Haryana

StateCommission

A/393/2015

SBI LIFE INSURANCE CO.LTD. AND ANOTHER - Complainant(s)

Versus

BALWAN - Opp.Party(s)

RAJNEESH MALHOTRA

02 May 2016

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION HARYANA, PANCHKULA

                                                 

                                                         First Appeal No.393 of 2015

Date of Institution: 29.04.2015

                                                               Date of Decision: 02.05.2016

 

1. S.B.I. Life Insurance Company Ltd., Central Processing Centre, Kapas Bhawan, Plot No.3-A, Sector 10, CBD Belapur, Navi Mumbai-400614, through its authorized person.

II Address: Natraj, MV road & Western Express Highway Junction, Andheri (East Mumbai-400069).

2. SBI Life Insurance Company Ltd.,Upper Union Bank of India, G.t. Road, Fatehabad,Tehsil & district Fatehabad, through its Branch Manager.

…..Appellants

Versus

 

Balwan # Ram Parshad, S/o Sh.Mool Chand, r/o village Sanchla, Tehsil Tohana,Distt. Fatehabad.

                                      …..Respondent

 

CORAM:             Mr. R.K.Bishnoi, Judicial Member.

                             Mrs. Urvashi Agnihotri, Member.                                                                                                                                        

Present:              Mr.Rajneesh Malhotra, Advocate counsel for the appellants.

Mr.R.S.Sihag, Advocate counsel for the respondent.

 

                                                   O R D E R

R.K.BISHNOI, JUDICIAL MEMBER:

 

It was alleged by the complainant that his father obtained  SBI Life-Flexi Smart Insurance policy and paid due premium.  He was not having any history of pre-disease and was examined by the panel of doctors of O.Ps. (opposite parties-appellants).  After his death he submitted the claim, but, was repudiated without any reasonable cause. 

2.      O.Ps. filed reply controverting his averments and alleged that this policy was available to the persons less than 60 years old.  At the time for obtaining insurance policy Deceased Life Assured (DLA) told his date of birth as 13.07.1951.  As per letter issued by Head Teacher of Government Primary School and voter ID-Card DLA was more than 60 years old, so his claim was rightly repudiated.  As complicated question of law and fact was involved only Civil Court was having jurisdiction to adjudicate upon the matter.  As he under stated his age the contract was avoid ab initio. Other averments were also denied and requested to dismiss the complaint.

3.      After hearing both the parties, learned District Consumer Disputes Redressal Forum, Fatehabad  (In short “District Forum”)  allowed the complaint and directed as under:-

“Hence, we allow the present complaint directing the Ops  to pay a sum of Rs.4,99,000/- (sum assured) to the complainant.  Compliance of this order be made within 30 days failing which the complainant would be entitled for interest @ 6% per annum on sum assured from the date of filing of this complaint till realization of amount.”

4.      Feeling aggrieved therefrom the O.Ps.-appellants have preferred this appeal.

5.      Arguments heard. File perused.

6.      Learned counsel for the appellants vehemently argued that from the perusal of Annexure G it is clear that the age of entry in this policy was less than 60 years. As per Annexure A complainant told his death of birth  as 13.07.1951 on 11.04.2012, in this way he was more than 60 years old at that time and was not entitled to get this policy.  He produced driving licence at the time of obtaining insurance policy, in proof of his age, but, as per report Annexure D the licence was found fake. As per certificate of Head Teacher, Annexure F, his date of birth was 13.04.1951 and not 13.07.1951. In this way he gave wrong information about his age and this insurance contract was found ab-initio and complainant was not entitled for any compensation.  Learned District forum failed to take into consideration this aspect, so impugned dated 06.04.2015 be set aside.

7.      However there is no dispute that as per Annexure G the age of entry in the scheme was 60 years, but, it cannot be opined that complainant obtained this policy by concealing any fact or playing fraud.  When he applied for this policy on 11.04.2012 he was already 60 years old as per date of birth mentioned therein. When he told his death of birth and he was more than 60 years old then why insurance policy Annexure B, applicable from 25.04.2012, was issued.  Insurance company could have declined his request at that very time.  In this case insurance company was not clubed in any manner if, as per proposal form his date of birth is 13.07.1951 and, head teacher mentioned his date of birth as 13.04.1951.  In both ways he was more than 60 years old when Annexure B was issued. The insurance company accepted this offer with open eyes and believing his age to be true.  Had he told his age less than 60 years and obtained the insurance policy then it could have been a different matter.  Now it does not lie in the mouth of insurance company that there a difference in dates of birth and dependent of DLA is not entitled for compensation.  In this situation, learned District Forum rightly allowed the claim as mentioned above. Findings of learned District forum is well reasoned based on law and facts and cannot be disturbed. Resultantly appeal fails and the same is hereby dismissed.

8.      The opposite parties-appellants are directed to fix the responsibility of the concerned official, who was responsible for this lapse. The loss suffered by department be recovered from the concerned employee/employees as per opinion of Hon’ble Supreme Court expressed in  Oriental Aroma Chemical Industries Ltd. Vs. Gujarat Industrial Development Corporation reported in (2010) 5 SCC 459 and Lucknow Development Authority V. M.K.Gupta, AIR 1994 SC 787. Hon’ble Supreme Court has observed  in Lucknow Development Authority V. M.K.Gupta (Supra) as under:-

“When the Court directs payment of damages or compensation against the State the ultimate sufferer is the common man.  It is the tax payer’s money which is paid for inaction of those who are entrusted under the Act to discharge their duties in accordance with law.  It is, therefore, necessary that the Commission when it is satisfied that a complainant is entitled to compensation for harassment or mental agony or oppression, which finding of course should be recorded carefully on material and convincing circumstances and not lightly, then it should further direct the department concerned to pay the amount to the complainant from the public fund ‘immediately’ but to recover the same from those who are found responsible for such unpardonable behavior by dividing it proportionately where there are more than one functionaries.”

9.      The statutory amount of Rs.25,000/-  deposited at the time of filing the appeal be refunded to the appellants against proper receipt and identification in accordance with rules, after the expiry of period of appeal/revision if any.

 

May 02nd, 2016          Urvashi Agnihotri                                R.K.Bishnoi,                                                               Member                                              Judicial Member                                                         Addl. Bench                                        Addl.Bench                

S.K.