A. P. STATE CONSUMER DISPUTES REDRESSAL COMMISSION : AT HYDERABAD
FA 649 of 2013 against CC. No. 06 OF 2013 on the file of the District Consumer Forum, Guntur.
Between :
- The Reliance Life Insurance Co. Ltd
Rep. by its branch Manager
D.No.18-7-43, Sri Pavan Sairam complex
Opp. Andhra bank, Surya Talkies road,
Sattenapalli, Guntur District – 522 403.
- The Reliance Life Insurance Co. Ltd
Rep. by its authorized signatory
H Block, 1st floor, Dhirubhai Ambani Knowledge city
Navi Mumbai, Maharastra – 400 710.. Appellants/opposite parties
- Koti Ratnam, S/o prabhakar Rao
H. No. 3-184, Main Bazar,
R/o Irukupalem, Sattenapalli Mandal,
Guntur – 522 403 .. respondent/complainant
Counsel for the appellants : M/s. A. Naveen Kumar
Counsel for the Respondent : M/s. G. L. Nageswara Rao
Coram
Sri S.Bhujanga Rao . ……Hon’ble Member
And
Sri R. Lakshminarasimha Rao… Hon’ble Member
Thursday, the Fifteenth Day of May
Two Thousand Fourteen
Oral Order : ( As per Sri R. Lakshminarasimha Rao , Hon’ble Member )
****
01 The appeal is challenge to the order dated 23.04.2014 passed in CC 6/2013 by the District Forum, Guntur.
02 The facts of the case leading to filing of the appeal are that the respondent’s father obtained Life Insurance policy bearing no. 16638248 from the appellant insurance company for sum assured of Rs.3,75,000/- for the period commencing from 23.3.2010 till 23.03.2020 and the premium was payable half yearly @ Rs.12,500/-. The respondent’s father died on 14.5.2010. The respondent being nominee of his father for the sum assured in terms of the insurance policy, lodged claim with the appellant which repudiated the same on the ground that the insured suppressed his correct age at the time of obtaining the insurance policy.
03 Questioning the rationality of repudiation of his claim, the respondent filed the complaint before the District Forum and the appellant resisted the same on the ground that the insured submitted proposal form bearing No. C1145913 on 20.03.2010 for obtaining insurance policy under “ Reliance Life Highest – NAV Guarantee plan ( Regular ) “ and at page 1 of the proposal form he mentioned his date of birth as 1.2.1961 and he signed declaration in the proposal form that he made accurate disclosure of the facts. The appellant contended that the insured submitted his affidavit in proof of his age and date of birth.
04 The appellant submitted that during claim investigation it was revealed that the insured possessed ration card and voter ID card and with malafide intention he did not produce them at the time of submitting the proposal form. As per the voter ID No. AP/15/104/336536, the age of the insured was 58 years and as per his ration card, the age of the insured was 68 years in the year 2006 which show his age was 72 years at the time of submitting the proposal form. The appellant contended that there is difference of 23 years in the age of the insured as seen from the age mentioned in the proposal form, ration card and voter list.
05 The appellant has contended that on the basis of investigation report and the documents received from the respondent, it was convinced that the insured made incorrect statement of his age and thus the claim was repudiated on the ground of mis-statement of age of the insured. It is contended that non-disclosure of age amounts to fraud and the respondent cannot take advantage of his own wrong.
06 In support of his claim, the respondent filed his affidavit and the documents, Ex. A1 to A7 and on behalf of the appellant insurance company, SK. Jhani Bash, Branch Manager filed his affidavit and the documents, Ex. B1 to B9.
07 The District Forum allowed the complaint on the premise that the appellant failed to produce application form submitted for obtaining ration card in order to show the age of the insured and his wife and in absence of the application form, the District Forum held that the age mentioned in the ration card authenticity. The District Forum observed that the appellant insurance company failed to prove that the insured suppressed his age while obtaining the insurance policy.
08 Feeling aggrieved by the order of the District Forum, the opposite party insurance company filed appeal contending that the insured knew well his age as on the date of submitting the proposal form and he deliberately stated his age below his correct age by 23 years and that he was 68 years old by the time of submitting the proposal form which amounts to suppression of material facts and the appellant rightly repudiated the claim.
09. The appellant contended that the District Forum failed to see that there was no denial of the age mentioned in the ration card, by the respondent and that the appellant has not issued the ration card to the respondent. It is contended that the District Forum failed to consider the declaration in the proposal form submitted by the respondent as also, that the respondent’s father died within two months from the date of issuance of insurance policy.
09 The learned counsel for the respondent has filed written arguments.
10 The Point for consideration is, whether repudiation of the claim is justified ?
11 The facts which do not require discussion in view of their admitted position are that the respondent’s father Balijipalli Prabhakara Rao during his life time obtained life insurance policy bearing No. 16638248 for the sum assured of Rs.3,75,000/- and the risk in terms of the insurance policy commenced from 23.3.2010 and the insured died on 14.5.2010. The insured at the time of submitting proposal, submitted his affidavit as regards to his age. The appellant repudiated the claim on the premise that the insured suppressed his correct age while submitting the proposal.
12 It is not disputed that the insured along with the proposal form submitted his affidavit wherein he mentioned his age and date of birth as 1.2.1961 and 49 years respectively. The appellant filed the affidavit submitted by the insured and the respondent had also filed copy of the affidavit.
13. The investigator submitted his report opining that the insured died due to ‘ heart attack ‘ and he mentioned his age in the proposal form 49 years while his age according to the ration card was 68 years and as per the voter list it was 58 years. The investigator filed his affidavit wherein he stated that he collected the ration card for the age proof and as per the entries made in the ration card the age of the insured is 68 years in 2006 and he had appended copy of that ration card to his report.
14. The age of the insured as seen from the ration card is 68 years as on the date ration card was issued, i.e., 1.7.2006, the District Forum declined to consider the age of the insured mentioned in the ration card on the premise that it was so noted basing on the particulars given by the applicant. The District Forum opined that application form submitted by the insured for the purpose of obtaining the ration card has to be produced by the respondent and the District Forum held that in absence of the application form, no authenticity can be given to the ration card.
15. The learned counsel for the appellant insurance company has contended that the District Forum has not considered the fact that the respondent had not denied issuance of the ration card to the father of the respondent. A perusal of the copy of voter list would show the age of the insured different from what is mentioned in the ration card. The entries made in the ration card or the voter list by themselves cannot be consider as criteria to ascertain the correct age of the insured more particularly, there has been discrepancy in the age of the insured as seen from the voters’ list and the ration card. The appellant ought to have brought on record any other evidence in support of its case.
16. This Commission considered the age of the insured mentioned in the ration card as not the basis for insurance company to rely upon, in “ Maddi Laxmi Vs. LIC of India” in FA No. 941/2009 decided on 11.07.2011 and it was held :
“ In somewhat similar case in Life Insurance Corporation of India Vs. Smt. Asha Devi reported in 1996 (2) CPR 103 it was opined that the age mentioned in the ration card or hospital bed ticket could not be taken as admissions of insured with regard to his/her age. There could not have been any basis for the enumerators to note the age as mentioned in the voter’s identity card there being no record maintained. In fact at sometimes inmates or villagers may give age without knowing the exact age. The age mentioned in the voter’s identity card cannot be decisive. It is only a tentative age in order to show that she had attained the age in order to exercise her franchise, and that she could vote. However, it could not be a record showing her age.
There is no law where the age mentioned in the voter’s identity card is final or authenticated. Having admitted the age of the deceased the insurance company is estopped from stating that the age given by her was incorrect. It is not a case where the deceased had played fraud upon the insurance company in getting her age admitted. Having admitted the age, the insurance company as of right is precluded from producing evidence, to disprove the age admitted by her. The complainant was thus relieved from the necessity of proving the age in the action brought on the policy. It is only in cases where authenticated date of birth is filed then only a presumption could be drawn. Where the assessment of age based on the information, and appearance was made, the insurance company cannot turn round and say nor the insured cannot be permitted to contend that she was aged more than what was mentioned in the policy, more so, when the birth certificate was not available. The Dist. Forum went wrong in relying the age mentioned in the voter’s identity card in order to deny the claim of the complainant “.
17. The District Forum has come to right conclusion that the appellant Insurance company failed to substantiate its contention that the insured was aged 68 years at the time of submitting the proposal form. The appellant has not produced any other document in order to support its decision to repudiate the claim. On the foregoing reasons, we are of the considered view that the repudiation of the claim is not sustainable. As such, the appeal is liable to be dismissed.
18. In the result, the appeal is dismissed confirming the order of the District Forum. There shall be no separate order as to costs. Time for compliance four weeks.
MEMBER MEMEBR
DATED : 15.05.2014.
