ORDER

BY HON’BLE Mr.JUSTICE HULUVADI G RAMESH : PRESIDENT

1. This complaint is filed U/s.47 of CPA 2019 by the Complainant against OP.1 to 4/Insurance company and prays to direct them to settle the claim and against OP.5 to 7/bank to withdraw the notices issued under SARFAECI Act, and sought to pass any other order deem fit in the facts and circumstances of the case.

2. The brief facts of the case are that: The Complainant/Smt.Mariya and her husband/Sri.Azhar Nadeem have availed home loan amount of Rs.87,50,000/- on 27.10.2016 for the purchase of the flat bearing no.42263, 26^th floor, T2 tower, Building 4, Prestige Falcon city, Kanakapura road, Bengaluru-62 from OP.5 to 7/bank and to cover the risk, insured the said loan for Rs.32,75,500/- by the Complainant and for Rs.83 lakhs by her husband with OP.1 to 4/insurance company by paying prescribed premium. While the policy was in force, her husband expired on 11.05.2021 due to covid-19. In the same grief, she filed a claim for settlement before OP.1 to 4 but the same was rejected as the cause of death due to covid-19 was not covered under the policy conditions. As long as her husband was alive, they were being paid the EMIs as per the repayment schedule. However OP.1 to 4 refused the settlement of claim, and being hand-in-glove with OP.5 to 7, have invoked the provisions of SARFAESI Act for recover of the loan amount and also issued possession notice against her. Such attitude of Ops has pushed the Complainant and her two minor children to a lot of depression, financial and emotional distress. Hence prays to allow the complaint.

3. OP.1 to 7 put their appearance through their counsel and files version of OP.1 to 4/insurance company denying the allegations made against them, however, admitted the issuance of policy securing the home loan. Since the cause of death falls outside the purview of the policy coverage, they justified the repudiation of the claim vide letter dtd.28.01.2022, thereby held there is no liability whatsoever neither on OP.1 to 4 much less OP.5 to 7, hence have pray to dismiss the complaint.

4. To substantiate the case, the Complainant filed her affidavit evidence and marked the documents at Ex-C1 to C24. The OP also filed its affidavit evidence. Heard. Now, the Commission to decide, (1) Whether the disease covid-19 a major/critical/severe illness ?

(2) Whether the claim repudiated by the Ops is justifiable ?

(3) Whether the Complainant proved there is deficiency in service on the part of OPs ? if yes, what reliefs could be granted ?

Our answers to the above points are:

(1) Affirmative (2) Negative (3) Affirmative for the following;

REASONS

5. Point no.1 to 3: Since the factors involved in all three points are interrelated, we have taken all together to record common findings. We perused the complaint, OP‟s version, affidavit evidence and the documents.

6. The undisputed facts are: The Complainant while his husband was alive, together have purchased the flat in question bearing no.42263 (allotment letter/Ex-C10, measuring 1591 sq.ft, value of the 3 BHK flat + car parking Rs.1,25,64,472/-) by availing home loan from OP.5 to 7/bank (home loan a/c no.LBBNG00003033929) of Rs.87,50,000/- during November 2016 and agreed to pay monthly EMI of Rs.91,106/- for 180 months at floating rate of interest vide Ex-C3 and C4/home loan sanction letter. The said home loan was insured by both the loanee i.e. husband and wife vide Ex-C11 & C12/policy. Ex-C11 & C12 are the home loan policy bearing no. 4065/ICICILL/123103513/00/000 and 4065/ICICILL/ 123115732/00/000 obtained by the Complainant and her husband from OP.1 to 4/insurance company by paying premium of Rs.31,348.91 and Rs.1,40,872.75 and insured the said home loan for Rs.83,00,000/- for the period commencing from 27.10.2016 to 26.10.2021. Ex-C13 is the death certificate of the insured i.e. husband of the Complainant. He died on 11.05.2021 while policy was in force. Ex-C14, inkpage.127/Kanachur Hospital medical records shows the cause