BEFORE THE DISTT. CONSUMER DISPUTES REDRESSAL FORUM; FATEHABAD.
Complaint case No.165 of 2016.
Date of Instt.: 29.06.2016.
Date of Decision: 30.03.2017.
Dalip Singh son of Zile Singh Caste Jat resident of village Bhuthan Kalan Tehsil & District Fatehabad.
..Complainant.
Versus
1.Birla Sun Life Insurance Registered Office: One India bulles Centre, Tower I 16th Floor, Jupiter Mill Compound, 841, Senapati Bapat Marg, Elphinstone Road, Mumbai-400013 through its Chairman-cum-Managing Director, Managing Director.
2.Birla Sun Life Insurance Company Limited, Branch Office, Ist Floor, Canara Bank, G.T.Road, Fatehabad Tehsil & District Fatehabad through its Branch Manager.
..Opposite Parties.
Complaint U/S 12 of the CP Act,1986
Before: Sh.Raghbir Singh, President.
Smt. Ansuya Bishnoi, Member.
Present: Sh.Sukhbir Dhaka, Advocate for complainant. Sh.Yogesh Gupta, Advocate for opposite parties.
ORDER
The complainant has filed the present complaint against the Ops with the averments that brother of the complainant namely Om Parkash son of Zile Singh was insured with the OPs vide policy No.006656007 for a sum assured of Rs.4,80,000/- and the complainant was appointed as nominee in the said policy. Life assured Om Parkash, brother of the complainant died on 20.01.2015 due to heart attack and after his death the complainant informed the OPs about the death of his brother besides submitting all the requisite documents but despite that the OPs illegally, arbitrarily and against facts have repudiated the claim of the complainant vide letter dated 31.03.2016 on false and flimsy grounds. The complainant requested many times to the opposite parties to make the payment alongwith interest @ 18 % per annum but to no effect. The complainant has suffered mental agony and harassment at the hands of opposite parties and he is also entitled for compensation. Hence, this complaint. In evidence, the complainant has tendered his affidavit Annexure Ex.PW1/A and documents Ex.P1 & Ex.P2.
3. On notice, OPs appeared and resisted the claim of the complainant by filing joint reply wherein several preliminary objections such as maintainability, suppression of material facts and jurisdiction etc.have been taken. It has been further submitted that on the basis of information and declaration furnished by the life assured BSLI Vision Life Secure Plan was issued on 23.12.2014 and its premium mode was Semi-annual. The Ops had repudiated the claim of the complainant with specific reasons, and as per terms and conditions of the policy. The policy in question was obtained by playing fraud upon the Ops which came to their notice when the matter was examined thoroughly after submitting the death claim of the life assured who died on 20.01.2015 i.e. within 28 days from the date of issuance of the policy. During investigation it also came to the notice of the insurance company that life assured Om Parkash had already expired before signing the proposal form and the policy in question had been obtained by planning a well planned criminal conspiracy involving various individuals including the complainant. It has been further submitted that the matter in dispute involves complex questions of law and facts which requires voluminous evidence and cannot be adjudicated/decided in summarily manner. The complainant is only nominee under the subject policy and not the actual beneficiary of the policy and mere nomination does not have the effect of conferring to the nominee any beneficial interest in the amount payable under the life insurance policy on the death of insured. It has been further submitted that during further investigation it came to the notice that voter ID Card submitted at the time of taking the policy was fake and fabricated as it was belonging to one Smt.Sita of village Dhangad,Fatehabad and it all have been done by the ex-employees of Etka Hospital, Barwala and other individuals, therefore, it is clear that the policy in question was obtained for defrauding the insurance company. Other allegations made in the complaint have been controverted. Lastly, prayer for dismissal of the complaint has been made. In evidence, the Ops have tendered affidavit of Mrs.Aakriti Manocha, as Ex.RW1/A and documents Ex.R1 to Ex.R5.
4. Heard. The counsel for the complainant reiterated the averments made in the complaint and prayed for its acceptance whereas the counsel for opposite parties reiterated the averments made in the reply and prayed for dismissal of the complaint.
5. After hearing learned counsels for the parties and going through the material placed on case file we are of the considered opinion that this complaint cannot be decided in a summarily manner because it involves complicated and complex questions of law and facts which require elaborating evidence. The complainant has come with the plea that the deceased life assured had died during the subsistence of the policy but the OPs instead of settling the genuine claim has repudiated the same wrongly, illegally, without giving any opportunity of hearing and on false and flimsy grounds. On the other hand the OPs have come with the plea that the deceased life assured had obtained the policy in question by playing fraud upon the insurance company as the ID Voter Card attached with the proposal form at the time of obtaining policy in question was not found related with the life assured. Undisputedly, the insurance company had issued the policy in question to the deceased life assured but when the complainant had submitted claim on account of the death of deceased life assured then the insurance company had got conducted an investigation through Ganpati Associates who submitted its report with the insurance company which is placed on file as Ex.R4 and in para No.7 of this document has been mentioned that Voter I Card No.KQT 1479047 submitted by the life assured or investor involved in this case is fake as verified online from Election Commission website of Haryana govt. This voter I card belongs to Sita serial No.956 of Voter List of village Dhangad Fatehabad, Same voter card attested/signed by claimant (Dalip Singh) was again provided to investigator at the time of investigation. The plea of obtaining the policy in question by playing fraud further finds support from the voter list attached to this report and has also been placed on file. The investigator in its report (Ex.R4) in para No.13 has further opined that LA has other policies from other companies also. As per our information his policy has been declined in PNB Metlife and Kotak life Insurance. In Kotak Life Insurance when his policy bond came then it was returned with note that LA has already died 20 days before. Investigation for Max Life has recently taken place. He probably has policy in Reliance also. In this report the investigator has also opined that the claimant was not having any original document of the life assured with him. It is strange the same were stated to have been lost. Since the OPs have specifically taken the plea of fraud played upon it by the deceased life assured at the time or getting the insurance policy in question and for obtaining the policy the complainant has submitted forged ID voter Card. The OPs have also taken a plea that the deceased life assured had already died prior to signing the proposal form for insurance and the respondent company was misled to issue the said policy on the life of Mr.Om Parkash DLA through forged documents and by a well planned criminal conspiracy involving various individuals including the present complainant as he is ex-employee of Ekta Hospital, Barwala. On investigation, it was found that the ex-employee of Ekta Hospital were involved in procuring the manipulated death certificate despite the fact that the said hospital was already closed one year back. It has also been pleaded by OPs that they are contemplating to initiate criminal proceeding against the persons involved in the conspiracy. Keeping in view the facts as discussed above the present matter involves forgery, fabrication, cheating, criminal conspiracy and mis-deeds. Therefore, this Forum is of the view that the present complaint before this Forum is not maintainable and the matter in question cannot be adjudicated in summary jurisdiction and it requires elaborating and voluminous evidence. On this point reliance can be taken from case law titled as Uco Bank vs. Sh.S.D.Wadhwa, 2013 (4) CLT (NC).
6. Hence, in view of above discussed factual as-well-as legal position, we are of the considered view that the present complaint is hereby disposed of as both the parties have failed to lead sufficient evidence to reach any conclusion. Moreover, in order to resolve the controversy alleged in the pleadings elaborating evidence and enquiry is required. However, the complainant is at liberty to approach at appropriate Court/forum if he so advised and in that eventuality, the period of litigation before this Forum shall not be counted towards the period of limitation for approaching appropriate court/forum. Exemption of time spent before this Forum is granted in terms of the judgment of the Hon’ble Supreme Court of India in the case titled “ Laxmi Engineering Works versus PSG Industrial Institute (1995) 3 SCC page 583. A copy of this order be supplied to both the parties free of cost. File be consigned after due compliance.
ANNOUNCED IN OPEN FORUM Dt.30.03.2017
(Raghbir Singh)
President District Consumer
Disputes Redressal Forum, Fatehabad.
(Ansuya Bishnoi)
Member
