Learned counsel for the appellant files written note of submission. Heard learned counsel for both sides.
2. Here is an appeal filed u/s 15 of the erstwhile Consumer Protection Act, 1986 (hereinafter called the ‘Act’). Parties to this appeal shall be referred to with reference to their respective status before the District Forum.
3. The case of the complainant in nutshell is that complainant’s father has purchased insurance policy from the OPs for sum assured of Rs.50,000/- commencing from 12.8.2003. It is alleged inter alia that the insured died on 19.3.2004 and complainant being nominee lodged claim for payment of insurance amount, but the OPs repudiated the claim. So, finding no other way, complainant filed the complaint alleging deficiency in service on the part of the OPs.
4. OPs filed written version admitting that they have issued the policy to the father of the complainant for sum assured of Rs.50,000/-. They submitted that they have repudiated the claim only on the ground that the policy holder has suppressed the true date of birth to prove is age. Therefore, there is no deficiency in service on their part.
5. After hearing both the parties, the learned District Forum passed the order which is as follows:-
“xxx xxx xxx
Accordingly the OPs 1 and 2 are directed to pay the complainant an amount of Rs.50,000/- along with interest @10% P.A. from 19.5.2004 till payment along with other benefits under the scheme.”
6. Learned counsel for the appellants submitted that the learned District Forum has committed error in law by not considering the written version with proper perspectives. Further, he submitted that the complainant has not produced the exact birth certificate but the OPs have found later that the age of the complainant has wrongly mentioned in the proposal form which the complainant has filled up. Learned District Forum ought to have considered all these facts and law. Since the complainant has suppressed his true age, they have right to cancel the same and as such they have cancelled the policy. He relied upon the decisions of Hon’ble National Commission passed in SBI Life Insurance Company Ltd. vs. Lakshymi Devi in Revision Petition No. 1371 of 2019 disposed of on 30.7.2019 (NC), SBI Life Insurance Co.Ltd vs. Rattn Lal in Revision Petition No. 634 of 2015 disposed of on 30.3.2015 (NC) and Lakbhir Kaur and others vs. Life Insurance Corporation of India in Revision Petition No. 1840 of 2014 disposed of on 16.12.2014 (NC). Therefore, they have repudiated the claim and submitted to set aside the impugned order by allowing the appeal.
7. Considered the submission of learned counsel for the appellants and perused the DFR including the impugned order.
8. It is admitted fact that he complainant’s father has purchased the policy on 12.8.2003. It is also submitted that sum assured was Rs.50,000/-. It is admitted fact that he expired on 19.3.2004. The only allegation of the OPs are that the complainant has made wrong statement at the time of filling up of the proposal form for that they have repudiated the claim. Learned District Forum has observed that after due verification, the policy has been issued by the OPs and there is no any gainsaying now to repudiate the claim on the ground that true age has been suppressed.
9. Section – 45 of the Insurance Act, 1938 before amendment is as follows:-
“45. Policy not to be called in question on ground of mis-statement after two years - No policy of life insurance effected before the commencement of this Act shall, after the expiry of two years from the date of commencement of this Act and no policy of life insurance effected after the coming into force of this Act shall, after the expiry of two years from the date on which it was effected, be called in question by an insurer on the ground that a statement made in the proposal for insurance or in any report of a medical officer, or referee, or friend of the insured, or in any other documents leading to the issue of the policy, was inaccurate or false, unless the insurer shows that such statement was on a material matter or suppressed facts which it was material to disclose and that it was fraudulently made by the policy-holder and that the policy-holder knew at the time of making it that the statement was false or that it suppressed facts which it was material to disclose.”
(Provided that nothing in this section shall prevent the insurer from calling for proof of age at any time if he is entitled to do so, and no policy shall be deemed to be called in question merely because the terms of the policy are adjusted on subsequent proof that the age of the life insured was incorrectly stated in the proposal).
10. The proviso to Section – 45 is clear to show that the OPs – insurer cannot call the policy in question in the event of age even found wrong later on. It means that during life time of insured, it was the duty of the insurer to call proof of age at any time but this defect in the age cannot be agitated to call the policy in question after death of the insured. We are of the view that the learned District Forum has not committed any wrong in coming to the conclusion. So the facts and circumstances of decisions cited by the learned counsel for the appellants are not same as facts and circumstances of the present case. Therefore, we are inclined to affirm the impugned order. But the learned counsel for the appellants only seeks little modification of the impugned order to direct the payment sum assured with interest from the date of impugned order not from the date of death. Since it is an old matter, we consider the same and accordingly modify the impugned order by directing OP to pay sum assured with interest @9% per annum from the date of impugned order till the date of payment. Rest portion of impugned order remains unaltered. No cost.
DFR be sent back forthwith.
Supply free copy of this order to the respective parties or the copy of this order be downloaded from Confonet or Website of this Commission to treat same as copy supplied from this Commission.
