DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SUBARNAPUR
C.D. Case No. 12 of 2013
Udhaba Bagarty, S/o. Jala Bagarty, R/o. village Sardhapali, P.S. Sonepur, District – Subarnapur.
………… Complainant
Vrs.
1. Branch Manager, Reliance Life Insurance Co. Ltd. In front of Durga Mandir, At – Ramjee Pada, Bolangir, P.O./P.S./District - Bolangir
2. Claim Manager, Reliance Life Insurance Co. Ltd., Reliance House, 5th Floor, No.6, Haddows Road, Nungambakkam, Chennai, 600006,
…… Opp. Parties
Advocate for the Complainant …………. Sri R.Agrawal
Advocate (G.P.)for the O.Ps. …………. Sri S.K.Sandha
Present
1. Sri S.C.Nayak, President
2. Smt. S.Mishra Lady Member
Date of Judgment Dt.30.11.2015
J U D G M E N T
By Sri S.C.Nayak, P.
This is complainant’s case alleging deficiency of service on the part of the Reliance Life Insurance Co. Ltd.
The case of the complainant is that his deceased mother Dhar Bagarty had taken Reliance Endowment Plan on 29.8.2011 with sum assured of Rs.1.00 Lakh through the agent of the company namely Sanjay Kumar Baboo. His deceased mother had supplied all the required documents including V.I. card at the time of taking of the said policy. The deceased mother of the complainant was aged 61 years at the time of taking the policy as her date of birth is 12.12.1949. The information supplied by her was verified by the sale Manager of the company Pradeep Kumar Mohanty and he has submitted moral hazard report to the company before submitting proposal form. The company accepted the proposal of the deceased after verifying the genuineness of the information supplied by the deceased policy holder and received the premium amount.
As per the term of the policy the insurance company has to pay the sum assured amount i.e. One Lakh in case of death of the policy holder to the nominee of the policy. The policy commenced from 20.9.2011. The policy holder died on 29.9.2011 due to Cerebral Malaria and she was under the treatment of Dr.Trilochan Bishi. M.B.B.S., Sonepur.
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After the death of the policy holder the complainant as the nominee applied before the O.Ps. for payment of death benefit claim. He also submitted all required documents for the settlement of his claim.
But the O.Ps. have rejected the claim of the complainant on the ground that the deceased policy holder was aged about 79 years at the time of taking the policy. The complainant alleges that the O.Ps. have illegally rejected his claim. Therefore the complainant has prayed that the O.Ps. be directed to release the death claim of the complainant alongwith compensation and cost of litigation.
The O.Ps. have filed written version. The gist of their version is :-
1. This Forum does not have territorial jurisdiction to decide the lis.
2. The age of the L.A. has been under estimated.
3. The claim of the complainant has been repudiated on the ground of mis-statement in the proposal form.
4. The V.I. card of the L.A. relied on by the complainant cannot be considered as conclusive proof of her age.
5. The L.A. himself filled up the proposal form and duly signed after going through the terms and conditions of the policy.
6. The deceased was seriously ill at the time of making the policy.
7. Since there were suppression of facts at the time of taking the policy the policy was void abinitio.
8. The L.A. was bed ridden and paralysed since last 3 to 4 years prior to her death. The Medical Certificate issued by Dr. Trilochan Bishi is fake one.
9. There has not been any deficiency of service by the O.Ps. Hence the O.Ps. have claimed that the complaint should be dismissed with exemplary cost.
We have heard Mr.R.Agrawal, learned counsel for the complainant and Mr. S.Sandha learned Counsel for the O.Ps. We have also perused the materials on record. From the pleadings of the parties, submission of learned counsels at the time of hearing the following points fall for determination by the Forum :-
1. Does the Forum have jurisdiction to decide the lis ?
2. Is the repudiation of the claim by the O.Ps. justified ?
3. To what relief the complainant is entitled. ?
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The O.Ps. allege that this forum does not have territorial jurisdiction to decide the lis in as much as no part of cause of action has arisen within the district of Subarnapur. The learned counsel for the O.P. have relied on different decisions on this point. It is profitable to quote Section 11 Sub-Section (2) Clause (a) of the Consumer Protection Act, 1986 -
Section 11 X X X X
“ (2). A complaint shall be instituted in a District Forum within the local limits of whose jurisdiction – The O.P. or each of the O.Ps., where there are more than one, at the time of institution of the complainant, actually and voluntarily resides or carries on business or has a branch office or personally works for gain. “Learned counsel for the Complainant vehemently contends that the O.Ps. work for gain in the district of Subarnapur through their agent Sanjaya Kumar Baboo. The O.Ps. in their written statement though seriously challenged that the proposal form has been filled up by the L.A., they have not specifically denied that Sanjaya Kumar Baboo is not their agent within the district of Subarnapur. So we are of the considered view that the O.Ps. are carrying on their business in the district of Subarnapur through their agent Sanjaya Kumar Baboo and as such this Forum has got territorial jurisdiction to decide the lis.
Now it is to be seen whether the repudiation of the claim by the O.Ps. is justified or not. The O.Ps. have alleged that the age of the L.A. has been under estimated. It is vehemently argued that the V.I. card submitted by the complainant is not conclusive proof of age. The learned counsel relied on different decisions of Apex Court on this point. We find from the copy of the V.I. card filed by the complainant that on 1.1.1994 the L.A. was aged 45 years. The V.I. Card has been issued by the Election Commission of India under the facsimile signature of Electoral Registration Officer, Sonepur on 31.12.1994. The O.Ps. allege that after the death of the L.A. the investigator investigated in to matter, collected the voter list of the year 2011, wherein it was detected that the age of the L.A. at the time of opting for the policy was actually 79 years. The same has been affirmed by the Sarpanch of the Grama Panchayat . In his written version the O.Ps. have mentioned that the true copy of Investigation Report, investigator affidavit, voter list of 2011 and the certificate by the Sarpanch of the Gram Panchayat has been annexed and marked as annexure R.2, R.3, R.4 and R.5 respectively. But the written version has been filed by the advocate for the O.Ps. on 18.6.2014 without any annexure. On 9.11.2015 when we insisted for filing of documents the advocate for O.Ps. took time and on 16.11.2015 i.e. on the date of
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hearing filed documents marked annexure R.1, Annexure R 1(B) and annexure R.1(C) upon perusal of these documents we find that these are certain decisions since the V.I. card is 2011 and the report of the investigator is not supplied to us we are unable to appreciate the same.
Learned counsel for the O.Ps. vehemently argued that voter list is not conclusive proof so far as age is concerned. He has relied on different decisions. In the case of Kumari Das Vrs. Upendra Biswal and others 2006(1) O.L.R. 16 (Orissa High Court 2006) which has been relied by him the Hon’ble Orissa High Court has held – “ Entry of age or other description in the voter list of a person is not conclusive proof of such age or status but that is probative evidence with rebuttable presumption.” In the instant case the probative value of the V.I. card filed by the L.A. has not been successfully rebutted by the O.Ps. Further more, the O.Ps. have accepted the proposal form, issued policy and accepted premium, accepting the V.I. card to be genuine. If they had any doubt regarding the genuineness of the V.I. Card submitted by the L.A. they would have insisted on production of other proof of age. Once accepting the V.I. Card to be genuine and issuing the policy on the same, now they will be estopped to deny the same. Further more we found the L.A. was an old rustic lady of a remote village of Subarnapur District. We are not inclined to believe that he has mislead the O.Ps. by under estimating her age. For the reasons stated above we are not in a position to hold that there has been mis statement in the proposal form by the L.A.
The O.Ps. have alleged that the L.A. has not died due to cerebral malaria and died due to old age. The L.A. was bed ridden and paralysed since last 3 to 4 years. They further allege that investigation report reveals that the medical certificate issued by Dr. Trilochan Bishi is a fake one. That investigation report has not been filed before us. The O.Ps. have denied that the agent has submitted a health hazard report at the time of procurement of policy. Affidavit of the said agent is not filed before us. Further more the O.Ps. allege that as per the version/application of the son namely Jala Bagarty the L.A. was seriously ill at the time of taking the policy. But the said version/application has not been filed before us. No step was also taken by the O.Ps. to call the said Jala Bagarty as a witness.
Be it as it may the claim of the complainant has been rjected on the ground of misstatement of age, which we have held to be incorrect for the reasons stated earlier. So in the facts and circumstances of this case we are of the considered opinion that the repudiation of the claim by the O.Ps. is not justified.
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Now it is to be seen to what relief the complainant is entitled. In the instant case the policy has commenced from 20.9.2011 and the L.A. died on 29.9.2011 i.e. within ten days from the date of commencement of the policy. In the peculiar facts and circumstances of this case we are of the considered view that, interest of justice will be better served if we give a direction to return the premium paid with interest. So we direct the O.Ps. to return the premium amount, paid i.e. Rs.9874.23 paise, which is rounded upto Rs.9875/- by us with interest from the date of commencement of policy i.e. 20.9.2011 till the date of realization. We order accordingly, the O.Ps. are made jointly and severally liable for the deficiency.
ORDER
It is hereby ordered as follows :-
1. The O.Ps. shall pay to the complainant Rs.9875/- with interest at the rate of 12% P.A. from 20.9.2011 till the date of realization.
All these should be done within a period of one month from the date of receipt/production of this order. Complaint is partly allowed.
Dated the 30th day of November 2015
Typed to my dictation
I agree. and corrected by me.
Smt. S.Mishra Sri S.C. Nayak
Lady Member President
Dt.30.11.2015 Dt.30.11.2015
