DISTRICT CONSUMER FORUM OPPOSITE CSI CHURCH VARADAIAH NAGAR KHAMMAM 507 002 TELANGANA STATE Complaint Case No. CC/13/65 ( Date of Filing : 06 Nov 2013 ) 1. Kanaganti Saidulu, S/o. Late Kanaganti Ramulu, Age 34 years, Occ Coolie, R/o. H.No.4-1-164/1, Rotary Nagar, Khammam Town Dist R/o. H.No.4-1-164/1, Rotary Nagar, Khammam Town and Dist Khammam Dt Andhra Pradesh ...........Complainant(s) Versus 1. Tat AIA Life Insurance Company Ltd, Rep. by its Branch Manager, H.No.5-1-186/1, 2nd floor, Swarna palace, Wyra Road, Khammam Town and Dist H.No.5-1-186/1, 2nd floor, Swarna palace, Wyra Road, Khammam Town & Dist Khammam Dt Andhra Pradesh ............Opp.Party(s) BEFORE: HON'BLE MR. P. MADHAV RAJA PRESIDENT HON'BLE MR. R. Kiran Kumar MEMBER For the Complainant: For the Opp. Party: Dated : 11 Jan 2018 Final Order / Judgement BEFORE THE DISTRICT CONSUMER FORUM AT KHAMMAM Dated this, the 11th day of January 2018 CORAM: 1. Sri. P. Madhav Raja, B.Sc., M.Li.Sc. LL.M.,? President 2. Sri. R. Kiran Kumar, B.Sc., LL.M. ? Member C.C. No.65/2013 Between: Kanaganti Saidulu, S/o. late Kanaganti Ramulu, Age: 34 years, Occu: Coolie, R/o. H.No.4-1-164/1, Rotary Nagar, Khammam town and District. ?Complainant And TATA AIA Life Insurance Company Ltd., Rep. by its Branch Manager, H.No.5-1-186/1, 2nd Floor, Swarna Palace, Wyra Road, Khammam town and District. TATA AIA Life Insurance Company Ltd., Rep. by its Managing Director, Registered @ Corporate office, Delphi ? B Wing, 2nd Floor, Orchard Avenue, Hiranandani Business Park, Powai, Mumbai ? 400 076, Board Tel No.91 22 6647 9000, Website: tataaia.com ?Opposite parties This C.C. is coming before us for hearing in the presence of Sri. Y. Ravi Kumar, Advocate for complainant; and of Sri. N. Naveen Chaitanya, Advocate for opposite parties No.1 & 2; upon perusing the material papers on record; upon hearing arguments and having stood over for consideration, this Forum passed the following:- O R D E R (Per Sri. P. Madhav Raja, President) This complaint is filed under section 12(1) of the Consumer Protection Act, 1986. 2. The set of brief facts in the complaint are that the complainant?s father Sri. Late Kanaganti Ramulu had obtained three life insurance policies from the opposite party No.1 namely 1) TATA AIG Life Assurance-II vide policy bearing No.U009517536 dated 19-05-2009 for coverage amount of Rs.1,20,000/-, 2) policy of TATA AIG Life Shubh Life vide policy bearing No.C071646338,dt.28-09-2010 for coverage amount Rs.1,00,000/-and 3) policy of TATA AIG Life Raksha-10 vide policy bearing No.C071646341, dt.28-09-2010 for coverage amount of Rs.6,00,000/-. The complainant further submitted that late Kanaganti Ramulu father of the complainant was passed away on 02-11-2012 at Pedda Munagala village while the said policies were in force. The complainant being a nominee claimed the said policies amounts from the opposite party No.1 and the opposite party No.1 repudiated the claims of the three said policies and rescinding the policies the opposite parties have remitted back the premiums paid amount for the policy No..U009517536 Rs.42,000/- in to the claimant account No.62066007770 towards full and final settlement of the claim of the policies. Aggrieving on repudiation of claims the complainant got issued legal notice to claim the said policies death benefits and policy amount. On the silence of the opposite parties the complainant preferred this complaint before this Forum claiming Rs.8,20,000/- insurance coverage amount of the 3 said policies with interest @ 24% per annum and Rs.2,00,000/- for the gross negligence . 3. In support of his case, the complainant filed some documents along with complaint, IA.No.17/2015 and IA.No.45/2017 which were marked as Exhibits A-1 to A-16. 4. On receipt of notices, the opposite parties appeared through their counsel and filed their counters by denying the averments as mentioned in the complaint. In their counter, the opposite party No.2 submitted that it has no role in this complaint as complainant has never availed any services from the opposite party No.2. Therefore, without going into merits the complaint is to be dismissed against the opposite party No.2. The opposite parties have admitted that availing of 3 policies for sum assured Rs.1,20,000/-, Rs.6,00,00/- and Rs.1,00,000/- respectively and the death of the complainant?s father on 02-11-2012. The opposite parties have repudiated the said policies as mis-match of date of birth and age issue. The policy No.1) U009517536 issued on 19-05-2009 for Rs.1,20,000/- maximum issue age 55 years. 2) C071646341 issued on 28-09-2010 for Rs.6,00,000/- maximum issue age is 50 years and 3)C071646338 was issued on 28-09-2010 for Rs.1,00,000/- maximum issue age is 60 years. The said policies were issued on production of ration card copy and voter ID copy for proof of age and as per insurer application form his date of birth is mentioned as 27-12-1960. After the death of the insurer the complainant has claimed the policies amounts and on verification it has come to know that the insurer has forged the documents and wrongly mentioned his date of birth to gain money and also revealed that as per Aadhar card the year of birth of the deceased / life assured is 1947 and as per official website of Chief Electoral officer the deceased age was 65 years as on 01-10-2012, in ration card copy the insured age was 58 years in 2008 and in voter ID the birth year is 1948. The opposite party has asked to produce the original ration card and voter ID card but the complainant was failed to produce the same. Hence the opposite parties have rightly have repudiated the claim on the ground that the deceased / life assured was beyond insurable age and as the deceased/policy holder has suppressed the material facts so all claim benefits shall seize, however, Rs.16,779/- for policy No.C071646338 was paid by way of NEFT to account No.62066007770 and was rescinded from inception. Therefore there is no meaning to file this complaint and prayed to dismiss complaint in the interest of the justice. 5. In support of its case, the opposite parties have not filed any documents to prove their contentions. 6. In view of above submissions, now the point that arose for consideration is, 1) Whether the opposite party No.2 can be made party to the Proceedings? 2) Whether the complainant is entitled as prayed for? Point No.1:- According to the afore mentioned averments and basing on the material available on record are that the opposite party No.2 is life insurance company represented by its Managing director. Being head of the institution organizing its transactions and business through various branches, it cannot escape from the responsibilities and liabilities of its business, therefore, the opposite party No.2 is to be made as party to the proceedings. Accordingly this point is answered in favor of the complainant. Point No.2:- It is an admitted fact that the life assured had obtained 3 life insurance policies as mentioned supra from the opposite parties and died on 02-11-2012 at Pedda Munagala Village, Konijerla Mandal, Khammam district and the complainant is the nominee to the said policies issued by the opposite parties. As per Ex.A4 to A6 the opposite parties have repudiated the all 3 claims on the ground that Mis-Match of date of birth and age issue while remitting through the NEFT to the complainants account Rs.13,320/- for policy No. C071646341, for policy No. U009517536 Rs.42,000/-and for policy No. C071646338 Rs.16,779/-, but in complaint the complainant has stated that he has received Rs.42,000/- and the opposite parties in counter have mentioned only Rs.16,779/-, and have not taken any word about the other amounts. The opposite parties have averred that they have investigated in to the matter and found on Aadhar card and Electoral web site the diseased/Insurer age was mismatching with that of the records of the application of the insurer. The opposite parties have not filed any substentative evidence or documentary proof in support of their contention. The opposite parties has to be vigilant while issuing the policies and on proper verification, medical checkup and endorsement of the competitive authorities only the policies will be issued for the insurers. The complainant has filed a birth certificate issued by the Registrar Births and Death i.e. Ex.A-15 and opposite parties have not contradicted it in anywhere. The Hon?ble NCDRC in Azaz Hider V/s. LIC of India IV (2017), CPJ, 452p observed that ?the policy accepted after agents report ? no person will intentionally declare his age wrongly ? policy was issued after due verification and medical examination ? repudiation not justified?. The Opposite Parties have further contended that the insurance is on the Principle of Uberrimae fides i.e. utmost good faith and in this contention the Hon?ble APSCDRC in The Branch Manager, LIC of India & others V/s Pasupuleti Bhagya Laxmi & others 2014 (4) CLT, 115p observed that when the policy issued by the insurance company with utmost good faith the same yard stick has to be applied while settling the claims also. In this instance the opposite parties have issued one of the policy in the year 2009 and two policies in the year 2010 on the same date after due verifications of the concerned authorities. The opposite parties to support their contention and averments have not filed any document and failed to prove their contention. Therefore by observing the Hon?ble National and state Commission decisions, we are of the opinion that the opposite parties are failed to perform their services properly, which amounts to deficiency of service on the part of opposite parties. Therefore, the opposite parties no.1 and 2 are liable to pay Rs.8,20,000/- covered under insurance policies. However, the complainant have already received an amount of Rs.72,099/- from the opposite parties through NEFT to his account. Hence the complainant is entitled for the balance amount of Rs.7,47,901/-. Accordingly this point is answered in favour of the complainant. 7. In the result, the complaint is allowed in part, directing the opposite parties No.1 and 2 to pay an amount of Rs.7,47,901/- towards insurance covered under 3 policies bearing Nos. C071646341, U009517536 and C071646338, with interest @9% per annum from the date of complaint i.e. 04-12-2013, and also pay Rs.2,000/- towards costs of the litigation. Typed to dictation, corrected and pronounced by us in the open forum, on this the 11th day of January, 2018. Member President District Consumer Forum, Khammam. APPENDIX OF EVIDENCE WITNESSES EXAMINED:- For Complainant For Opposite party None None DOCUMENTS MARKED:- For Complainant For Opposite party Ex.A-1:- Photocopy of Policy information page of policy No.C071646338. Ex.A-2:- Photocopy of policy information page of Policy No.U009517536. Ex.A-3:- Photocopy of life insurance premium certificate of Policy No.C071646341. - Ex.A-4:- Opposite parties letter for policy No. U009517536, dt 01-03-2013. Ex.A-5:- Opposite parties letter for policy No. C071646338, dt 25-02-2013. - Ex.A-6:- Opposite parties letter for policy No. C071646341, dt 25-02-2013. - Ex.A-7:- Office copy of Legal notice, dt. 12-03-2013 for policy No.C071646341. - Ex.A-8:- Office copy of Legal notice, dt. 12-03-2013 for policy No.C071646338. - Ex.A-9:- Office copy of Legal notice, dt. 12-03-2013 for policy No.U009517536. - Ex.A-10:- Photocopy of premium receipt of policy No.C071646341, dt. 15-09-2011. - Ex.A-11:- Photocopy of premium receipt of policy No.C071646338, dt. 15-09-2011. - Ex.A-12:- Photocopy of premium receipt of policy No.U009517536, dt. 06-05-2011. - Ex.A-13:- Photocopy of House Hold card of Kanaganti Ramulu. - Ex.A-14:- Certificate in Telugu issued by V.R.O., Munagala, dt. 08-11-2014. - Ex.A-15:- Photocopy of Birth Certificate issued Registrar of Births & Deaths, Khammam. Dt.10-03-2013. - Ex.A-16:- Death certificate issued by Panchayath Secretary, Pedda Munagala, dt. 15-11-2012. Member President District Consumer Forum, Khammam. [HON'BLE MR. P. MADHAV RAJA] PRESIDENT [HON'BLE MR. R. Kiran Kumar] MEMBER