PNB METLIFE INSURANCE COMPAMY LTD. Vs. MOPIDEVI LALITHA

JUDGEMENT

(1.) This first appeal has been filed under section 19 read with Sec. 21(a)(ii) of the Consumer Protection Act, 1986, against the impugned order dated 04.12.2014, passed by the Andhra Pradesh State Consumer Disputes Redressal Commission, Hyderabad (hereinafter referred to as "the State Commission") in Consumer Complaint No. 79/2013, filed by the present respondent, vide which, the said complaint was partly allowed.

(2.) Briefly stated, the facts of the case are that the husband of the complainant/respondent Mrs. Mopidevi Lalitha, during his life time, had taken a life insurance policy, bearing no. 20527202 dated 24.03.2011 for a sum assured of Rs. 30 lakhs, commencing from 10.03.2011. The policy in question has been designated as Met Suraksha LT 2A 16. As per the complainant, her husband paid the renewal premium vide cheque no. 247463 dated 24.02012 drawn on Axis Bank Ltd., Hyderabad and receipt no. C3161385 dated 27.02012 was issued by the Insurance Company. However, her husband fell seriously ill on 06.03.2012 and was taken to Primary Health Centre, Nizampatnam, but he died on the same day. The complainant filed claim with the Insurance Company alongwith necessary documents under the terms and conditions of the policy, but the same was not settled by the OP Insurance Company despite reminders. The OP Insurance Company informed her that the income tax returns, said to have been submitted as proof of income by the complainant's husband, were fabricated. By not disclosing proper income to the Insurance Company, the complainant had violated the principle of utmost good faith. Vide their letter dated 13.09.2012, the Insurance Company repudiated the claim, stating that any non-disclosure or misrepresentation in the application form renders the claim voidable. The Insurance Company stated that they had treated the policy as void ab initio and they enclosed a cheque of Rs. 13,898.20 as full and final payment of the claim. The complainant filed the consumer complaint in question, seeking directions to the OP Insurance Company to pay the sum insured under the policy, amounting to Rs. 13 lakhs to her and also to provide compensation of Rs. 1 lakh for mental agony etc. and Rs. 30,000.00 as cost of litigation and further to award interest @ 18% per annum on the insurance amount from the date of claim till payment.

(3.) The complaint was resisted by the OP Insurance Company by filing a written reply before the State Commission in which they stated that as per the terms and conditions of the policy, which were duly explained to the insured, the policy contract becomes null and void, if any untrue statement is made. During the course of investigation and assessment of the claim, the ITR submitted by the complainant was found to be fabricated. It was further revealed that the life assured was working as net fish maker and his annual income was only Rs. 13,000.00. He had, therefore, misrepresented the facts before the Insurance Company and played fraud upon them. However, they still refunded the fund value available in the policy amounting to Rs. 13,898.20, acting as a customer-friendly organisation. The life insured had described his occupation as Civil Contractor and stated that his annual income was Rs. 3,30,000.00. The complainants had not approached the consumer fora with clean hands.