Adv. For the Complainant: - Sri R.K.Mahakur
Adv. For O.P :- Sri S.S.Mishra and Others
Date of filing of the Case :-04.12.2017
Date of Order :-17.02.2020
JUDGMENT
Sri A.K.Purohit, President
1. The complainant being the nominee of deceased policy holder late Juddha Patra has preferred this case alleging deficiency in insurance service.
2. The case of the complainant is that, her grandfather late Juddha Patra had taken a LIC Policy vide policy No. 594667977 which commence from 22.4.13 and the yearly premium of Rs. 15339/- is payable. The maturity date for the said policy is 22.4.29 and the assured amount is Rs.200000/-. The policy holder had paid the premium regularly up to 2016 and died before the next due date of the yearly premium. The said policy holder Late Juddha Patra died on dated 22.5.16 in his home at village Kutupala. After the death of the policy holder the complainant being the nominee has lodged her claim before the O.P. in prescribed format but the O.P. has not settled her claim. Hence the complainant alleging deficiency in service on the part of the O.P. has approached this Forum for redressal.
3. The O.P. contested the case by filing written version. According to the O.P. the claim of the complainant was repudiated vide letter dated 14.9.17 on the ground that there was suppression of date of birth and the date of death. AS per their internal inquiry the O.P. found that the school certificate supplied by the policy holder in support of his date of birth is a forged one and the date of death supplied by the complainant in her claim form is not correct as per the report of the CHC M.Rampur. Hence on the grounds of suppression of material facts the O.P. has repudiated the claim of the complainant and there is no deficiency in service on his part. The O.P. claims dismissal of the case.
4. In support of her case the complainant has filed Xerox copy of payment of premium receipts, claim application and death certificate of the deceased policy holder. On the other hand in support of his case the O.P. has filed Xerox copy of repudiation letter, proposal form, report of CHC and report of block education officer and Xerox copy of voter list.
5. Perused the complaint petition, written version and documentary evidence available on record. The policy taken by the deceased policy holder late Juddha patra has not been disputed. The payment of premium has also been not disputed. The claim of the complainant as the nominee of the deceased policy holder has also been not disputed . Simply the claim has been repudiated on the ground of suppression of material facts relating to age. Therefore the point for consideration is whether the repudiation of the claim of the complainant is on valid grounds or not.
6. It is seen from the death certificate filed by the complainant that, the certificate has been issued by the competent authority in prescribed format and the age mentioned therein is corroborative with school certificate filed by the O.P. So far the genuineness of the death certificate is concerned it is issued by the competent authority and the report of the Medical Officer relied on by the O.P. does not disclose on what basis he has submitted the report and hence the death certificate filed by the complainant is a genuine one and the age mentioned therein is same which is available in the proposal form. Therefore it cannot be said that there is any suppression of age in the insurance proposal form. So far the report of the Block Education Officer, Balangir is concerned it is submitted by the complainant that the school is in the district of Kalahandi and it is not within the jurisdiction of BEO Balangir. On this point there is no satisfactory answer from the O.P. Further it is seen that the said school certificate was issued in presence of the agent of the O.P. The settled principle of law is that entry in the voter list is not a conclusive proof and the same is rebuttable. When other believable documents are available the entry in the voter list is not sufficient to disbelieve the age of the policy holder.
7. During the time of submission of the proposal form along with documents the O.P. accepted the same as genuine and hence the O.P. cannot escape from its liability.
8. Under the aforesaid discussion and material available on record, The O.P. has repudiated the genuine claim of the complainant which amounts to deficiency in service on the part of the O.P. Hence:-
O R D E R
The O.P. is directed to pay Rs.2,00,000/- ( Two Lakhs ) along with interest @ 9 % P.A. from the date of repudiation i.e. from 14. 9. 17 till payment to the complainant within one month from the date of receipt of this order. There shall be no order as to cost.
Order pronounced in the open Forum to-day the 17th day of February 2020.
Sd/- Sd/-
(S.Rath) (A.K.Purohit)
MEMBER. PRESIDENT
