Date of filing: 23-6-2016 Date of Order :28-11-2017
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
TUESDAY THE 28th DAY OF NOVEMBER, 2017
CONSUMER COMPLAINT No. 54 / 2016
- Veresi Subbarayudu, S/o Subbaramaiah,
Age 34 years,
- Veresi Venkataiah, S/o Subbaramaiah,
Age 25 years,
Both are r/a D. No.8/35-A, Besthapalli Village,
Pedda Orampadu Post,
Obulavaripalli Mandal, YSR District. … Complainant.
Vs.
- Mahindra & Mahindra Financial Services Ltd.,
Rep. by its Manager,
-
Opposite to Chakralamadugu Bridge,
By-pass Road, Rajampeta Town and Mandal,
Y.S.R. (Kadapa) District.
- Kotak Mahindra Old Mutual Life Insurance Ltd.,
Rep. By its Branch Manager,
-
1-1-92, R.P. Road,
Above Kalaniketen R.P. Road,
Secunderabad, Telangana. ….. Opposite parties.
This complaint coming for final hearing on 14-11-2017 in the presence of Sri G. Trivikram Singh, Advocate for Complainant, Sri V. Rama Mohan, Advocate, Kadapa for opposite party no.1, and Sri G.S. Murthy, Advocate, Kadapa for opposite party no.2, and upon perusing the material papers on record, the Forum made the following:-
O R D E R
(Per Sri 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 Opposite parties to pay rs.4,59,310/- towards insurance coverage for policy certificate No. CC0000230D01700 outstanding amount payable by the mother of complainant to 1st opposite party together with interst from the death of insured i.e., from 25-5-2015till realization, to pay Rs.10,000/- towards compensation for mental agony and physical strain and Rs.5,000/- towards costs of the complaint.
2. The averments of the complaint in brevity are as follows; The Complainant’s mother by name Veresi Gangamma had purchased new Mahindra Tractor 475 DI, and O.P.no.1 has provided finance an amount of Rs.4,70,000/- under hypothecation agreement and at the time of providing finance on the advice of 1st O.P. complainant’s mother had taken Suraksha (policy of Group Insurance) plan with O.P.no.2 and by paying premium amount of Rs.8,249/- and O.P.no.2 issued the above mentioned policy certificate and loan I.D. No.3271656 in favour of Veresi Gangamma. The complainant’s mother paid installments from time to time at Rs.53,410/- in three installments and died on 25-5-2015 due to sun stroke at her house in Besthapalli Village, Pedda Orampadu Post, Obulavaripalli Mandal, Y.S.R. District. The Complainants being legalheirs of their mother Veresi Gangamma applied for benefits of insurance policy for payment of outstanding due amount with Mahindra & Mahindra Finance Services Ltd., which is under hypothecation agreement for the tractor bearing No.AP04 AY 1942 by submitting all the documents, but the opposite parties did not settle the claim for the reasons best known to them. In the mean time the O.P.no.1 made demands for the payment of the outstanding amount, but O.P.no.2 not settle the benefits to the complainants for the above policy. The complainants are entitled and eligible for all the benefits under the policy issued by O.P.no.2 to their mother Veresi Gangamma inspite of issued legal notice on 26-3-2016 the opposite party no.2 not settle the claim and O.P.no.2 stated that Veresi Gangamma gave mis statement about her age as 48 years as against 64 years at the time of submitting declaration of good health on 31-7-2014. Therefore they settle claim on revised basis which comes Rs.1,09,510-74ps. but the complainants are entitled total outstanding amount of Rs.4,30,892/- during the year 2014 as per Aadhar card and Arogyasree card of Gangamma, she was age 48 years only at the time of taking policy on 31-7-2014, but O.P.no.2 without application of mind has revised coverage policy unilaterally which is not correct. After filing of this complaint O.P.no.1 has initiated arbitration proceedings before sole arbitrator, Thane in Arbitration Case No.2839/2016 for recovery of the amount. Hence, they are force to pay the claim amount to the 1st O.P. as there is an insurance policy in force on the date of death of Veresi Gangamma is insured with O.P.no.2, O.P.no.2 is liable to pay an amount of Rs.4,30,892/- to the complainants who are the legal heirs of her. Hence, the complaint for the above reliefs.
3) O.P.s 1 & 2 filed separate written versions/Counters.
4) O.P.no.1 filed counter/Written Version admitting the purchase of Mahindra Tractor bearing No.AP04 AY 1942 as pleaded by complainants by their mother and insured with O.P.no.2 and insured by 25-5-2015 due to sun stroke, but denied the other allegations.
5) It is further averred that as per the terms of the loan agreement, the complainants are supposed to repay the amount as per the terms and conditions of the agreement in installments. The second complainant approached the O.P.no.1 on 14-9-2016 for settlement of loan agreement and paid an amount of Rs.1,05,000/- and given an undertaking letter stating that he will pay the balance amount within one month and pay the installments regularly as he filed complaint against the insurance company mainly and settle the matter. Thus there is no deficiency in service on their part and O.P.no.1 is not liable to pay the amount claimed by the complainants and complaint is liable to be dismissed against him.
6) O.P.no.2 also filed Written Version (Reply) admitting the purchase of Tractor by complainant from O.P.no.1 under hypothecation agreement on 31-7-2014 by complainant’s mother Veresi Gangamma and insured the same with O.P.no.2 by paying premium of Rs.8,249/- from 31-3-2014 i.e., coverage commencement date of policy for an amount of Rs.4,70,000/- and cover termination date is 30-7-2017 and issued certificate of insurance No.CC0000230D01700, but however denied the other allegations.
7) It is further contended that on receipt of death claim intimation this opposite party conducted a survey investigation through their investigator and found the age of insured was discrepent with the age given by her at the time of taking policy. According to insured her age was 48 years as on 31-7-2014 as per Aadhar card. but as per Voter I.D. her age was 40 years as on 1995, and 40 years as per house hold card as on 2005. Thus the life assured did not disclose her actual age at the time of proposal stage with malafied intention to get benefits from this O.P. This O.P. did not reject the claim of complainants but as a matter of goodwill gesture settle the claim on revised cover amount as per the terms and conditions of the policy and had made the payment of Rs.1,09,510-74 ps. as per the rate applicable for the age croup of 61-66 years. Therefore the reduced cover amount was assessed at Rs.1,09,510-74ps. and settle the claim. Thus there is no deficiency in service on the part of this O.P. The complainants are not entitled any relief against this O.P. and complaint is liable to be dismissed with exemplary costs.
8)No oral evidence has been let in by the parties. But on behalf of the complainants Ex. A1 to Ex.A11 documents are marked. On behalf of the opposite party no.1 Ex. B1 to Ex.B4 and marked and on behalf of the opposite party no.2 Ex. B5 to Ex.B12 are marked.
9) Complainant and O.P.no.1 not filed written arguments. O.P. no.2 filed written arguments.
10) Heard arguments on both sides, carefully perused the documents filed by both parties and considered the written arguments filed by O.P.no.2.
11)The point that arise for determination are ;
- Whether is there is any deficiency in service on the part of the
opposite parties no.1 and 2 as pleaded by complainants ?
- Whether the complainants are entitled for the reliefs claimed against O.P.no.1 and 2, if so to what extent against whom?
iii) To what relief ?
12) Point No.1 :- Learned counsel for complainant contended that except denial of age of insured Veresi Gangamma, all the other aspects accepted by O.Ps and at the time of death of insured, the insurance was under force as per Exhibit A3 and Ex.A6 Aadhar Card, Ex.A3 Rajiv Aarogyasree card clearly reveal the age of insured Gangamma was 48 years at the time of taking policy under Ex. A3. The age mentioned in Voter I.D. card, house hold card is only imaginary not given by the insured. Therefore they cannot be taken into consideration and Ex.A6, and Ex.A7 age is the proof. Hence O.P.no.2 cannot revise the claim of the complainant on the basis of excess age at Rs. 1,09,510.74ps. instead of Rs.4,30,892/-. Therefore complainant proved the deficiency of service in reducing the claim of complainants under the policy of their mother. Hence, O.P.no.2 is liable to pay the amount though not O.P.no.1.
13) It is contended on behalf of the O.P.no.1 that the O.P.no.1 is only facilitator and as per the terms and conditions of the hypothecation agreement, he demanded the payment of installments and is no way concerned with the insurance claim settlement between complainants and O.P.no.2. Therefore he is unnecessary party and no deficiency of service on his part and complaint is liable to be dismissed, as he is not liable to pay any thing to the complainants.
14) Learned counsel for O.P. no.2 vehemently submitted that the life assured wantonly gave wrong age at the time of giving declaration of good health as per Ex. B5 on 31-7-2014 and age of insured is varied from Ex.A6, Ex.A7 to Ex.B9, Ex.B10 and her age at the time of declaration of good health under Ex.B5 is not 48 but it is more than 60 years. Thus the complainants mother i.e., insured gave mis statement about her age at the time of taking policy and she did not disclose her actual age for wrong ful gain, however as a matter of goodwill gesture O.P.no.2 settled the claim on revised cover amount as per the terms and conditions of the policy at Rs.1,09,510-74ps and complainants are not entitled more than that and there is absolutely no deficiency in service. Hence complaint is liable to be dismissed.
15) There is no dispute in this case that the complainant’s mother had taken policy as per Ex. A3 from O.P.no.2 on 31-7-2014 and paid premium of Rs.8,249/- and the complainant’s mother Veresi Gangamma died on 25-5-2015. According to complainant’s their mother i.e., insured under Ex.A3 policy gave actual age as per Ex.A6 and “Ex.A7 as 48 years on 31-7-2014 at the time of giving declaration under Ex.B5 of good health. According to O.P.no.2 the complainants mother age was more than 60 years as per exhibits B9,B10, so the claim was reduced on revised cover amount and settled. But a perusal of Ex.A6 Aadhar Card and Ex.A7 Rajiv Arogyasree card of insured Gangamma her age was 48 years only at the time of giving her declaration of good health under Ex.B5. Though Ex.B9 Voter I.D. card shows she was 40 years as on 1-1-1995, but the same cannot be taken into consideration in view of the reliable authenticated documents of Ex.A6 and Ex.A7. so also the age in Ex.B10 house hold card of insured Gangamma also cannot taken into consideration in similar lines above. Basing on Ex.B9 and B10 the O.P.no.2 cannot say that there is discrepancy in the age of complainants mother i.e., insured, therefore the claim of complainants had settled on revised cover amount as per the terms and conditions of the policy cannot be accepted. The policy under Ex.A3 issued by O.P.no.2 was in force at the time of death of insured on 25-5-2015. The insured had regularly paid the premium to cover the risk so the age of her as 48 years as on 31-7-2014 declared by her as per Ex.B5 is supported by Ex.A6, A7 Aadhar Card and Rajiv Aarogya Sree card which are more authenticated to prove age of the insured rather than Ex. B9, voter I.D. card Ex.B1 house hold card. As such we hold that there was no mis statement of age by complainants mother Gangamma at the time of giving declaration by her on 31-7-2014 and she did not suppressed her age for wrongful gain at that moment. So, O.P.no.2 cannot reject the claim of complainants or reduce it on his own calculations. The insured is entitled to the whole benefits covered under the policy under Ex.A3 consequently the complainants who are legal heirs and sons of insured Gangamma are entitled for the full claim of Rs.4,30,892/- which is the outstanding amount. But O.p.no.2 not settle the claim to that extent, hence we hold that there is deficiency of service on the part of O.P.no.2. Thus O.P.no.2 is liable to pay the amount of Rs.4,30,892/- to the complainants. However O.P.no.1 who is the financier under hypothecation agreement is not liable to pay any claim as no deficiency of service on his part. Hence the complaint against O.P.no.1 is dismissed. Accordingly point no.1 is answered.
16) Point No.2 :- In point one, it is held that there is deficiency in service on the part of O.P.no.2 and no deficiency of service on the part of O.P.no.1 and O.P.no.2 is liable to pay Rs.4,30,892/- and Rs.10,000/- towards physical strain and mental agony and Rs.5,000/-towards costs of the complaint. Since no deficiency of service on the part of O.p.no.1, O.P.no.1 is not liable to pay any amount to the complainants and complaint is liable to be dismissed against him. Accordingly point no.2 is answered.
17) Point No.3 :- In the result, the complaint is allowed against the opposite party no.2 directing him to pay Rs.4,30,892/- (Four Lakh Thirty Thousand Eight Hundred and Ninety Two Only) with interest at 9% p.a. towards insurance coverage amount under policy no. CC000023OD01700 from the date of filing of this complaint i.e., on 23-6-2016 till the date of realization to the complainants and shall also pay Rs.10,000/- towards mental agony and Rs.5,000/- towards costs of this complaint, within 45 days from the date of receipt of this order. The complaint against O.P.no.1 is dismissed without costs.
Dictated to the Typist, transcribed by him, corrected and pronounced by us in the open forum, this the 28th day of November, 2017
MEMBER PRESIDENT
APPENDIX OF EVIDENCE
Witnesses examined
For complainant : NIL For opposite party : Nil
Exhibits marked on behalf of the Complainant :-
Ex: A1:- P/c of Certificate of Registration pertaining to Tractor bearing Registration No.
AP 04 AY 1942 stands in in the name of mother of the complainant by name
Veresi Gangamma.
Ex: A2:- P/c of Letter of Agreement issued by the 1st opposite party dt.04-08-2014 in
favour of the Veresi Gangamma,.
Ex: A3:- P/c of Loan Suraksha complete cover group insurance certificate issued by the
2nd respondent in fevour of Veresi Gangamma.
Ex: A4:- P/c of Statement of Account issued by the 1st Opposite Party.
Ex: A5:- Death Certificate of Veresi Gangamma,
Ex: A6:- P/c of Aadhar Card pertaining to Veresi Gangamma,
Ex: A7:- P/c of Rajiv Arogya Sree card pertaining to Veresi Gangamma,
Ex: A8:- P/c of Legal notice dated 26-03-2016 issued by the complainant to the
opposite parties.
Ex: A9:- Acknowledgement card.
Ex: A10:- Reply letter dated 26-05-2016 issued by the 2nd respondent to the complainant,
Ex: A11:- P/c of House hold card bearing No. WAP114401400038..
Ex: A12:- P/c OF Three Bill for Rs.4,59,320/- paid by the complainant to the O.P.no.1.
Ex: A13:- P/c of no objection certificate Dt. 18-3-2017 issued by the O.P.no.1 in favour of
the complainant.
Exhibits marked on behalf of the Opposite party No.1: -
Ex:B1:- Copy of letter addressed by the son of the V.Gangamma to the Mahindra Finance Manager, Dated 25-11-2016.
Ex:B2:- P/c of cash receipt dated 17-09-2016 issued by the respondent..
Ex:B3:- P/c of letter addressed by the V.Venkataiah, dated 14-09-2016 by giving undertaking.
Ex:B4:- copy of statement of account dated 19-1-2017 issued by the respondent.
Exhibits marked on behalf of the Opposite party No.2: -
Ex:B5:- P/c of declaration of good health dt 31-07-2014.
Ex:B6:- P/c of certificate of insurance dt 31-07-2014.
Ex:B7:- P/c of death claim intimation.
Ex:B8:- P/c of Aadhar card.
Ex:B9:- P/c of Voter ID Card.
Ex:B10:- P/c of House hold card..
Ex:B11:- P/c of claim settlement letter dt 24-12-2015..
Ex:B12:- P/c of reply legal notice dt 26-05-2016.
MEMBER PRESIDENT
Copy to
1) Sri G. Trivikram Singh, Advocate, Kadapa.
- Sri V. Rama Mohan, Advocate, Kadapa.
3) Sri G.S. Murthy, Advocate, Kadapa.
& & &
P. R.
