STATE CONSUMER DISPUTE REDRESSAL COMMISSION
BIHAR, PATNA
Appeal No. 401 of 2018
1. The Branch Manager, H.D.F.C Life Insurance Co. Ltd., Amgola Road, 2nd Floor, Vikash Bhawan, Near Orient Club, Muzaffarpur- 842002
2. The Managing Directors, H.D.F.C Standard Life Insurance Company Limited, Lodha Excelus, 13th Floor, Appollo Mills Compound, N.M. Joshi Marg, Maha Lakshmi, Mumbai- 400011
… Appellants
Versus
Bijili Rai, S/o- Late Ram Sewak Rai, Resident of Vill- Hasanpura, PO- Garkha, PS- Garkha, District- Saran at present, Mohalla- Majaulia, PS- Kazi Mohammadpur, District- Muzaffarpur
…. Respondent
Counsel for the Appellant: Adv. Sunil Kumar Dubey
Counsel for the Respondent: Adv. Sanjay Singh Thakur
Before,
Hon’ble Mr. Justice Sanjay Kumar, President
Mr. Ram Prawesh Das, Member
Dated 14.06.2023
As per Sanjay Kumar, President.
O r d e r
- Present appeal has been filed on behalf of appellant/opposite party/HDFC Life Insurance Company Ltd for setting aside the order dated 30.06.2018 passed in Complaint case no. 148 of 2016 whereby and whereunder the Ld. District Consumer Forum has allowed the complaint case and directed appellant/opposite party to pay Rs. 2,79,206/- with interest @8% p.a from the date of filing of complaint case and further directed to pay a sum of Rs. 10,000/- as compensation for physical and mental harassment and as cost of lititagion.
- Briefly stated the case of complainant is that his father Ram sevak Rai had obtained a policy for sum assured amount of Rs. 2,79,206/- from the HDFC Life Insurance Co. Ltd. and insurance coverage was valid from 15.07.2014 to 14.07.2029. The premium amount was to be paid half yearly of Rs. 12,371/- which was paid by the insured on 15.07.2014 along with submission of proposal form.
- It is further stated that on 12.12.2014 insured Ram Sevak Rai complained of loose motion, vomiting and fever and he was rushed to Dr. R.K. Ropy (M.D) for treatment but inspite of best effort insured Ram Sevak Rai could not be saved and he died on 12.12.2014.
- Complainant being son and nominee of Late Ram Sevak Rai filed a death claim with all relevant documents before the insurance company on 03.03.2015 but no decision was taken on the claim filed by complainant as such filed a complaint case before District consumer Forum. Complainant along with claim form had submitted documents such as insurance policy, death certificate, prescriptions of doctors and decision of NCDRC passed in First Appeal-1696/2016 and a complainant made against the investigator demanding Rs. 50,000/- to settle his claim.
- Notices were issued to opposite parties who appeared and filed their written statement dated 25.06.2018 stating therein that father of the complainant had died on 15.12.2011 whereas, insurance policy was issued in the year 2014. This fact is evident from record of Anganbari Kendra as date of death of insured Ram Sevak Rai has been mentioned as 15.02.2011 and insurance policy was fraudulently got issued by the complainant and claim of the complainant was repudiated by letter dated 13.10.2014 by the insurance company.
- District Consumer Forum after considering and appreciating the materials available on record has held that O.P./Insurance company has admitted the insurance policy and sum assured amount. The claim made by complainant was repudiated on the ground that insured had died in the year 2011 much prior of taking the policy in the year 2014, but, no supportive document with respect to death of insured in the year 2011 has been filed on behalf of insurance company. On the other hand complainant has filed death certificate dated 07.01.2015 issued by government of Bihar in which date of death of insured Ram Sevak Rai has been recorded as 12.12.2014. Complainant has also filed a certificate issued by sub registrar birth and death Anganbari Kendra in which also date of birth of Insured has been mentioned as 12.12.2014 and accordingly allowed the case of complainant by order dated 30.06.2018 as impugned in this appeal.
- Counsel for the appellant submits that complainant had obtained the policy by playing fraud as life assured had already died prior to issuance of life insurance policy which is evident from the records kept by Anganbari Karyakarta. On the other hand counsel for the respondent submits that deceased life assured had duly filled the proposal form for availing HDFC Insurance policy and after being satisfied with soundness of health, income and age of the D.L.A., the appellants received first premium amount and issued the policy schedule and bond in favour of the D.L.A.
- The entire proposal form was filled up by the appellant’s insurance agent in presence of the company officials. The proposal form of the DLA was accepted by them and insurance policy for a sum assured was issued in favour of the D.L.A. The risk coverage was from 15.07.2014 to 14.07.2029. It is further stated that the sudden and unfortunate death of the L.A. is evident from the death certificate issued by the Registrar, Birth & Death, Government of Bihar as well as the prescription issued by the treating doctor, is available on record.
- Heard the parties.
- Fraud is to be proved by the party who alleges fraud. Appellant/Insurance company has alleged that the insurance policy was obtained by playing fraud as such onus was upon the insurance company to establish fraud but no evidence has been adduced by the insurance company in this regard as such onus has not been discharged.
- There is presumption under the Evidence Act that official act is performed in a regular manner and as such presumption is that certificate issued by the government officials are genuine and correct unless establish otherwise. Nothing has been placed on record to doubt about the correctness of the death certificate issued by the competent authority while discharging his statutory function.
- There is no merit in this appeal and is accordingly, dismissed.
(Ram Prawesh Das) (Sanjay Kumar,J)
Member President
Md. Fariduzzama
