F.A. No. 553 of 2012. Case: Shriram Life Insurance Co. Ltd. and Anr. Vs Yedla Purushotham Reddy. Andhra Pradesh State Consumer Disputes Redressal Commission
| Case Number | F.A. No. 553 of 2012 |
| Counsel | For Appellant: M/s. KRR Associates and For Respondents: Mr. V. Narasimha Rao, Advocate |
| Judges | R. Lakshminarasimha Rao and Thota Ashok Kumar, Members |
| Issue | Consumer Law |
| Citation | I (2014) CPJ 245 (AP) |
| Judgement Date | June 20, 2013 |
| Court | Andhra Pradesh State Consumer Disputes Redressal Commission |
Order:
R. Lakshminarasimha Rao, Member
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The opposite party is the appellant. The respondent filed complaint seeking for setting aside the repudiation of his claim and for award of the sum assured under the insurance policy. The respondent's wife during her life-time obtained insurance policy bearing number LN071000032266 from the appellant for the period commencing from 24.2.2010 for a period of one year till 23.2.2011. The sum assured in terms of the insurance policy is Rs. 1,00,000. The insured died on 24.7.2010 at Omni Hospital, Hyderabad due to cardio-respiratory arrest. After the death of his wife, the respondent being her nominee, submitted claim along with relevant documents to the appellant and the appellant required the respondent to submit medical record of his wife relating to the treatment for epilepsy for which the respondent had given reply that he did not have any such medical record since the insured did not take any treatment. The appellant closed the claim on the premise that the respondent failed to submit the medical record of the insured whereon the respondent filed the complaint.
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The respondent submitted that his wife was not treated for curing of epilepsy and as such he did not possess any such medical record insisted on by the appellant unreasonably and thus the repudiation of his claim is bad and unjust.
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The appellant resisted the claim on the premise that the respondent's wife concealed the fact that she suffered from epilepsy at the time of filling up the proposal form and through the claim form it was disclosed that she was suffering from epilepsy and the appellant requested the respondent to submit the medical record of his wife as regards treatment obtained for cure of epilepsy and as the respondent failed to submit the medical record despite giving sufficient time, the appellant closed the claim.
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The respondent filed his affidavit and the documents Exs. A1 to A6. On behalf of the respondents, its Assistant General Manager filed his affidavit and the documents, Exs. B1 to B8.
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The District Forum allowed the complaint on the premise that the closure of claim for non-submission of medical record of the insured is not justified and it amounts to deficiency in service on the part of the appellant-Insurance Company.
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Feeling aggrieved by the order of the District Forum, the opposite party has filed appeal contending that basing on the information furnished in the proposal submitted by the respondent's...
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