IN THE KODAGU DISTRICT CONSUMER DISPUTES REDRESSAL FORUM MADIKERI

SRI. C.V. MARGOOR,PRESIDENT

O R D E R

1. This complaint filed by Mrs. Meena w/o. late Tenzin Thordoe, aged 50 years, resident of Bylakuppe, Periyapatna Taluk, Mysore District against the opponents with prayer to direct the third opponent to pay the insurance amount of Rs.2,00,000/- and direct the opponent no.2 to adjust insurance amount towards the balance amount of the vehicle and pay the remaining insurance amount to her along with compensation of Rs.20,000/- for mental agony.

2. The opponent no.1 is Shriram Transport Finance Company Limited registered office at Chennai, opponent no.2 branch office of opponent no.1 at Kushalnagar, Kodagu District and opponent no.3 Shriram Life Insurance Company Limited situated at Hydrabad.  The late husband of complainant had purchased a Bajaj Auto bearing registration No.KA 12B 0476 by availing loan of Rs.1,98,000/- from the opponent no.2 on 21/07/2014.  The husband of the complainant was regularly paying monthly installments to the opponent nos.1 and 2.  While availing the loan the opponent no.2 assured that there is insurance coverage for the vehicle and the 3^rd opponent by taking insurance premium amount issued policy on the vehicle and it was included in the loan amount.  The husband of complainant was died on 24/10/2015 due to illness.  The opponent no.2 gave visit to the hospital where the husband of complainant was admitted and told that the complainant need not pay the balance loan amount since the loan is covered under insurance.  After the death of Tenzin Thordoe the opponent no.2 told that her husband was suffering from TB as such she is not eligible to get the insurance amount from the opponents.  Thus the opponent nos.2 and 3 have played fraud by not giving the insurance amount to the complainant though the complainant and her husband have paid the loan installments regularly to the tune of Rs.1,21,000/-.  It is further case of complainant that while sanctioning the loan the opponents would have get medical examination of the husband of complainant.  Hence this complaint.

3. The opponent nos.1 and 2 appeared through their learned counsel and filed version admitting that the late husband of complainant had purchased the Bajaj Auto by availing loan and he was running the said vehicle for hire purpose.  Therefore, the complainant is not a consumer.  The opponents have denied that at the time of sanctioning loan informed that the vehicle is covered with insurance and also late husband of the complainant has life insurance policy.  The opponents denied that the opponent no.2 visited the hospital when late husband of the complainant was admitted due to ill health and told the complainant that he need not pay the balance loan amount as the said loan is covered under insurance.  The complainant is liable to pay more than Rs.1,00,383/- to the opponent nos1 and 2 toward the loan account.  The complainant with an ulterior motive to avoid the payment of loan installments has filed this false case. 

4. It is further case of opponents that to claim insurance benefits the complainant has to approach the opponent no.3 and it will decide as to whether she is eligible for insurance benefits or not.  If the complainant is eligible for insurance benefits then the 1^st and 2^nd opponent would adjust the loan amount out of the insurance claim.  The opponent No.1 and 2 are not liable to pay compensation and cost to the complainant since the opponent no.3 is exclusively dealing the insurance liability of the late husband of complainant.  There is no deficiency in service on behalf of opponent no.1 and 2.

5. The opponent no.3 after the service of notice appeared through its learned counsel on 20/04/2017 and inspite of sufficient opportunity more than one year till 26/05/2018 it did not care to file version or affidavit evidence.

6. The complainant filed her affidavit in lieu of evidence and got marked exhibits P1 to 22 documents.  On behalf of opponent nos.1 and 2 one Shivakumar.B.R. s/o. Raghavendra (GPA holder) and the Credit  Executive  has filed affidavit evidence. 

7. Heard the arguments of  the son of complainant by name Sandeep whereas the learned counsel for the opponents no.1 and 2 have submitted written arguments and the points  that would arise for determination are as under;

1. Whether the complainant proves that the act of opponents repudiating the insurance claim amounts to deficiency in service?
2. What order?

8. Our findings on the above points is as under;

• Point No.1:- In the affirmative
• Point No.2:-  As per final order for the below

R E A S O N S

9. The complainant contention is that why the opponents have not got medical treatment before issue of policy and disbursement of loan in favour of her late husband Tenjin Thordeo.  The opponents No.1 and 2 have sanctioned loan a sum of Rs.1,98,000/- to the late husband of complainant on 21/07/2014 for purchase of Bajaj Auto bearing No.KA 12 B 0476.  The opponents no.1 and 2 have not disputed the purchase of an Auto by the late husband of complainant by availing loan from their company.  The opponents have not disputed that during the life time of husband of complainant had paid monthly installments total sum of Rs.1,20,000/-. The complainant marked exhibits P1 to P17 receipts issued by opponents no.1 and 2 for a total sum of Rs.1,19,600/-.  The last payment was made by the late husband of complainant on 16/10/2015 vide exhibit P17 a sum of Rs.9,000/-.  The husband of complainant was passed away on 24/10/2015 and exhibit P22 is the death certificate of late husband of the complainant.

10. It is the contention of opponent no.1 and 2 that the complainant is not consumer under Act and to claim insurance benefits the complainant has to approach the third opponent to know that as to whether she is eligible for insurance benefits or not.  The opponent nos.1 and 2 are not liable to pay compensation and cost of the proceedings.  The opponent no.1 and 2 in their version, affidavit evidence and arguments not disputed taking insurance policy by the late husband of complainant from the opponent no.3.  The complainant produced  exhibit P20 premium receipt dated 26/02/2015 issued by the opponent no.3 for Rs.6,690/- and according to this the late husband of complainant has taken Shriram  Life Cash Back Term Policy  from the opponent on 26/02/2015, sum assured is Rs.2,00,000/- and policy term is 15 years.  The date of maturity of the policy is on 26/02/2030.  According to exhibit P20 the policy number is NN071500119495 and agent name shown as Shriram Transport Finance Company that means opponent nos.1 and 2. It indicates that at instance of opponent nos.1 and 2 the late husband of complainant had taken insurance policy. 

11. Before taking exhibit P20 the late husband was customer of opponent nos.1 and 2 since he had taken loan for purchase of an auto in the month of July, 2014.  Exhibit P19 letter dated 20/08/2016 has been issued by opponent no.3 addressed to the complainant repudiating the claim of her husband on the ground that her husband in the proposal form has suppressed the fact of his illness Tuberculosis.  Exhibit P18 is decision of internal claims review committee dated 14/12/2016 and it addressed to the complainant that the committee has upheld the decision of repudiation dated 30/08/2016 of the policy taken by her husband.  These documents reveal that the husband of complainant had taken insurance policy from the opponent no.3 at the instance of opponents no.1 and 2 and on his death the opponent no.3 has repudiated the claim.  Therefore, the complainant falls under the definition of consumer since the opponents have been running transport and insurance business.

12. In this case the opponent No.3 after the service of notice put in appearance through its learned counsel on 20/04/2017.  The opponent no.3 inspite of sufficient opportunity till posting the case for orders did not care to file version or affidavit evidence.  The opponent no.3 under exhibit P19 letter dated 30/08/2016 addressed to the complainant repudiated the claim on the ground that her husband in the proposal form for insurance policy had suppressed the fact of suffering from Tuberculosis prior to taking insurance dated 26/12/2015.  The opponent No.3 has not produced the proposal form and the medical report of the late husband of complainant to show that he was suffering from Tuberculosis prior to the date of signing proposal form for insurance dated 26/02/2015.  Except exhibit P19 letter produced by the complainant there is no material on behalf of opponent no.3 to believe that the deceased husband of complainant was suffering from Tuberculosis prior to signing the proposal form for insurance and suppressed the said fact in the proposal form.  Therefore, there is no iota of material or evidence on behalf of opponent no.3 to repudiate the claim of complainant since the opponent no.3 neither filed written version nor produced affidavit evidence and supporting documents though it appeared through its learned counsel since beginning, 

13. Exhibit P20 first premium receipt dated 26/02/2015 indicates that the opponent nos.1 and 2 are the agents and at their instance the husband of complainant has taken a life insurance policy from opponent no.3.  Though the opponent nos.1 and 2 are aware of taking life insurance policy from opponent no.3 which is their sister concern have come up with a false plea that they are not liable to the act of opponent no.3.  In view of the above circumstances, the opponent nos.1 to 3 shall liable to pay sum assured amount of Rs.2,00,000/- to the complainant as they have illegally repudiated the claim without any just cause.  Further the opponents shall liable to pay compensation of Rs.20,000/- towards mental agony and cost of this proceedings since the complainant has to approach this Forum and she has to pay interest on the balance EMI amount of the auto loan.  Hence, we proceed to pass the following;

O R D E R

1. The complaint filed by Mrs.Meena w/o. late Tenzin Thordoe is allowed directing the opponent nos.1 to 3 shall jointly and severally liable to pay a sum of Rs.2,00,000/- to the complainant with interest at the rate of 12% per annum from 24/10/2015 till the date of realization. 
2. The opponent nos.1 and 2 shall adjust the remaining amount of EMIs a sum of Rs.1,00,383/- due towards Auto loan availed by the late husband of complainant with future interest from 08/06/2017. The remaining amount shall be paid to the complainant after adjusting the EMIs amount.
3. It is further ordered that the opponents shall liable to pay a sum of Rs.20,000/- as compensation for mental agony and cost of this proceedings to the complainant within two months from the date of order otherwise, it carries interest at the rate of 12% per annum  from the date of default till its payment.
4. Furnish the copy of order to the complainant and opponents at free of cost.

(Dictated to the Stenographer, got it transcribed, corrected and pronounced in the open Forum on this 19^th day of JANUARY, 2019)

                                                  (C.V. MARGOOR)

                                                      PRESIDENT 

                                                (M.C. DEVAKUMAR)

                                                        MEMBER