1.     

Appellant Shrikant Wallalwar has preferred the present Appeal feeling aggrieved by the impugned judgment and order dated 17/11/2014 passed by the learned District Consumer Forum, Chandrapur in Consumer Complaint No.18/2012, whereby the Consumer complaint filed by the present appellant came to be allowed and direction was given to the respondent/ Reliance Life Insurance Company Limited to pay the claim amount withing a period of 45 days and to pay compensation of Rs.10,000/- and cost of litigation amounting to Rs.5,000/- . (The appellant and respondent shall be referred by their original nomenclature).

2.      Brief facts leading to the present appeal may be narrated as under. :-

3.      Complainant Shrikant Wallalwar claims to be resident of  Area Hospital,  Lalpeth, Chandrapur. The wife of complainant namely Shraddha was serving as a teacher in Zilla Parishad and during her life time had taken a policy in the month of October 2010 namely Reliance Life Insurance Company Limited and the same was matured within a period of 15 years. Complainant has alleged that O.P. namely Reliance Life Insurance Company Limited had assured to      pay the amount of Rs.2,00,000/- in case of death of insured. Complainant thereafter paid the single premium of Rs.1,00,000/- and had taken policy No.18075553 in the month of October 2010. Complainant has contended that his wife Shraddha died suddenly due to Cardiac arrest  on 16/09/2011. After the death of his wife the present complainant submitted the claim on 03/10/2011 alongwith necessary documents. However the claim submitted by the complainant came to be repudiated on 30/12/2011 on the ground of suppression of material facts relating to illness of complainant. Complainant has alleged that the O.P. namely Reliance Life Insurance Company Limited had refused the claim on false and untenable ground and so the complainant issue notice through advocate on 10/01/2012, but still there was no response and so the complainant was compelled to file the present complaint U/s 12 of the Consumer Protection Act 1986.

4)      O.P. namely Reliance Life Insurance Company Limited appeared and resisted the complaint by filing written version on record. O.P. has admitted that the complainant had taken a policy in the month of October 2010 for his wife Shraddha,  but has denied that the Reliance Life Insurance Company Limited had assured to cover the risk to the extend of Rs.2,00,000/-. On the other hand the O.P. had admitted that one Reliance Life Insurance Company Limited NVA Advantage Plan (Single) issued to the complainant and the same was to matured on 31/10/2025. O.P. has contended that the complainant had suppressed the material fact relating to the fact that she was suffering from illness namely ‘Idiopathic Sithimbosyatophania’ and she was taking medicines since last five years. Complainant had suppressed the material fact and so complainant was only entitled to sum of Rs.83,698.72. Complaint filed by the complainant is not tenable in law and deserve to be dismissed.

5)      The learned District Consumer Forum Chandrapur thereafter recorded the evidence led by the complainant as well as by O.P. The learned District Consumer Forum also went through the documents as well as written notes of argument filed by the complainant and the O.P. After appreciating the evidence on record the learned District Consumer Forum came to the conclusion that there was deficiency in service on the part of O.P./Reliance Life Insurance Company Limited. The learned District Forum therefore allowed the complaint and directed the O.P. to pay the sum assured in policy No.18075553   and also to pay compensation of Rs.10,000/- and Rs.5000/- towards cost of litigation. It appears that the learned District Consumer Forum did not award any interest on the said amount and so feeling aggrieved by the said judgment and order dated 17/11/2014 passed by learned District Consumer Forum Chandrapur the present appellant has come up in appeal.

6)      We have heard Shri Kullarwar, learned advocate for appellant. We have also heard learned advocate for respondent. We have also gone through the record and proceedings copies of which are filed on record. Before dealing with the contentions advanced by Shri Kullarwar, learned advocate for appellant it would be relevent to mention certain undisputed facts. There is no dispute that complainant’s wife Shraddha had taken policy of Reliance Life Insurance Company Limited  advantage plan (Single) and the said policy was for the period of 15 years. There is also no dispute that the sum assured was Rs.2,00,000/- and the date of maturity was 31/10/2025. It is also not in dispute that the wife of complainant namely Shraddha died on 16/09/2011 but despite these facts the O.P./ Reliance Life Insurance Company Limited repudiated the claim as per letter dated 30/12/2011 on the ground that the complainant had not disclosed the medical ailment which were material to the issuance of the  policy and ought to have been disclosed in the proposal form.

7)      It is vehemently submitted by Shri Kullarwar, learned advocate for appellant that complainant had not only taken the insurance policy but had also complied with all conditions by paying single premium as per the terms of Rs.1,00,000/- It is submitted by Shri Kullarwar, learned advocate that the learned District Consumer Forum had given findings that there was deficiency in service on the part of Reliance Life Insurance Company Limited and further had also given the findings that the O.P. had falsely repudiated the claim on the ground of suppression of material facts relating to the medical illness, but the learned District Consumer Forum had not awarded the sum of Rs.2,00,000/- assured to the deceased policy holder. Further it is argued by Shri Kullarwar, learned advocate for appellant that the learned District Consumer Forum had also erroneously  not awarded any interest on the amount. Further it is submitted that the learned District Consumer Forum had also not awarded proper compensation as claim.

8)      We have heard the learned advocate for respondent and he has strongly repudiated the contentions advanced by learned advocate for appellant. Further he has supported the findings given by the learned District Consumer Forum and so we have carefully gone through the impugned order dated 17/11/2014 passed by the learned District Consumer Forum Chandrapur. We have also going through the copy of the insurance policy which was taken in the month of October 2010 by paying single premium of Rs.1,00,000/-. We have also find that specific findings have been given by the learned District Consumer Forum relating to the falsity of repudiation letter as well as deficiency in service. The appellant has not seriously challenged this aspect and so it is not necessary to go into the same. It is submitted by Shri Kullarwar, learned advocate for appellant that though the complainant was entitled for sum assured in the policy of Rs.2,00,000/-, the O.P. had transferred only sum of Rs.83,698.72/- instead of Rs.2,00,000/-. On going through the copy of policy we find that the sum assured was Rs.2,00,000/- in the event of death and so the complainant was clearly entitled for the sum of Rs.2,00,000/-, but the sum was not specifically mentioned in the impugned order under challenge. Further it is submitted by Shri Kullarwar, learned advocate for appellant that the complainant was also entitled for interest on the amount @ 18% p.a., but no interest was awarded by the learned District Consumer Forum, Chandrapur.

9)      We do find much substance in the contentions advanced by Shri Kullarwar, learned advocate for appellant. We are therefore of the view that the complainant was not only entitled for the sum assured of Rs.2,00,000/- but was also entitled for interest on the amount from 16/09/2011 which was the date of death of wife of claimant. As such we feel that it is necessary to modify the order and so we partly allowed the appeal and pass the following order.

                                                // ORDER //

1. Appeal is partly allowed.
2. Order dated 17/11/2014 is hereby modified as under :-
3. Complaint is partly allowed.
4. O.P. is hereby directed to pay the sum assured of Rs.2,00,000/- in policy No.18075553 alongwith interest @ 12% p.a. from 16/09/2011 till realization of the entire amount.
5. O.P. is further directed to pay sum of Rs.10,000/- by way of compensation and Rs.5,000/- by way of cost of litigation.
6. The above order shall be complied by O.P. within a period of 30 days from the receipt of copy of order.
7. The copy of  order be furnished to both parties free of cost.