Date of filing : 15.06.2017.

IN THE TAMILNADU STATE CONSUMER DISPUTES REDRESSAL COMMISSION, CHENNAI Present: Hon’ble Thiru. Justice R. SUBBIAH: PRESIDENT C.C. No.154 of 2017 Friday, the 30th day of August 2024 M.S. Raji W/o Late M. Srikanth New No.22, Old No. 17 Vijayalakshmi Street, Mahalingapuram, Nungambakkam, Chennai – 600 034. .. Complainant - Vs –

1. PNB Met Life India Insurance Co. Ltd., Rep. by its Authorized Signatory, 1st Floor, Techniplex -1 Techniplex Complex Off Veer Savarkar Flyover Goregaon (West)

Mumbai – 400 062.

2. PNB Met Life India Insurance Co. Ltd., Rep. by its Branch Manager, S-4, Floor No.2, Alsa Mall

147/149, Montieth Road Egmore, Chennai- 600 008.

3. Punjab National Bank Rep. by its Branch Manager Neelankarai Branch Neelankarai, Chennai. .. Opposite Parties Counsel for the Complaint : M/s. V. Balaji Counsel for the 1^st & 2^nd Opposite Party : M/s. N. Kishore Kumar For the 3^rd Opposite Party : Ex-parte This Complainant came up for final hearing on 08.04.2024, and on hearing the arguments of the counsel for the Complainant and the counsel for the opposite parties 1 & 2 and upon perusing the material records, this Commission made the following :-

O R D E R

R. SUBBIAH J, PRESIDENT This Complaint has been filed under Section 17 of the Consumer Protection Act, 1986 to direct the 1^st & 2^nd Opposite Parties, jointly and severally and individually, (i) To pay a sum of Rs.30,00,000/- towards the sum assured under the Policy No. 21740290 dated 29.11.2015 with accrued benefits;

(ii) to pay a sum of Rs.5,00,000/- as compensation for mental agony and deficiency in service; and (iii) To pay a sum of Rs.50,000/- towards the cost of this complaint.

2. The case of the complainant is that she is the wife of the life assured Late M.Srikanth. Her husband was a Chartered Accountant. During his life time, the 2^nd opposite party through their agent R.Balaji approached her husband for taking life policy. Her husband specifically informed the agent that he is having diabetics and hypertension. The 2^nd opposite party and their agent without explaining the exclusion clauses obtained the signature of her husband in blank proposal form. The proposal was signed at Chennai. The sum assured under the policy was Rs.30,00,000/- and the annual premium was fixed as Rs.1,01,643/-. The first annual premium was paid through the 3^rd opposite party under Auto Debit Mandate. An account was opened with the 3^rd opposite party only for the purpose of remitting annual premium covered under the policy. The policy was issued by the 1^st opposite party as per their administrative convenience. After getting opinion from the panel of Doctors and agent confidential reports, the 1^st opposite party issued the policy and the details of the policy are as follows:

The policy was issued after commencement of IRDA Regulations 2002. Hence the policy is covered under the IRDA Regulations. Prior to issuance of the policy, it is mandate under Sub Regulation 4 of Regulation 3 that the agent and the 2^nd opposite party are duty bound to inform the Exclusion clause and a certificate is required to be incorporated at the end of the Proposal Form from the prospects that the contents of the form and documents have been fully explained to the insured. Admittedly neither the 1^st and 2^nd opposite parties nor the Agent explained the Exclusion Clause. Further, the deceased was not aware of what was filled by the Agent. Whileso, on 17.10.2016 at 08.15 am, the complainant’s husband developed severe headache which was sudden in onset and was followed by loss of consciousness. He did not regain conscious since then. Initially he was taken to Apollo First Med Hospital where he was intubated in view of low GCS. He was evaluated with CT brain plain there which revealed acute intracerebral hemorrhage involving left frontal lobe with venticular extension, mass effect, midline shift and diffuse cereb