SUNITA Vs. HDFC STANDARD LIFE INSURANCE CO. LTD.

JUDGEMENT

(1.) Delay condoned.

(2.) Challenge in this First Appeal is to the Order dated 20 th January, 2016 passed by the State Consumer Disputes Redressal Commission, Maharashtra, Circuit Bench at Nagpur (for short, "the State Commission"?) in Complaint Case No. 14 of 2012 whereby the Complaint filed by the Complainant/Appellant herein, was dismissed holding that there was no deficiency in service on the part of the Opposite Parties/Respondents herein in repudiating the claim preferred by the Complainant.

(3.) Concisely put, the facts leading to the filing of the Complaint before the State Commission are that the Husband of the Complainant (for short, the "Deceased"?), during his life time, had obtained two Insurance Policies from the Opposite Party No.1, namely, HDFC Standard Life Insurance Company Ltd. (for short, the "Insurance Company"?) bearing No.12992586 on 30. 06.2009 with assured sum of 12,50,000/- and HDFC Term Assurance Policy bearing No.13006145 dtd. 25/8/2009 with assured sum of 75,00,000/-. During the validity of the said Policies, the Deceased was murdered by the Naxalites and a case was registered by the Police on 1. 05.2011. The Complainant, being legal heir of the Deceased submitted the Claim under the said two Policies with the Insurance Company along with all necessary documents, which were acknowledged by the Insurance Company vide their letter dtd. 13/9/2011. By the said letter, the Complainant was also informed that since the death of the Deceased has taken place within two years of issuance of Policies, the Claim is an early Claim and the Insurance Company would verify certain facts before deciding the Claim and may call additional information or clarifications to be provided by the Complainant. However, subsequently, vide two separate Letters both dated 12. 10.2011, the Complainant was informed by the Insurance Company that they were not able to accept the Claim of the Complainant under the said two Policies inasmuch as the Deceased had not disclosed the information regarding 'Existing Insurance Covers' at the time of applying for the subject Insurance Policies. Consequently, Complainant approached the Grievance Committee of the Insurance Company and the Insurance Ombudsman Office. The Grievance Committee, vide letter dtd. 21/12/2011, informed the Complainant that her claim had been repudiated by the Insurance Company as at the time of taking the aforesaid Policies her husband has not disclosed the material information about the existing Policies taken from the other Insurance Companies. The Insurance Ombudsman also, vide its letter dtd. 19/12/2011, informed the Complainant that she may approach any Appropriate Forum like Consumer Forum or Civil Court since the amount of compensation claimed was more than 20,00,000/- which was beyond their pecuniary jurisdiction.