Haryana

StateCommission

A/746/2015

SACHIN - Complainant(s)

Versus

BIRLA SUN LIFE INSURANCE CO. - Opp.Party(s)

M.K.TAYA

04 Feb 2016

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION HARYANA, PANCHKULA

                                                 

First Appeal No.           746 of 2015

                                                Date of Institution:       09.09.2015

                                                Date of Decision:         04.02.2016

 

1.      Sachin Kumar, 30 years

2.      Naveen Kumar, 27 years, son of late Shri Balwan Singh, resident of House No.79, VPO Bhindwan, Tehsil Siwani, District Bhiwani.

                                      Appellants-Complainants

Versus

1.      Birla Sun Life Insurance Company Limited, SCO No.149-151, 1^st Floor, Red Square Market, Hisar, through its Branch Manager.

2.      Birla Sun Life Insurance Company Limited (Claim Department) SCO No.149-151, G. Corp Tech Park, 5^th & 6^th Floor, Kasarvadavali, Ghodbunder Road, Thane – 400601 (Telephone No.022-39961817) through its Authorized Signatory.

3.      Birla Sun Life Insurance Company Limited, having its Registered Office – One Indabulla Centre, Tower-1, 15^th & 16^th Floor, Jupiter Mill Compound, 841, Senapati Bepat Marg, Eliphinstone Road, Mumbai-400013 through its Authorized Signatory.

                             Respondents-Opposite Parties

 

CORAM:             Hon’ble Mr. Justice Nawab Singh, President.

                             Mr. B.M. Bedi, Judicial Member.

                             Mr. Diwan Singh Chauhan, Member.

                                                                                                                   

For the Parties:            Sh. Sanchit Punia, Advocate for the appellants.      

Sh. S.C. Thatai, Advocate for respondents.

 

                                                   O R D E R

 

NAWAB SINGH J, (ORAL)

 

          This complainants’ appeal is directed against the order dated July 22^nd, 2015 passed by District Consumer Disputes Redressal Forum, Hisar (for short, ‘District Forum’) whereby complaint was dismissed. 

2.      Balwan Singh, aged 48 years, father of Sachin Kumar and Naveen Kumar-complainants purchased BSLI Vision Plan-GSB Pay 27 by filing application form on May 24^th, 2011 from Birla Sun Life Insurance Company Limited (for short ‘Insurance Company’).  The insurance policy was issued on June 14^th, 2011 as finds mentioned in the premium paid certificate (Exhibit C-4). The sum insured was Rs.13,93,000/-.  Balwan Singh died natural death on July 10^th, 2011.  Complainants filed their claim before the Insurance Company but it was repudiated on the ground that Balwan Singh died on May 06^th, 2011 and not on July 10^th, 2011. 

3.      Learned counsel for the appellants has assailed the impugned order on the ground that District Forum considered the report (Annexure R-5) of the Investigator, that is, Transparent World to prove that insured died on May 06^th, 2011 ignoring the other piece of evidence led by the complainants, that is, death certificate (Exhibit C-3) issued by Registrar Death and Birth, affidavits of Sachin Kumar son of Balwan Singh (Exhibit CW1/A), Mukesh Kumar son of Azad Singh (Exhibit C-6), Phool Kumar son of Maan Singh (Exhibit C-7) and Balbir Singh, Sarpanch of Gram Panchayat Bidhwan (Annexure A) filed before the District Forum stating therein that Balwan Singh died on July 10^th, 2011.

4.      On the other hand, learned counsel for the Insurance Company has heavily relied upon the report (Annexure R-5) of the Investigator.

5.      After hearing learned counsel for the parties, perusing the record over the file and the documents relied upon by the parties, the question arises as to whether the report (Annexure R-5) of the Investigator over weighs the evidence led by the complainant or not?

6.      It is not in dispute that Balwan Singh, life assured filled up the application form in the presence of representative of the Insurance Company on May 24^th, 2011.  It is also not in dispute that the insurance policy was issued on June 14^th, 2011.  Death Certificate (Exhibit C-3) issued by Registrar Death and Birth and the affidavits referred to above including the Sarpanch of the Gram Panchayat, Bidhwan shows that Balwan Singh died on July 10^th, 2011. 

7.      The concluding part of the report (Annexure R-5) of the Investigator is reproduced as under:-

          “As per our investigation and evidence, LA was suffering from liver problem.  He used to drink the wine mostly time. Ten days before death his stomach was increased due to habitual of wine.  Our investigator met with authorized person in PHC.  He did authenticate given death certificate is genuine; our investigator met with authorized lady in Anganwadi (Manju 91-9416632484), she did authenticate given death certificate is genuine but she also informed to investigator that she didn’t verify LA’s death from anywhere.  LA’s son came and informed us about death occurrence.  We made the death certificate. Village Sarpanch. Corroborated that LA died on 10.07.2011.

          Tenure of our investigation we have come to know that LA was died prior to purchase the policy and Anganwadi is also involved in fraud.  LA was died prior to purchase the policy in May 2011.  We have contacted several person and we have collected written paper that LA was died on May 2011”.

8.      Since the above lines have been extracted from the report of the surveyor, no error of language, although there are many, has been corrected.

9.      A reading of the report shows that Investigator confirmed about the date of death from the official of the PHC (Primary Health Centre) and he verified that the death certificate was genuine.  Not only that, the Investigator met the official of the Anganwadi. She also authenticated the genuineness of the death certificate though it has been stated by the Investigator that she did not inform that she verified the life assured death from anywhere else.  Further it has been made clear by the Investigator that Village Sarpanch also corroborated that life assured died on July 10^th, 2011 and in the report, it is nowhere stated that insured died on May 06^th, 2011 rather it has been stated that he contacted many persons and they had stated that life assured died in May 2011.  In the report of the Investigator, it was stated that life assured was having liver problem and used to consume liquor but to prove the same, no evidence was led by the Insurance Company except the report (Annexure R-5), which cannot be proved to be genuine.

10.    From the evidence led by the complainants, it is proved to the hilt that Balwan Singh, life assured filed the application form on May 24^th, 2011.  The insurance policy was issued on June 14^th, 2011.  The sum assured was Rs.13,93,000/-.   The life assured died on July 10^th, 2011 and not on May 06^th, 2011 as pleaded by the Insurance Company. 

11.    For the reasons recorded supra, the appeal is accepted, impugned order is set aside and the complaint is allowed.  The Insurance Company is directed to pay Rs.13,93,000/- alongwith interest at the rate of 9% per annum from the date of filing of the claim form till its realization.  The Insurance Company is further directed to comply with the direction within 30 days from the date of receipt of this order.

 

 

04.02.2016

(Diwan Singh Chauhan) Member

(B.M. Bedi) Judicial Member

(Nawab Singh) President

U.K