DISTRICT CONSUMER DISPUTES REDRESSAL FORUM,HISAR.
CONSUMER COMPLAINT NO.519 of 2012
DATE OF INSTITUTION:- 16.11.2012
DATE OF ORDER:- 22.07.2015
- Sachin Kumar,30 years
- Naveen Kumar, 27 years, sons of Late Shri Balwan Singh, resident of House No.79, VPO Bhindwan, Tehsil Siwani, District Bhiwani.
……………COMPLAINANTS
VERSUS
- Birla Sun Life Insurance Company Limited, SCO No.149-151, Ist Floor, Red Square Market, Hisar, through its Branch Manager.
- Birla Sun Life Insurance Company Limited (Claim Department), SCO No.149-151, G. Corp Tech Park, 5th & 6th Floor, Kasarvadavali, Ghodbunder Road, Thane-400601(Telephone No.022-39961817) through its Authorized Signatory.
- Birla Sun Life Insurance Company Limited, having its Registered Office-One Indabulla Centre, Tower-1, 15th & 16th Floor, Jupiter Mill Compound, 841, Senapati Bapat Marg, Eliphinstone Road, Mumbai-400013 through its authorized signatory.
………….. OPPOSITE PARTIES
COMPLAINT U/S 12 OF CONSUMER PROECTION ACT
BEFORE :- Rajesh Jindal, President
Smt. Rajni Goyat, Member
Present:- Shri Satish Kumar, Advocate for the complainants.
Shri Ashish Goyal, Advocate for the opposite parties.
ORDER:-
Rajesh Jindal, President:
According to the complaint, brief facts are that Balwan Singh, father of the complainants,(Now deceased) had obtained an Insurance policy “BSLI Vision Plan-GSB pay 27” vide policy No.004894407 dated 14.6.2011 from the opposite parties. After depositing the payment of first premium of Rs.31,321.47 paise, insured Balwan Singh, suddenly died on 10.7.2011. When the complainants came to know about this policy, then they lodged the death claim of their father in the month of March,2012 requesting for making the payment of benefits as admissible in respect of the policy.
2. It is averred that the opposite party No.1 got carried out the investigation about the genuineness of the death claim . During the investigation, surveyor had visited many persons and all of them, in one had confirmed about the date of death of Balwant Singh as 10.7.2011 and there was no dispute at all about the date of death of the insured. The opposite parties have repudiated the claim of the complainants vide their letter dated 31.3.2012; interalia mentioning that as per their investigations, Balwan Singh had expired long before he allegedly signed application for getting said insurance. The complainants again requested the opposite parties vide letter dated 24.4.2012 for reconsideration of the claim but the opposite parties refused to consider the claim which is wrong, illegal, discriminatory, in violation of the principles of natural justice and the terms and conditions of the policy. The complainants have prayed that the opposite parties be directed to pay the death claim and to pay the entire benefits of the policy in question along with interest, besides claiming compensation of Rs.25,000/- for mental agony and harassment.
3. The opposite parties filed joint reply stating, inter-alia, therein that being an early claim, the opposite parties had processed the case for conducting necessary investigation and during the course of investigation, it has been revealed to the opposite parties that the father of the complainants passed away on 6.5.2011 i.e. much prior to the applying for the policy and the proposal applied after the death of the life assured upon which the policy stands issued is the result of fraud so played by the complainants with the opposite parties with a view to cause undue loss to the opposite parties. Death of the life assured occurred much prior to the issuance of the policy,So the claim of the complainants repudiated vide repudiation letter dated 31.3.2012. The complainants are not entitled to any relief from the opposite parties. There is no deficiency in service on the part of the opposite parties. In the end, it is prayed that the complaint be dismissed with costs.
4. In order to make out their case, the complainants have placed on record Ex.CW1/A their own supporting affidavit of Sachin Kumar complainant No.1 and Ex.C-1 copy of impugned repudiation letter dated 31.3.2012; Ex.C-2 copy of letter of the opposite parties dated 31.7.2012, dismissing the representation of the complainant dated 24.4.2012; Ex.C-3 copy of death certificate of Balwan Singh; Ex.C-4 copy of premium paid certificated dated 11.10.2012; Ex.C-5 copy of ration card of the deceased; Ex.C-6 & Ex.C-7 affidavits of Mukesh Kumar and Phool Kumar and also supporting affidavit of Sh.Balbir Singh Sarpanch of the Gram Panchayat.
5. In reply thereto, the opposite parties have placed on record copy of policy Annexure R-1; copy of certificate of Balwan Singh issued by Sarpanch Annexure R-2; copy of affidavit of Sh S.K.Sharma(Investigator) Annexure R-3; Copy of claim agreement Annexure R-4; copy of insurance policy detail Annexure R-5;copy of application of Naveen Kumar Annexure R-6 and other documents.
6. We have gone through the record of the case carefully and have heard the learned counsels for the parties.
7. Learned counsel for the complainants reiterated the contents of the complaint. He submitted that the opposite parties have illegally repudiated the claim of the complainants.
8. Learned counsel for the opposite parties reiterated the contents of their reply. He submitted that the alleged insured Balwan Singh had already died much before the date of getting the insurance policy in question. In support of his contention, he referred the certificate of Sarpanch Annexure R-2 and the statement of Phool Kumar Annexure R-7, whereas the aforesaid persons had stated that Balwan Singh had expired on 6.5.2011 suddenly at his home. He submitted that the policy in question was obtained on 14.6.2011 and said Balwan Singh was not alive on the date of issue of the policy. The counsel for the complainants refuted the version of the opposite parties and stated that the investigator of the opposite parties got the signatures of the aforesaid persons on blank papers and he referred the affidavit of Phool Kumar as Annexure C-7 and affidavit dated 30.9.2013 of Balbir Singh Sarpanch which are typed in English.
9. The counsel for the opposite parties further contended that in the proposal form the income of Balwan Singh had been shown as Rs.7 lacs per annum , while Naveen Kumar one of complainant and son of Balwan Singh, Annexure R-6 in a letter to the opposite parties for the payment of the claim has stated that Balwan Singh, his father was earning his livelihood by way of labour and his income from all source was Rs.1,18,000/-, he further stated that the figure and word of Rs.one lac has been added later on. The counsel for the opposite parties stressed that the policy in question has been obtained by the complainants by impersonation and played fraud on the opposite parties to get huge amount of claim.
10. In the context of the pleadings and arguments of the parties, we have examined the relevant material on record. As per the version of the complainants, the policy in question had been obtained on 14.6.2011 for the sum insured of Rs.13,93,000/- and the said insured Balwan Singh died on 10.7.2011, and the complainants made the claim for the insured amount from the opposite parties on the strength of death certificate of Balwan Singh annexure C-3.To controvert the said death certificate, counsel for the opposite parties has referred the conclusion para of the report of the investigator Annexure R-5, according to which the Anganwari worker did not verify the death of the life assured from anywhere. The son of the life assured informed the date of death of the Balwan Singh and death certificate was issued accordingly.
11. The Policy in question has been got issued on 14.6.2011 for sum insured amount of Rs.13,93,000/- . It is stated that Balwan Singh insurer died on 10.7.2011, within 26 days from the date of issue of the policy. As per the version of the opposite parties, after the receipt of the claim request from the complainants, the claim was processed and during the course of investigation, it was found that the said insured had already expired on 6.5.2011 and the complainants in order to get the claim had got fabricated the death certificate in collusion with other persons and got death certificate Ex.C-3. There are specific allegations of impersonation and fraud by opposite parties against various persons including complainants.
12. In view of pleadings of fraud and impersonation, the mater in question cannot be adjudicated before the District Forum in summary proceedings under the Consumer Protection Act,1986. For the Just and proper decision of the matter, witnesses, handwriting expert, are to be examined and cross examined and voluminous documents are to be examined. In view of the decision of Hon’ble National Commission, when there are allegations of fraud, proper remedy lies in Civil Court. Thus we relegate the complainants to the civil court for their claim, if so advised. With these observations the complaint of the complainants is dismissed with no order as to costs.
Announced
Dated:22.07.2015 President
District Consumer Disputes
Redressal Forum, Hisar
Member/22.07.2015
