THE KARNATAKA STATE CONSUMER DISPUTES

REDRESSAL COMMISSION, BANGALORE. (ADDL. BENCH)

DATED THIS THE 19^th DAY OF JANUARY 2022

PRESENT

SRI RAVI SHANKAR – JUDICIAL MEMBER

SMT. SUNITA C.BAGEWADI - MEMBER

APPEAL NO. 450/2015

Manjunath S/o Balaram

Age:25 Years, Occ:Business,

R/o Yarrinatha Colony,

Near Durgamma Temple,

3^rd Ward, Toranagal,

Tal:Sandur, Dist:Bellary.

……….Appellant/s

(By Sri. N.P.Singri, Adv.,)

V/s

DHFL Premerica Life Insurance Co., Ltd.,

Ground Floor, SMR House No.11,

Convent Road, Richmond Town,

Bangalore-560 025.

(Served-absent)

……….Respondent/s

:ORDERS:

BY SRI. RAVISHANKAR -  JUDICIAL MEMBER

         This appeal is filed by the appellant/complainant being aggrieved by the order dated:04/04/2015 passed by Koppal District Consumer Commission in C.C.No.77/2014. 

2.      The facts of the case is that the complainant had obtained the insurance policy from the Opposite Party on 22.03.2013 for an assured sum of Rs.5,59,420/- and paid an annual premium of Rs.38,801/-.  The term of the policy is 15 years after.  After obtaining the policy, the policy holder died on 10.12.2013 i.e. after 8 & ½ months from the date of obtaining the policy.  The complainant being the beneficiary and nominee of the policy holder had claimed for sum assured under the policy.  The said claim was repudiated by the Opposite Party/company through their letter dated:13/08/2014 for the reason of suppressing of material facts at the time of taking the policy.  Against which, the complainant filed the complaint alleging deficiency in service before the District Commission.  The District commission after trial, dismissed the complaint.     

3.      Being aggrieved by the said order, the appellant/complainant filed this appeal on various grounds. 

4.      We have heard the arguments from both sides.

5.       On perusal of memorandum of appeal and certified copy of the order and documents produced before the District Commission, there is no dispute that the complainant had obtained the insurance policy on 22.03.2013 for a sum assured of Rs.5,59,420/- and term of the policy is 15 years.  It is also an admitted fact that the complainant had paid first premium of Rs.38,801/-.  After the payment of the premium, the policy was issued in favour of the Father of the complainant.  Such being the case, on 10.12.2013, the Father of the complainant i.e. policy holder died after lapse of 8 & ½ months from the date of obtaining the policy.  Thereafter the complainant made a claim before the Opposite Party, but the Opposite Party has repudiated the claim stating that the policy holder was suppressed the material facts about his health at the time of obtaining the policy.  Hence, the complainant filed the complaint against the Opposite Party alleging deficiency in service.   

6.       During the course of trial, the Opposite Party has filed their version and affidavit stating that the Father of the complainant prior to taking the policy had taken a treatment for Tuberculosis.  The said fact was not informed by the Father of the appellant at the time of proposal.  Hence, submits that the complainant is not entitled to get the assured amount for the reason of suppression of material facts.  The said ground was appreciated by the District Commission and dismissed the complaint.

7.       We are of the opinion that the policy of insurance has to be obtained in good faith.  The Father of the complainant during his lifetime ought to disclose his ailment at the time of taking proposal and it is the company which has recent information might have suggested to pay additional premium rather than rejection.  The Father of the complainant had not acted in a good faith at the time of taking the policy.  Hence, the complainant being a beneficiary is not entitled to get any claim from the insurance company.  The District Commission has rightly dismissed the complaint after appreciating the terms and conditions of the policy.  As such, we found no grounds to entertain the appeal.  Hence, the appeal fails.  Accordingly, we proceed to pass the following:-   

:ORDER:

The appeal filed by the appellant/complainant is hereby dismissed.

The impugned order dated:04/04/2015 passed by Koppal District Consumer Commission in C.C.No.77/2014 is hereby confirmed.

Return the L.C.R. forthwith to the concerned District Commission.

Send a copy of this order to both parties as well as Concerned District Commission.

Sd/-                                                                                    Sd/-

Member.                                                               Judicial Member.