| Final Order / Judgement | DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION PATIALA. Consumer Complaint No. 302 of 4.8.2016 Decided on: 2.3.2021 Baljinder Singh age about 35 years s/o Jaswant Singh @ Bant Singh r/o village Hamjhari, Tehsil Patran, District Patiala. …………...Complainant Versus - Bajaj Allianz Life Insurance Co. Ltd. Regd. and Head Office, GE Plaza, Airport Road, Yerawada, Pune-411006, through its M.D.
- Branch Manager, Bajaj Allianz Life Insurance Co. Ltd. Leela Bhawan, Opposite Income Tax Office, Patiala.
…………Opposite Parties Complaint under Section 12 of the Consumer Protection Act, 1986. QUORUM Sh. Jasjit Singh Bhinder, President Sh.Y.S.Matta, Member ARGUED BY Sh.Asheen Khan, counsel for complainant Sh.Dhiraj Puri, counsel for OPs. ORDER JASJIT SINGH BHINDER, PRESIDENT - This is the complaint filed by Baljinder Singh (hereinafter referred to as the complainant) against Bajaj Allianz Life Insurance Co. Ltd. (hereinafter referred to as the OP/s)
Facts of the complaint - Briefly the case of the complainant is that Smt.Kamla Kaur wife of Jaswant Singh @ Bant Singh and mother of the complainant got issued insurance policy No.0317474365 for Rs.4,34,000/-from the OPs having deposited the premium with the OPs and complainant is the nominee of his mother in the said insurance policy
- It is averred that Smt.Kamla Kaur died on 4.9.2014 at Rajindera Hospital, Patiala. After that complainant approached OPs and submitted all the documents regarding the claim of said policy. Complainant also wrote application dated 27.8.2015 to OP No.2 in this respect but to no effect. Then the complainant got sent legal notice dated 29.10.2015 upon the OPs. The OPs sent reply dated 31.12.2015 but did not pay any claim amount. There is thus deficiency in service on the part of the OPs. Hence this complaint with the prayer to accept the same by giving direction to the OPs to release the amount of insurance policy alongwith interest; to pay Rs.1,00,000/- as compensation for causing mental agony and harassment.
- Upon notice OPs appeared through counsel and contested the complaint by filing written reply having raised preliminary objections that deceased life assured Smt.Kamla Kaur deliberately, dishonestly and with malafide intention concealed true and correct facts regarding her health at the time of proposal for insurance on 14.8.2014; that the complainant has no locus standi to file the present complaint; that the policy in question was obtained by way of fraud and misrepresentation; that no cause of action has arisen in favour of the complainant.
- On merits, it is submitted that deceased life assured proposed for Non Linked Regular Premium Bajaj Allianz “Save Assure-Main Benefit” policy and submitted a proposal dated 14.8.2014 duly signed by her which was accepted in normal course by the OPs and policy bearing No.0317474365 was issued and dispatched on 3.9.2014 to her. However, proposer Ms.Kamla Kaur expired on 4.9.2014 within just 12 days. It is further submitted that the various investigations, medical reports and documents and hospital treatment records confirmed that Ms.Kamla Kaur was a known case of Pulmonary Koch’s with Bronchial Asthma for 20 years and had been taking regular treatment from TB Hospital, Patiala as confirmed by the Medical Officer & Deputy Medical Superintendent, TB Hospital, Patiala. Hence Ms Kamla Kaur was knowing well that she was suffering from the diseases but had given wrong and false answers to the questions of the proposal form. It is further submitted that the deceased life assured and the complainant committed fraud by concealing the true facts. Thus the claim under the policy has legally and rightly been repudiated vide letter dated 23.1.2015 for non disclosure of material facts. There is no deficiency in service on the part of the OPs. After denying all other averments, the OPs prayed for the dismissal of the complaint.
-
- In support of the complaint, the ld. counsel for the complainant has tendered in evidence Ex.CA affidavit of the complainant alongwith documents Exs.C1 to C7 and closed the evidence.
- On the other hand, the ld. counsel for the OPs has tendered affidavit, Ex.OPA of Ms.Ruchi Kochhar, Asstt. Branch manager alongwith documents Exs.OP1 to OP5.The evidence of OPs was closed by order vide order dated 19.1.2018.
- We have heard the ld. counsel for the parties and have also gone through the record of the case, carefully.
-
- The ld. counsel for the complainant has argued that Kamla Kaur w/o Jaswant Singh @ Bant Singh and mother of the complainant was holding insurance policy as is mentioned in para no.1 of the complaint for Rs.4,34,000/- and the maturity was Rs.6,50,000/-.The ld. counsel further argued that Kamla Kaur had deposited the premium of Rs.35000/- with the OP and receipt in this regard is Ex.C1. Kamla Kaur died on 4.9.2014 at Rajindera Hospital, Patiala and her death certificate is Ex.C2.The ld. counsel further argued that despite the fact no payment has been made by the OPs. So the complaint be allowed.
- On the other hand, the ld.counsel for the OPs has argued that this is a classic case of cheating by the complainant. The ld. counsel further argued that Kamla Kaur deliberately and dishonestly concealed the true facts regarding her health in the proposal form dated 14.8.2014 by giving wrong information. The ld. counsel further argued that there is medical record on the file which shows that she was totally unwell on 14.8.2014.The ld. counsel further argued that a gross fraud so complaint be dismissed.
- To prove this case Baljinder Singh has tendered his affidavit, Ex.CA and he has deposed as per the complaint.Ex.C1 is the receipt of first premium amount of Rs.35340/- deposited on 14.8.2014,Ex.C2 is the death certificate of deceased Kamla Kaur,Ex.C3 is the letter,Ex.C4 is legal notice,Ex.C7 reply to legal notice.
- On behalf of the OPs Ruchi Kochhar, Assistant Branch Manager has tendered her affidavit, Ex.OPA and has deposed as per the written statement. Ex.OP1 is the proposal form dated 14.8.2014. Ex.OP2 is an important document. It is revised National Tuberculosis Control Programme of Kamla Kaur w/o Jaswant Singh, in which it is mentioned that pretreatment was 16.8.2014 and it was a tuberculosis, this is dated 24.8.2014. Ex.OP4 is final investigation report, in which it is mentioned that Kamla Kaur was TB treatment and she was suffering from tuberculosis prior to the commencement of the policy. Ex.OP5 is most important document. This is certificate of treatment signed by doctors of TB Hospital, Patiala, in which it is mentioned that Kamla Kaur admitted on 14.8.2014 in the hospital, then on 29.8.2014 vide bed head ticket no.2466/14 and 2636/14 respectively. It is mentioned that the patient was semi conscious with difficulty in breathing and she is known case of asthma for the last 20 years as per the record.
- So it is clear that on 14.8.2014, she was in semiconscious condition when she was admitted in the hospital. It is to be seen that when she was unwell on 14.8.2014 and difficulty in breathing how she signed on the proposal form. There was definitely collusion with the officials of the OPs and the complainant by whom this complaint has been filed. Detail has been mentioned in the reply filed to the legal notice by the insurance company on 31.12.2015. So it is clear that cheating was played by the family members of Kamla Kaur as she was unwell on 14.8.2014, by getting this policy by not mentioning the illness of Kamla Kaur. OPs is directed to register a case under 420 IPC against the agent and against the official who has issued this policy.
- So due to our above discussion, there is total a fraud played by the family members of Kamla Kaur with the insurance company as she was unwell on 14.8.2014 and semiconscious when she was admitted in the hospital. So there is no ground to grant any compensation and the complaint is dismissed accordingly. Parties are left to bear their own costs.
ANNOUNCED DATED:2.3.2021 Y.S.Matta Jasjit Singh Bhinder Member President | |
