The complainant Madan Singh Chauhan has filed this complaint petition against Branch Manager, Sri Ram Life Insurance Company Ltd. Alhera Complex near Bhagawanpur chowk and one another (o.p) for realization of Rs. 4,00,500/- ( sum assured), with interest @ 9 % p.a. from the date of death till realization, Rs. 50,000/- for economical, mental and physical harassment and Rs. 10,000/- as litigation cost.
The, brief, facts of the case is that father of complainant namely Jai Nandan Singh purchased policy bearing No. NP141400004533 for sum assured RS. 4,00,500/- from o.p no.1 in his life time in which he complainant is nominee. The further case is that the D.L.A was paying the premium of the policy. The further case is that father of the complainant namely Late Jai Nandan Singh died on 21-05-2014. The complainant informed the o.ps and filed the claim petition before o.p no.1 with original papers, death certificate, I.D. proof and other documents. The further case is that the o.p assured the complainant of making payment as earliest. The further case is that on 14-04-2017, the o.ps repudiated the claim of the complainant on the ground that he had taken the insurance policy of other companies whereas income was meager.
The complainant has filed the following documents with the complaint petition - photocopy of application of claim after death -annexure-1-, photocopy of repudiation letter annexure-1A, photocopy of death certificate of late Jai Nandan Singh Chauhan -annexure-2-, photocopy of proposal form annexure-3-, photocopy of first premium receipt annexure-4-, photocopy of Non ulip policy schedule of o.p company annexure-5-, photocopy of letter of o.p company regarding acceptance of proposal -annexure-6, photocopy of prescription report of Dr. Md Ashraf annexure-7, photocopy of certificate regarding death of Jai Nandan Singh -annexure-8 photocopy of Voter I.D. card of Jai Nandan Singh annexure-9, photocopy of Electoral list for the year 2014 annexure-10, photocopy of PAN Card of Jai Nandan Singh Chauhan -annexure-11
On issuance of notice, o.p appeared and filed his w.s. on 13-07-2019 with prayer to dismiss the complaint as there is no deficiency in service on their part. The issuance of policy is an admitted fact in the w.s.. It has been mentioned in the w.s. that L.A. did not disclose any medical infirmities in his proposal form, hence the policy was issued without subjecting L.A for any medical test. The proposal form and insurance policy Bearing No. NP141400004533 and the policy documents have been annexed as annexure-A and B. It has been further mentioned in the w.s. that L.A. had mentioned his occupation as agriculturist and rental income and is annual income was Rs. 2 lacs in proposal form. It has been further mentioned in the w.s. that in views of the claim under the policy in question being an early claim arises within 4 months and 24 days from the date of policy, the o.p investigated into the claim and found that L.A Jai Nandan Singh Chauhan had taken insurance policy with other companies prior to applying for a policy with the o.p. Detailed of the life policies have been mentioned in para-6 of the w.s. The o.ps have annexed emails exchange with the other insurance company providing the information of the policies of L.A. have been annexed as annexure-C. It has been further mentioned in the w.s. that the L.A willfully concealed the other insurance policies in the proposal form and as such non discloser of the material fact is void abinitio on the principal of uberrimae fide it has been further mentioned that the premium payable under the policies was above 89 % of his annual income. It has been further mentioned that o.p repudiated claim of the complainant for reason of non disclosure of the other insurance policies held by the L.A and obtaining of 5 more policies in a short span of a time. In the w.s. repudiation letter has been annexed as annexure-D.
On behalf O.Ps, OPW1 AW-1 E. Sridhar has been examined he has marked photocopy of annexure as exhibit 1 to 4 in his deposition which will be read as A to D for convenience.
O.ps company has repudiated the claim of the complainant on the ground that D.L.A have purchased 3 other policies of Bharti AXA life insurance company prior to insurance of policy -bond and he had not disclosed the same in the proposal form. The o.p company has also repudiated the claim of the complainant on the basis that the D.L.A had suppressed the material fact by not disclosing his existing life insurance policies information in the proposal form which is ought to have been disclosed.
On behalf of complainant three witnesses AW-1 Madan Singh Chauhan (complainant ). AW-2 Pramod Kumar Singh, & AW-3 Rakesh Kr Singh have been examined on affidavit. On behalf of complainant certified copy of order dated 19-06-2018 passed in complaint case no.18/2017 by this forum has been filed which has been marked as exhibit-1.
The complainant has mentioned in the complaint petition that the father of complainant had about 6 acres land. He has also mentioned in the complaint petition that during the course of investigation surveyor had found that no fact has been mislead in the proposal form.
Complainant has examined three witness including complainant (himself). Complainant Madan Singh Chauwhan has stated in his deposition, filed on affidavit, that his father had taken two policies in his life time from Bharti AXA life insurance and another of Sri Ram life insurance company in which he is nominee AW-2 Pramod Kr Singh has stated in his deposition filed on affidavit in para-2 of his examined in chief that father of complainant namely Late Jaynandan Singh had taken life insurance policy through agent in his presence he has further stated that at the time of taking policy the father of the complainant had disclosed before agent that he had already taken three policies of Bharti AXA company AW-3 Rakesh Kr has also stated the above facts in para -2 of his examination -in –chief. On perusal of photocopy of proposal form annexure-3 and A, it transpires that the proposal form has been filledup in the English whereas the L.A Jay Nandan Singh has put his signature in Hindi on his proposal form. Agent of the company Sri Dharmendar Singh has made following statement in the proposal form.
“Declaration for signing in vernacular or for illiterate Cases :- The company requires that this proposal is completed by the proposer himself. However, if this not possible as the proposer does not read, write or speak English, then this proposal form can be completed by another person who can read, speak and write English and who is not connected to the company either as an agent/ employee or insurance intermediary). “ I have explained the contents of this proposal to the proposer and done my best to ensure that contents have been fully understood by the proposer. I have accurately recorded the proposer’s responses to the information sought by the proposal form and I have read the responses back to the proposer and he/she has confirmed that they are correct.”
O.P. company has not examined the agent who explained the proposer, the averment made by him. The burden of proof to examination the company’s agent was on o.p company who repudiated claim but he has neither examined the agent nor surveyor to prove above facts. On behalf of o.p company E.Sridhar General Manager, has been examined, who is neither agent, who filledup the proposal form, nor the surveyor rather he is working as General Manager, of the company. He is only a hear say witness so, o.p has not been able to establish the fact raised in the repudiation letter.
The complainant has also filed the order dated 19-06-2018 passed in complaint petition No. C.N.-18/2017 as exhibit 1 to prove taking of other policy and as such it transpires that he has not misrepresentated the o.p. company. In the case of C. E. O Sahara India life insurance company V/s Renyani Ramanjanelulu in R.P. No.-1117/2014 decided on 01-08-2014 by Hon’ble National Commission in which it has been held that “the suppression of the previous policy cannot be sole ground for repudiation.” This observation has also been conformed by the Hon’ble National Commission in AEGON Religar life insurance company Ltd. V/s Rajendra Ray in the case of FA/1696/2016.
On the basis of above discussion we are of the opinion that there is deficiency in service on part of o.p company and as such he is liable to pay the claim amount.
Accordingly the claim petition is allowed. The o.ps are directed to pay Rs. 4,00,500/- sum assured with 7 % interest p.a. from the date of filing of complaint petition, Rs. 20,0000/- as physical and mental harassment and Rs. 10,000/- as litigation cost. Within 2 months from the date of order, on failure he shall be liable to pay aforesaid amount with 9 % interest p.a. till realization. Let a copy of this order be furnished to both the parties as per rule
