Page 39 - Suri’s - NCDRC ON LIFE INSURANCE 2017 V1.3

Suri’s - NCDRC ON LIFE INSURANCE 2017 39

Dated : 16 Oct 2017
ORDER
DR. S. M. KANTIKAR, MEMBER

1. The above said cross Appeals have been filed under Section 19 of the Con-
sumer Protection Act, 1986 against the impugned order dated 30.09.2014 passed by
U. P. State Consumer Disputes Redressal Commission, Lucknow (in short, ‗the State
Commission‘) in Complaint Case No. 64 of 2013. By the said order, the State Com-
mission allowed the complaint of the complainant and directed the OP to pay
Rs.26,13,623/- to the complainant.
2. The brief facts for the disposal of both appeals are that the complainants,
Ms. Sunita and the complainant‘s husband, Shri Bijender Singh had taken housing
loan for the sum of Rs.26,13,623/- from PNB Housing Finance Limited/OP-3 on
31.5.2011. In pursuance of the internal arrangement with the TATA AIG Life Insur-
ance Company/Opposite Party No. 1 and 2, the OP 3 financer purchased a policy of
insurance covering the risk of the life of the Borrower/Late Brijendra Singh. The
total tenure of the policy was 10 years i.e. till 30.5.2021. Unfortunately, her husband
died on 25.7.2011 by heart-attack. The death intimation was given to OP-2 and OP-3
on 3.9.2011. The OP 2/insurance company neither settled the claim nor informed
about progress despite several reminders/letters were sent by the complainant. There-
after, two legal notices were also served to the OPs but the claim was repudiated by
OP on 19.3.2013. Hence, aggrieved by the repudiation, the complainant filed a com-
plaint before the State Commission, U.P.
3. After due service of notice, the OPs did not file written statement and OPs
abstained from the proceedings. Therefore, the State Commission allowed the com-
plaint ex parte and directed the OPs 1 and 2 to pay Rs.26,13,623/- along with interest
@ 9% per annum from 3.5.2012. It allowed Rs.2,00,000/- as punitive damage and
Rs.15,000/- as costs.
4. Being aggrieved by the order of State Commission, OPs 1 and 2 filed first
appeal No. 1432 of 2014 for dismissal of complaint whereas first appeal No. 1163 of
2014 was filed by Ms. Sunita, the complainant for enhancement of the compensation.
5. We have heard learned counsel for both the parties. Learned counsel for
OPs 1 and 2 submitted that there was delay of 8 days in filing the appeal (FA No.
1432 of 2014). The delay is condoned for the reasons stated in the application for
condonation of delay. Learned counsel further argued on merits that on receipt of
death claim from the complainant, the matter was assigned by OPs to the investigat-
ing agency, which submitted report inter alia alleging that deceased was having medi-
cal history prior to the inception of the policy and he was suffering from kidney dis-
ease. He had also taken treatment from Yashoda Hospital in Meerut. The Sanjivni
Diagnostic Center, which was located in front of the house of the deceased, had
helped the deceased during treatment of kidney disease. Also, the records of Astha
Blood bank situated at Baraut proves that in July, 2011, the blood bank had sent blood
to Kidney Hospital, Meerut in the name of deceased. The counsel further stated that
the deceased was not CGHS beneficiary. He had taken treatment and benefits under
CGHS in the name of Shri Ravindra Singh, a constable working in Delhi Police.
Thus, deceased was hiding his identity and his previous medical history about his

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