BEFORE THE KARNATAKA STATE CONSUMER DISPUTES REDRESSAL COMMISSION,
BANGALORE (ADDL. BENCH)
DATED THIS THE 3rd DAY OF AUGUST 2022
PRESENT
MR. RAVISHANKAR : JUDICIAL MEMBER
MRS. SUNITA CHANNABASAPPA BAGEWADI : MEMBER
APPEAL NO. 1695/2014
Smt. Vijayalakshmi, W/o Late T.R. Manjunatha, Aged about 39 years, R/o Sakrebailu Village, Gajanur Post, Shivamogga Taluk & District. Pin – 577 201. (By Sri P.N. Harish) | ……Appellant/s |
V/s
The Senior Divisional Manager, LIC of India, Divisional Office, Jeevan Prakash, KSSIDC Building, Sagar Road, Shivamogga 577 202. (By Sri Ramachandra.G. Bhat) | ..…Respondent/s |
ORDER
MR. RAVISHANKAR, JUDICIAL MEMBER
1. The appellant/Complainant has preferred this appeal being aggrieved by the Order dt.06.11.2014 passed in CC.No.277/2013 on the file of District Consumer Disputes Redressal Commission, Shimoga.
2. The brief facts of the case are as hereunder;
It is the case of the complainant that the husband of the complainant Mr. T.R. Manjunatha had obtained Jeevan Anand Policy bearing No.629567295 from Opposite Party on 28.03.2011 which covers accidental benefit together with assured bonus. The sum assured is Rs.2,00,000/-. The husband of the complainant earlier to this policy also obtained two more policies from the Opposite Party and was paying premiums regularly without any default. Such being the case on 28.11.2011, the husband of the complainant was died due to accident slip to Tunga Left Bank Channel near Navodaya Vidyapeetha on Shimoga-Thirthahalli Road. The police have recovered the body near the garden land of Prafullachandra and as such registered FIR No.422/2011 subsequently filed a complaint before JMFC, Shimoga. The case was registered as UDR case. Subsequently being a nominee of the deceased/ insured, the complainant claimed for the assured amount by virtue of the policy, but, the Opposite Party has repudiated the claim dt.31.03.2012 stating that the insured committed suicide within a year of the policy, hence, declined to settle the claim. Against which, the complainant filed a complaint before the District Commission alleging deficiency in service and prayed for settlement of the claim. After issuance of the notice, the Opposite Party appeared before the District Commission and took a contention that the insured was committed suicide within one year of the commencement of the policy, hence, repudiated the claim and submitted no deficiency in service. After trial, the District Commission dismissed the complaint holding that there is no any deficiency in service in repudiating the claim of the complainant.
3. Aggrieved by the said order, the appellant/ complainant is in appeal. Heard the arguments.
4. On going through the memorandum of appeal, certified copy of the order of the District Commission, we noticed here that the husband of the appellant had obtained three policies from the respondent company. It is also not in dispute that the two policies were settled and the policy which was obtained in the year 2011 was not settled to the complainant for the reason that the husband of the complainant was committed suicide. The reason for repudiation of the claim narrated by the respondent during trial is that the complainant herself has signed the claim form and stating that her husband committed suicide. Basing on the said submission, the respondent repudiated the claim, hence, submitted no deficiency in service.
5. On perusal of the said Claim Form, we noticed that it was filled by an Agent of the respondent company and it is only a signature made by the appellant and without any verification of the FIR, the Claim Form was filled by the agent of the respondent company. The cause of death indicates suicide which was written by them and at this junction of time we suspect that the appellant has expressed that it was a suicide. Apart from that on perusal of the UDR registered before JMFC Court, it was clearly mentioned that due to an accidental slip death was caused and the cause of death was not known and the case was registered u/s 302 of IPC was dismissed. The District Commission made an error in not appreciating the order passed by the JMFC, Shimoga and UDR filed by the Police Department which categorically states that it is not death due to suicide and it is due to accidental slip the death was caused. The said UDR report and Order of the JMFC are the authenticated documents to establish the death of the insured is an accidental and not suicide. Mere mentioning the cause of death as suicide in the claim form could not be a ground for repudiation of the claim. It is a clear case of deficiency in service on the part of the respondent/ Opposite Party in repudiating the genuine claim of the complainant. The District Commission also made an error in dismissing the complaint. As such the order passed by the District Commission has to be set aside. Hence, the following;
ORDER
The appeal is allowed. Consequently, the complaint is allowed.
The Opposite Party directed to pay the assured amount of Rs.2,00,000/- to the complainant along with interest at 9% p.a. from the date of repudiation, till realization.
The Opposite Party is further directed to pay a sum of Rs.1,00,000/- as compensation for repudiation of the genuine claim of the complainant and a sum of Rs.25,000/- as costs of litigation to the complainant.
The Opposite Party is granted 30 days time from this date to comply the Order.
Forward free copies to both parties.
Sd/- Sd/-
MEMBER JUDICIAL MEMBER
KCS*
