BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM ::
KADAPA Y.S.R DISTRICT
PRESENT SRI V.C. GUNNAIAH, B.Com., M.L., PRESIDENT
SMT. K. SIREESHA, B.L., LADY MEMBER
SRI M.V.R. SHARMA, MEMBER
Wednesday, 3rd February 2016
CONSUMER COMPLAINT No. 70/ 2015
S. Mahaboob Bee, W/o Late Shaik Kamal Sahbe,
Muslim, aged 49 years, Residing at Siddavaram Village,
Porumamilla Mandal, Kadapa District. ….. Complainant.
Vs.
1. The Chief Post Master General, A.P. Circle,
Abids, Hyderabad – 500 001.
2. The Superintendent of Post Officer,
O/o Postal Deaprtment, Upstairs, Kadapa Head Post Office,
Near I town Police Station, Kadapa Division, Kadapa – 516 001.
3. The Post Master, O/o Post office, Head Post Office,
D.No. 21/60, Near I town Police Station,
Kadapa City – 516 001. ….. Respondents.
This complaint coming for final hearing on 27-1-2016 in the presence of Sri Y. Srinivasulu, Advocate for complainant and Sri P. Subramanyam, G.P. for respondents and upon perusing the material papers on record, the Forum made the following:-
O R D E R
(Per V.C. Gunnaiah, President),
1. The complainant filed this complaint under section 12 of Consumer Protection Act 1986 (for short herein after called as C.P. Act) praying this forum to direct the respondents to pay policy amount of ₹ 1,00,000/- along with interest due and vested bonus, to pay ₹ 50,000/- towards mental agony and ₹ 5,000/- towards costs of the complaint.
2. The averments of the complaint in brevity are that the complainant is the wife of Shaik Kamal Saheb, who has taken Postal Life Insurance policy bearing No. AP 424590-P for an amount of ₹ 1,00,000/- on 30-3-2010 through Inspector of Posts, Badvel. The said S. Kamal Saheb, worked as Branch Post Master, Siddavaram village, Porumamilla Mandal, Kadapa District. He had regularly paid premium amount of ₹ 615/- p.m through his salary and maturity term of the said policy is 60 years. As per said policy, in case the insured died before death of maturity the respondents have to pay the assured sum amount plus vested bonus. The Kamal Saheb died on 18-10-2010 due to heart attack. The complainant is the nominee of the said Kamal Saheb, who is the insured at the time of taking of the policy he was hale and healthy and he did not avail any medical leave during his services.
3. The complainant being the nominee complied all the requirements to the respondents for death claim of her husband S. Kamal Saheb through Postal Inspector, Badvel in the month of January 2011. But they have not settled the claim for the reasons best known to them. 1st respondent sent reply on 6-8-2014 with false allegations. The complainant approached the respondents to settle the claim but they postponed the same on some pretext or other. The deceased S. Kamal Saheb was having three postal life insurance policies. The respondents paid those claim amounts but not paid this claim. Hence, the complaint for the above reliefs.
4. Respondents 1 to 3 filed common counter denying the allegations regarding negligence and deficiency of service on their part and called upon the petitioner to prove all of them. It is further contended that Late S. Kamal Saheb, worked as Branch Post Master, Siddavaram Village. He was husband of complainant and he took Postal Life Insurance Policy bearing No. AP 424590-P for ₹ 1,00,000/- on 30-3-2010 with monthly premium of ₹ 615/- and paid premium upto October 2010 and died on 18-10-2010. The complainant who is the wife of insured applied for death claim in the month of January 2011 but the claim was rejected on 6-8-2014 as late S. Kamal Saheb was suffering with chronic liver disease, Diabetic Mellitus and chronic alcoholic as per case sheet issued by hospital authorities at the time of taking policy. Thus the deceased obtained policy by suppressing facts and medical reports. As per terms of the contract the policy is null and void for suppressing the facts of health and his premium shall be forfeited.
5. It is further averred Late S. Kamal Saheb had three more policies and among them one is above three years and other two are less than three years from the date of death of the insured. But in all the above three policies death claims were settled in favour of the complainant in the year 2012. Whereas in the present case the claim was rejected basing on the case history. Therefore the complaint is liable to be dismissed.
6. On the basis of the above pleadings the following points are settled for determination.
- Whether there is deficiency of service on the part of the respondents as pleaded by the complainant?
- Whether the complainant is entitled for the policy amount against the respondents?
- To what relief?
7. No oral evidence has been let in by the parties. But on behalf of the complainant Exs. A1 to A5 documents are marked and on behalf of the respondents Ex. B1 is marked.
8. Heard arguments on both sides and considered written arguments filed by 3rd respondent.
9. Point Nos. 1 & 2. It is admitted fact by the respondents that the complainant’s husband S. Kamal Saheb, worked as Branch Post Master, Siddavaram Village, Porumamilla Mandal, Kadapa District and he took Postal Life Insurance Policy bearing No. AP 424590-P for an amount of ₹ 1,00,000/- on 30-3-2010 and paid premium at ₹ 615/- p.m and the complainant is the nominee and the insured paid premium upto October 2010. It is further admitted by the respondents the insured died on 18-10-2010 and the complainant applied for death claim of her husband in the month of January 2011 and the claim was rejected on 6-8-2014. It is further admitted that late S. Kamal Saheb had three more policies and all the three policies were settled in favor of complainant in the year 2012 after his death.
10. The only contention of respondents to reject the claim is that the insured S. Kamal Saheb was suffering with chronic liver disease, Diabetic Mellitus and Chronic Alcoholic at the time of taking policy and he suppressed the above facts and obtained policy. Therefore, the complainant is not entitled for death claim. The respondents relied on Ex. B1 Photostate copy of case record said to have been issued by RIMS Hospital regarding insured S. Kamal Saheb. Basing on the recitals in Ex. B1 that the present illness is chronic liver disease, Diabetic mellitus and chronic alcoholic the claim was rejected. A perusal of case history Ex. B1 column history of past illness and family history shows not known. No doctor is examined to prove the case record what was the treatment given to the insured S. Kamal Saheb and what was condition at the time of admission in the hospital. So mere filing of the case history does not prove that the patient was suffering with chronic liver disease or he was chronic alcoholic and due to that he died. So Ex. B1 has not been strictly proved by the respondents to establish that the insured suppressed his health condition prior to taking the policy.
11. It is contended on behalf of complainant that the proposal form was certified by the doctor about health condition of insured Kamal Saheb and the same was accepted by the respondents and now they cannot go back and say that the health condition was suppressed by insured at the time of taking of policy on 30-3-2010. A perusal of proposal form filed by the complainant shows that in para 20 Govt. Medical Officer certified the health of the insured S. Kamal Saheb, after carefully examined him and held that he is medically fit to take the policy of PLI on 30-3-2010. Therefore, it cannot be said that the deceased was suffering with any chronic ill-health of liver or addicted alcoholic prior to his death or prior to taking policy. It may be noted here the deceased S. Kamal Saheb had three more PLI policies and all the claims made by the complainant herein were settled by the respondents after his death in the year 2012 without any objection regarding his health condition. If such is the case and when there was no objection on the ground of suppression of health condition of insured S. Kamal Saheb and settled all three claims made by the complainant herein, there is no point or reason to reject the present claim by the respondents on the pretext that the deceased suppressed health condition and obtained present policy. The documents filed by the complainant clearly goes to show that the complainant is entitled for the death claim of PLI of her husband S. Kamal Saheb from the respondents but the respondents rejected the same on flimsy grounds. Therefore, we find there is deficiency of service on the part of the respondents and the complainant is entitled for the death claim of policy of her husband as prayed. Accordingly, points 1 & 2 are answered in favour of complainant.
12. Point No. 3. In the result, the complaint is allowed, directing the respondents to pay policy amount of ₹ 1,00,000/- (Rupees one lakh only) plus vested bonus if any and shall also pay ₹ 5,000/- (Rupees five thousand only) towards mental agony and ₹ 2,000/- (Rupees two thousand only) towards costs of the complaint to the complainant. The respondents shall pay the above amounts within 45 days from the date of receipt of the order, failing which the complainant is entitled for interest at 12% p.a. till realization.
Dictated to the Stenographer, typed my dictation by Stenographer, corrected and pronounced by us in the open forum, this the 3rd February 2016
MEMBER MEMBER PRESIDENT
APPENDIX OF EVIDENCE
Witnesses examined.
For Complainant: NIL For Respondents : NIL
Exhibits marked for Complainant : -
Ex. A1 P/c of death claim application Annexure – VI submitted by the complainant to R2 through Inspector of posts, Badvel Sub-Division, Badvel in the month of January 2011.
Ex. A2 P/c of acceptance letter issued by the R2 in fvour of the complainant’s husband dt. 5-5-2010.
Ex. A3 P/c of death certificate of S. Kamal Saheb issued by the registrar of Births and Deaths, Kadapa municipal Corportion, Kadapa dt. 12-11-2010.
Ex. A4 P/c of family member certificate issued by the Tahsildar, Porumamilla Mandal, Kadapa District. Dt. 11-12-2010.
Ex. A5 P/c of reply letter issued by R1 to the complainant dt. 6-8-2014.
Exhibits marked on behalf of the Respondents.
Ex. B1 P/c of case record i.e. RIMS General Hospital, Kadapa filed by the R1 to R3
MEMBER MEMBER PRESIDENT
Copy to :-
- Sri Y. Srinivasulu, Advocate for complainant
- Sri P. Subramanyam, G.P. for R2 & R3.
B.V.P.
