Ld. Advocate(s)
For Complainant: Subhasis Roy
For OP/OPs :Raj Kumar Mondal
Date of filing of the case :07.02.2017
Date of Disposal of the case :22.02.2023
Final Order / Judgment dtd.22.02.2023
Complainant Shrabani Roy filed the present complainant against the aforesaid opposite parties under section 12 of the Consumer Protection Act, 1986 alleging deficiency in service and prayed for award amounting to Rs.5,45,000.00(Rupees five lakh forty five thousand) Plus Bonus, interest @ 12%, compensation amounting to Rs.5,00,000.00(Rupees five lakh) and cost of the case.
It is the allegation of the complainant that her husband purchased two Policy from the OP No.1 and 2 through OP No.3 and thereafter he died. After the death of her husband complainant had claimed the policy amount from OP No.1 and 2 but they did not pay the same.
OP No.1-3 appeared in this record and contesting the case by filing W/V.
OP No.1 and 2 in their W/V denied the entire allegations of the complainant. Deceased namely Dhrupad Roy expired on 02.03.2011 i.e merely after the 5 months 25 days from the date of purchase of policies and complainant is his nominee of those two polices.
But said deceased did not disclose his ailments in the proposal form. As such deceased violated the policy condition.
There is not deficiency in services on the part of OP No.1 and 2.
OP No.3 also contesting the case by filing separate W/V denying the entire allegations of the complainant and further contented that he is an agent of OP No.1 and 2. He further contended that deceased Dhrupad Roy intended to purchase two LIC Policy and as per his instruction he filled up two proposal form and thereafter OP No.3 read over and explained the same to the deceased in Bengali and thereafter deceased put his signature in English on two filled up proposal form and those two form were submitted before the office of OP No.1 and 2 and lastly alleged two policies were issued in favour of the deceased Dhrupad Roy.
Trial
During trial complainant Shrabani Roy did not file affidavit in chief.
She also filed certain documents
During trial OP No.1 and 2 filed two separate affidavit in chief.
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Documents
Following documents have been produced on behalf of the complainant viz :
- Xerox copy of Policy Bond vide no.447342768 dtd. 09.10.2013........(One sheet).
- Xerox copy of Policy Bond vide no.447342769 dtd. 09.10.2013........(One sheet).
- Xerox copy of letter to Chief Manager LIC, Krishnagar Branch-I dtd.09.06.2014...........(One sheet).
- Xerox copy of Death Certificate issued by the Kolkata Municipal Corporation D.O.D dtd.02.03.2014.........(One sheet)
- Xerox copy of Death Certificate issued by Ramakrishna Mission Seva Pratishthan,Kolkata D.O.D dtd.02.03.2014.........(One sheet)
Following documents have been produced on behalf of the OP No.1 viz :
- Xerox copy of proposal Forms dtd. 09.10.2013...........(Two sheets)
- Xerox copy of Policy vide no.447342768 dtd. 09.10.2013........(One sheet).
- Xerox copy of Policy vide no.447342769 dtd. 09.10.2013........(One sheet).
- Xerox copy of Certificate of Hospital Treatment dtd. 23.07.2014.......(One sheet)
- Xerox copy of Medical Attendants Certificate dtd. 23.07.2014.......(Two sheets)
- Xerox copy of letter along with treatment papers issued by complainant Smt. Shraboni Roy dtd. 15.09.2015..........(Sixteen sheets)
Brief Notes of argument.
Complainant in support of her case did not file Brief Notes of Arguments. On 06.02.2023 she filed a petition stating that her petition of complainant be treated as BNA and same was allowed.\
OP No.1 and 2 filed BNA.
Decision With Reasons
Ld. Adv. for the complainant argued before this commission that complainant’s wife purchased two Policy from the OP NO.1 and 2 but subsequ3ently he died, thereafter complainant claimed policy amount from the OP NO.1 and 2 but OP No.1 and 2 did not pay policy amount in favour of the complainant, hence he files this case. OP NO.1 and 2 admitted said fact in there W/V. Moreover on perusal of the documents (Xerox) filed by the complainant we find that complainant’s husband
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purchased one L.I.C policy vide no.447342768 sum assured of the policy is Rs.45,000.00.
Policy holder Dhrupad Roy purchased said policy on 05.09.2013 and paid premium amount of Rs.43,920.00.
Said policy is single premium policy and Dhrupad Roy paid the said single premium amount to Rs.43,920.00 and he got the said policy.
On perusal another document we find that Dhrupad Roy purchased another policy vide no.447342769.
Sum assured is 5 lakh Policy was supported on 05.09.2013 and said policy was effective for the period from 05.09.2013.
Last date of the payment of premium is 05.09.2013. Premium amount as mentioned as 13,940.00.
Said Dhrupad Roy got the said policy.
On perusal of Xerox of the documents dtd. 09.06.2014 we find that the complainant submitted aforesaid 2 and claim papers before office of OP No.1 and 2.
On perusal of other documents (Xerox) we find that complainant submitted the claim allegation before the OP No.1 and 2 on 09.06.2014.
From the aforesaid discussion it is clear before this Commission that Dhrupad Roy purchased the aforesaid two policy from the OP No.1 and 2 and subsequently he died on 02.03.2014 Legal heirs of policy holder are entitled to benefit of the policy.
Ld. Adv. for the OP No.1 and 2 argued before this Commission that said Dhrupad Roy suppressed his illness at the time of making proposal before the office of OP No.1 and 2.
OP No.1 and 2 had received the proposal form of Dhrupad Roy and issued the aforesaid two policies in favour of him but on enquiry they came to learn that said Dhrupad Roy suppressed that he was suffering with the decease which ultimately, called his death.
On perusal of the documents filed by the OP No. 1 and 2 we find that said Dhrupad Roy submitted one proposal form before the OP No.1 and 2 we find that said Dhrupad Roy submitted one proposal form before the OP No.1 and 2. In the said proposal form.
Said Dhrupad Roy gave answer of the questions in the said proposal form.
In clause No.9(i) it has mentioned that “during last 5 years did you consult any medial Practitioner for any ailment requiring treatment for more than a week.”
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Said Dhrupad Roy gave answer as “no”.
On perusal of the application of the complainant (Xerox) dt. 15.09.2015 we find that said Dhrupad Roy continued his treatment on 6 occasions before purchase of policy under different Doctors.
On perusal of prescription of aforesaid 6 doctors we find that Dhrupad Roy continued his treatment on 23.05.2013, 27.05.2013, 01.06.2013, 05.06.2013, 14.07.2013 and 15.07.2013.
On perusal of these prescription we find name of the patient has mentioned as K.Roy.
On perusal of affidavit sweared by the complainant on 24.08.2015 which was submitted before the office of O NO.1 and 2, we find that it has prescribed therein that Dhrupad Roy and K.Roy is the same an identical person.
On perusal of medical report (Xerox) issued by CMC Vellore dtd. 15.11.2013 we find that deceased Dhrupad Roy was suffering from fever which was continuing with last 5 months off and on. Accordingly we find that complainant was suffering with fever before the date of purchase of aforesaid 2 policy dtd. 09.10.2013 and 09.10.2013.
We also find that several investigation were done at CMC Vellore for the period from 16.11.2013 to 26.11.2013.
On perusal of prescription dtd. 14.02.2014 we find that said deceased Dhrupad Roy was treated before the Dr. K.R. Biswas on 14.02.2014.
On perusal of prescription issued by Ramkrishna Mission Seva Pratishthan dtd. 22.02.2014 we find that he was suffering with “cytogenetics and immunophinotyping of Bone marrow aspirate.
From the aforesaid discussion it is clear before us that on the date of purchase of policy, deceased Dhrupad Roy was suffering with ailments and he totally suppressed the said fact before OP NO.1 and 2. At the time of procurement of aforesaid 2 L.I.C policy deceased Dhrupad Roy totally suppressed the fact of his suffering with ailment.
Having regard to the aforesaid discussion it is clear before us that deceased Dhrupad Roy suppressed the fact that he was suffering with various ailment which may cause his death with the intention of providing money in favour of his family. He thought that if he would mention the fact of suffering of ailment then OP NO.1 and 2 would not issue the aforesaid two policy in his favour. Accordingly we find that complainant is not entitled to any benefit from the OP NO.1 and 2 as per her prayer.
In the result present case fails.
Hence,
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It is
` Ordered
that the present case be and the same is dismissed on contest against the OP NO.1 -3 but without any order as to costs
Let a copy of this order be supplied to the complainant as free of cost.
Let a copy of this order also be supplied to OP NO.1- 3 for compliance.
Dictated & corrected by me
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PRESIDENT
(Shri DAMAN PROSAD BISWAS,) .................................................
PRESIDENT
(Shri DAMAN PROSAD BISWAS,)
I concur,
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MEMBER
(NIROD BARAN ROY CHOWDHURY)
