facts, husband of the complainant obtained the policy fraudulently, the life assured died within 60 days from the date of the alleged proposal. Even the premium was not paid regularly and policy was lapsed. Though all these facts are established and proved were ignored by the DF. If the said order is not set aside, it is the appellant who will be put to greater hardship and prejudice. Among these grounds, OP/appellant prayed for allowing the appeal.
5. Heard the arguments.
6. In view of the above said facts, the points now that arise for our consideration in this appeal are as under:
1.
Whether the impugned order under appeal is unjust and improper?
2. If so, whether it calls for the interference from this commission?
3. To what order?
7. We have gone through the pleadings of the parties both oral and documentary evidence, the impugned order under appeal, the grounds urged in the appeal memo and the arguments advanced. In view of the reasons given by us in the foregoing paragraphs, our findings on point No.1 & 2 are in negative and point No.3 as per final order
-:REASONS:-
8. At the outset it is not in dispute that the complainant husband took the LIC mutual fund ULIS policy which covers the risk of Rs.4,80,000/-. Complainant is the nominee under the said policy. The said policy commenced from 28/11/2007 and the maturity date is 28/11/2017. The life assure was regular in making payment of the premium except one premium dated 15/07/2008. But subsequent premiums are paid. When life assures paid the subsequent premium without any objection it was accepted by the Op. If there is default in payment of any installments, OP would have caused notice to that complainant in that regard. It is not done. So there is a waiver of the alleged non-payment of one premium as stated above.
9. The monthly premium has been paid through ECS. If the policy was lapsed, the subsequent installment would not have been received by the Op till up to the death of insurer. The DF has thoroughly considered each and every aspect of the matter and rightly come to the conclusion that there is a deficiency in service on the part of the Op.
10. The other contention of the OP is that there is a suppression of material fact with regard to the health condition of the insured. It is stated that he was suffering from Hypertension and Adeno Carcinoma of the Liver but the records produced goes to show that the said cancer was detected after taking the policy not prior to that. There is no proof that the life assured was aware of the said cancer prior to the submission of proposal or the acceptance of the policy. He took the treatment on 29/10/2008 subsequently died on 15/03/2009. Under the circumstances, it cannot be said that there is a suppression of any material facts by the life assured that too when he obtained the policy on 28/11/2007. In that regard also DF has thoroughly considered both oral and documentary evidence and rightly held that the defense of the Op is unsustainable.
11. In view of the discussion made by us in the above said Paras, the appellant has failed to show before this commission that the Impugned Order under appeal is erroneous, suffers from legal infirmity, unsustainable in law. There is no proof that, the said order suffers from any error apparent on the face of record requiring our interference. We dont find any illegality or irregularity in the impugned order passed by the DF. Appeal appears to be devoid of merit.
Accordingly we answer Point No.1 and 2 and proceed to pass the following:
ORDER Appeal is dismissed.
The Deposit if any made by the appellants before this Commission be transmitted to the DF concerned, for needful.
PRESIDENT MEMBER MEMBER *s