DR. S. M. KANTIKAR, MEMBER

1.       This revision petition has been filed under Section 21(b) of the Consumer Protection Act, 1986 against the impugned order dated 2.5.2016 passed by the Haryana State Consumer Disputes Redressal Commission, Panchkula (herein after referred as ‘the State Commission’) in first appeal No. 393 of 2015, S.B.I. Life Insurance company Ltd. and Anr. Vs. Balwan, vide which, while dismissing the appeal, the order dated 6.4.2015, passed by the District Consumer Disputes Redressal Forum, Fatehabad (herein after referred as ‘the District Forum’) in consumer complaint No. 134 of 2014, allowing the said complaint, was upheld.

2.       Briefly stated, the facts of the case are that Mool Chand, father of the complainant, Balwan, obtained an insurance policy from the petitioner/OP-insurance company under the SBI Life Flexi Smart Scheme.  The complainant, Balwan was appointed as a nominee under the policy.  The insured died during the policy period, following which, a claim was filed with the OP/insurance company.  However, the said claim was repudiated by the OP/insurance company on the ground that the insured had provided false information about his date of birth at the time of obtaining the policy in question, and hence, he was not liable to be paid the claim in question. 

3.       The complainant filed consumer complaint No. 134 of 2014, seeking directions to the insurance company to pay the death claim as per policy, with interest @ 24% per annum from the date of death of the insured till realization and also to pay a sum of Rs.50,000/- as compensation for mental harassment alongwith Rs.11,000/- as litigation expenses.

4.       The complaint was resisted by the OP/insurance company by filing a written statement before the District Forum, in which it was stated that the contract of insurance was a contract of utmost good faith.  Any suppression of material facts in the proposal form, will render the insurance cover invalid in respect of the insured.  In the present case, the insured Mool Chand had stated his date of birth as 13.7.1951, based on a certificate issued by the School and the driving licence possessed by him; however, his actual date of birth was 13.4.1951 as indicated by another school certificate procured by the insurance company.  In case his date of birth was taken to be 13.4.1951, the insured could not be issued the policy in question.

5.       The District Forum, after considering the averments made by both the parties, allowed the consumer complaint and directed the OP/insurance company to pay a sum of Rs.4,99,000/- to the complainant alongwith interest @ 6% per annum from the date of filing of the complaint till realization.  The District Forum observed that at the time of issuance of the policy, the terms and conditions were never explained to the life assured.  Moreover, the OP/insurance company could not take the plea after the issuance of the policy that the life insured was more than 60 years old at the time of obtaining the policy.  Being aggrieved against the said order of the District Forum, the insurance company challenged the same by way of an appeal before the State Commission.  However, the said appeal having been dismissed, the OP/insurance company is before this Commission by way of the present revision petition. 

6.       During arguments before us, it was stated by learned counsel for the petitioner that the maximum age of entry for obtaining the policy under the said scheme was 60 years.  However, in the present case, the date of birth of the insured turned out to be 13.4.1951, rather than 13.7.1951 as per the school certificate issued in his favour.  Had the insured disclosed his actual age in the proposal form filled on 11.4.2012, the insurance company would not have issued the policy in question. 

7.       Learned counsel further stated that the driving licence possessed by the insured was found to be fake.  On the said driving licence, the date of birth had been written as 13.7.1951.  Learned counsel argued that the consumer fora had wrongly interpreted the conditions of the policy.

8.       The complainant/respondent did not appear despite proper service upon him in proceedings in the revision petition. 

9.       We have examined the entire material on record and given our thoughtful consideration to the arguments advanced before us. 

10.     An examination of the papers placed on file, indicates that the definitions of “Age” and “Age at entry” have been stated to be as follows in the policy booklet of the petitioner/insurance company :

11.     The main issue for consideration in the matter is whether the date of birth of the insured was 13.4.1951 or 13.7.1951, as filled in the proposal form on 11.4.2012.  The date of commencement of the policy is 24.4.2012.  In case the date of birth of the insured is taken as 13.4.1951, his last birthday would come on 13.4.2012, before the issuance of the insurance policy.  It would be clear, therefore, that on the date of issuance of the policy, the insured was more than 61 years of age.  However, if his date of birth is taken as 13.7.1951, his last birthday would be on 13.7.2011 i.e. before the issuance of the insurance policy and on that date, he had completed the age of 60 years.  It is clear from the facts on record and the definitions of ‘Age’ and ‘Age at entry’ that the policy could be issued only, if the insured was 60 years of age on the date of issuance of the policy and he had not crossed the age of 61 years.  It is clear, therefore, that if the date of birth was 13.4.1951, the insured had already crossed the age of 61 years and hence, he could not be issued the policy in question.

12.     In the present case, the insurance company has brought out that the driving licence was proved to be fake document, as per the inquiries got conducted by the insurance company.  Moreover, a copy of the school certificate issued by the Head Teacher on 2.7.2013 indicates that the date of birth of the insured was 13.4.1951.  There is another certificate issued on 30.1.2012 on record, which says that the date of birth was 13.7.1951.  However, considering the fact that the latest certificate issued by the School shows his date of birth as 13.4.1951 and that the driving licence in his favour has been found to be fake, it is evident that the date of birth of the insured was 13.4.1951, which indicates that the insured had crossed the age of 61 years at the time of issuance of the insurance policy.  The said policy could not have been issued, therefore, in his favour by the insurance company, had he disclosed his correct date of birth in the proposal form.  It is made out from the facts stated above that both the consumer fora below have made an erroneous interpretation of the facts and circumstances on record.  Both the consumer fora below have not taken into account the definitions of ‘Age’ and ‘Age at entry’, as appended with the policy documents.  Moreover, the contention made before the District Forum that the terms and conditions were not explained to the insured at the time of issuing the insurance policy, is not a valid ground by any standard.  It is held, therefore, that there is material defect in the orders passed by both consumer fora below and the same are ordered to be set aside.  This revision petition is, therefore, allowed and the consumer complaint in question stands dismissed.  There shall be no order as to costs.