NAGALAND STATE CONSUMER DISPUTES REDRESSAL COMMISSION KOHIMA, NAGALAND CC 1/2015 Mrs. Leno Lhouvisier Ziny(cid:252)

Wife of Late Thomas Jasokie Ziny(cid:252)

Lerie Chazou Colony, Kohima - 797001, Nagaland.

Mobile No. 9436060982 …Complainant -vs-

1. The Chairman, Max Life Insurance Company Ltd.

Max House (3^rd Floor), 1, Dr. Jha Marg, Okhla, New Delhi – 110020

2. The Managing Director & CEO Max Life Insurance Company Ltd.

11^th Floor, DLF Square Building, Jacaranda Marg, DLF City Phase II, Gurgaon – 122002, Haryana.

3. The Officer-in-Charge/Manager, Claim Support Unit, Max Life Insurance Company Ltd.

Operation Center, Plot No. 90-A, Udyog Vihar, Sector 18, Gurgaon – 122015, Haryana.

4. The Branch Head/Manager (Agent), Axis Bank Ltd., Kohima Branch, UT Complex, Opp UBC Church, Kohima – 797001, Nagaland.

Insurance/Corporate Agent …Opposite Parties Present:

For the Complainant: (K. H. SAVI) Advocate For the Opposite Party: (MAMANG SINGSON) Advocate Date of Hearing:

Date of Order:

The present complaint has been filed by Mrs. Leno Lhouvisier Ziny(cid:252)

whose husband had taken a life insurance policy with the Max New York Life Insurance Company and filled a proposal form dated 23.07.2011 bearing No. 796180719. The husband of the petitioner Mr. Thomas Jasokie Zinyü “Deceased Life Insurance” or DLA for an assured sum of ₹50,00,000/- (Rupees Fifty Lakhs only). The DLA died on 04.12.2012 and claim was intimated to the opposite party. However, the claim was repudiated by the opposite party on the ground that there was material suppression of facts in the proposal form.

Appearing for the Complainant, learned Counsel Mr. K. H. Savi appears and submits as follows:

Your Lordship and learned Member, at the outset kindly allow me to narrate ’Facts of the present case’, Max Life Insurance Co. Ltd is a corporate (Opp. Parties No. 1, 2 & 3) into the business of Life Insurance having its registered office at New Delhi and has branches across India. They have an Agent in Kohima namely AXIS BANK LTD KOHIMA (Opp. Party No. 4 as corporate/insurance Agent) and was operating in Kohima offering and accepting policy on behalf of the Opposite Parties (Opposite Party No. 1, 2 & 3). Originally the Insurance name was "Max New York Life Insurance Company Limited" and it continues till such time the present complaint petition was filed and later on it has changed to "Max Life Insurance Company Ltd." Accordingly, the complainant has filed an application to change the name of Opposite Parties, particularly No. 1, 2 & 3 to Max Life Insurance Company Ltd. and the Hon’ble Commission was pleased to consider the said application. All the annual Premium are deposited to the Axis Bank Ltd. Kohima Branch, Kohima, Nagaland (Agent Bank). Accordingly, their Agent (Opp. Party No. 4) approached and offered policy to the Policy Holder late Thomas Jasokie Ziny(cid:252) (hereinafter referred to as the "Deceased Life Insured" or "DLA") who was also a customer of Axis Bank Ltd, UT Complex, Kohima with account No.

909010031892358.

The moment Policy Holder (late Thomas Jasokie Ziny(cid:252)/DLA) had apply for the policy brought and offered to him by their Agent (Opp. Party No. 4), the Agent/Opp. Party No. 4 instructed him to file up the form as per the Life Insurance Policy Documents along with a medical assessment prior to the issued of policy. Since then the Insurance/corporate Agent Opp. Party No. 4 took the initiative and entirely led and guided the complainant/policy holder to get done all necessary formalities including health fitness as the policy has to be accepted solely subjected to a thorough physical examination where a medical assessment has to be done at the company’s approved expert hospital by its empaneled doctors. And to ensure health fitness, a medical assessment was carried on Thomas Jasokie Ziny(cid:252)(DLA/Policy Holder) conducted by Max company’s approved Expert at Windrobe Hospital, Guwahati by its empaneled doctors in the person of Dr. Tridib Baruah, MBBS, MD, on 10th August