Orissa

Cuttak

CC/29/2019

Mrs Sarojini Parida - Complainant(s)

Versus

Chairman-Cum-Managing Director,HDFC Life Insurance Company Limited - Opp.Party(s)

R K Pattanaik

06 Dec 2022

ORDER

IN THE COURT OF THE DIST. CONSUMER DISPUTES REDRESSAL COMMISSION,CUTTACK.

C.C.No.29/2019

 

Mrs. Sarojini Parida,

W/O:LatePurastamParida,

At:Bijadihi,Mahulapal,P.S:Kamaksya Nagar,

Dist:Dhenkanal,Odisha,759026.                                                             ... Complainant.

 

                                                                Vrs.

1.       HDFC Standard Life Insurance Company Limited,

Represented through its Chairman-cum-Managing Director,

Having its registered office LodhaExcelus,

13^thFloor,Apollo Mills Compound,N.M.Joshi Marg,

Mahalaxmi,Mumbai-400011.

 

2.       HDFC Life Insurance Company Limited,

Represented through its Branch Head,Royal Tower,

Link Road,Cuttack-753012.                                                                              ... Opp. Parties.

 

 

Present:               Sri Debasish Nayak,President.

                                                Sri SibanandaMohanty,Member.

 

               Date of filing:     27.02.2019

Date of Order:    06.12.2022

 

For the complainants:          Mr.R.K.Pattnaik,Adv.& Associates.

For the O.Ps                :          Mr. C.Patra,Adv. & Associates.

 

Sri Debasish Nayak,President.                                   

          The case of the complainant as made in the complaint petition bereft unnecessary details in short is that her deceased husband had given proposal to the O.Ps for obtaining a life insurance from them on 17.12.12 vide policy no.15656289 and the name of the policy was “HDFC Life Click 2 Protect”.  The said policy was for twenty years and the sum assured was of Rs.10,00,000/-.  While the Policy was in force, the assured died due to Cardiac arrest while taking tea in the morning at his residence on 20.5.2013.  The complainant being the nominee in the said policy had put forth her claim but on 11.2.19 O. P No.2 had handed over the letter of repudiation of the claim which was antedated bearing dt.4.4.16.  The complainant thereafter had requested for reconsideration of her claim but the O.Ps had remained silent to such request of the complainant.  The cause of repudiation of the claim of the complainant was learnt to be non-disclosure of previous policies, which according to the complainant, is a baseless and vague ground being unsustainable in the eye of law.  Thus, the complainant has come up with this case before this Commission praying therein for the assured sum of Rs.10,00,000/- together with interest thereon @ 12% per annum from the date of repudiation till the total amount is quantified, a further for sum of 50,000/- towards compensation for her mental agony and harassment and also a for sum of Rs.20,000/- towards her litigation cost.

          The complainant has filed copy of the death certificate of her husband alongwith copies of policy papers in order to prove her case.

2.       Both the O.Ps have contested this case and have filed their written version jointly.  In their written version both the O.Ps admit about the policy of the deceased PurastamParida vide policy no.15656289 dt.28.1.2013 for which the first premium was of Rs.3814/-.  The next premium of the said policy waws to be paid on 28.1.14 which, according to the O.Ps.  They also admit that the complainant is the nominee of the deceased PurastamParida.  The death of the policy holder PurastamParida was intimated to the O.Ps on 22.3.16,  After his death and on getting information, the O.Ps  had enquired and had found out that the deceased had some other insurance policies prior to executing the proposal form with them which the deceased had not disclosed thereby had suppressed those informations.  The deceased had obtained a policy from Birla Sun Life Insurance Company Ltd. Vide policy no.005868270 and another from Shriram Life vide Policy No.NP141200005246.  Thus, according to the O.Ps, the deceased had suppressed material facts and had practised fraud upon them which is hit by clause-10 of the policy bond.  In this connection they have relied upon a decision of Hon’ble Supreme Court in the case of Satwant Kaur Sandhu Vrs. New India Assurance Company Ltd. (2009) 8 SCC 316 wherein it is held that the upshot of the entire discussion is that in a Contract of Insurance, any fact which would influence the mind of a prudent insurer in deciding whether to accept or not to accept the risk is a ”material fact”.  If the proposer has knowledge of such fact, he is obliged to disclose it particularly while answering questions in the proposal form.  Needless to emphasise that any inaccurate answer will entitle the insurer to repudiate his liability because there is clear presumption that any information sought for in the proposal form is material for the purpose of entering into a Contract of Insurance.  They have also relied upon decisions of Hon’ble National Commission in the case of Kunwar Pal Vrs. CEO Sahara India Life Insurance Co. Ltd. 2017(1) CPR-124(NC) wherein it is held that the duty of the Life Assured to provide truthful and correct information to the insurance company at the time of filling up proposal form and if not the insurance company has every right under the contract of insurance to repudiate the claim, and in the case of Sudesh Gupta Vrs. ICICI Prudential LIC Ltd. CPR-2011(3) p.g-149(N.C), it is held that Terms and conditions in insurance policy being in nature of contract between the parties, rights and obligations have to be governed by the terms as incorporated.  In construing terms of Insurance words used therein must be given paramount importance, in the case of LIC of India & others Vrs. N.P. Nagarathna – CPR-2012(2) it is held that “An insurance policy between two parties is based on utmost good faith” and breach of the same would justify, repudiation of insurance claim, and in the case of National Insurance Co. Ltd. Vrs. Aparna Kahar-CPR-2014(3),p.g-697 wherein it is held that “claims can be allowed only as per the terms and conditions of policy.  The O.Ps have also relied upon the decision of Hon’ble Supreme Court in the case of LIC & Another Vrs. Smt. S.Sandhu (CPR)-2006-p.g-258. Wherein it is held by their lordships that “Courts and Tribunals cannot rewrite contracts contrary to the terms of the contract to the defaulting parties”.  Accordingly, the O.Ps have prayed to dismiss the complaint petition.

          The O.Psalongwith their written version have also filed copies of several documents.

3.         Keeping in mind the averments as made in the complaint petition and the contents of the written version, this Commission thinks it proper to settle the following issues in order to arrive at a proper conclusion.

i.          Whether the case of the complainant is maintainable?

ii.         Whether there was any deficiency in service on the part of the O.Ps and if they had practised unfair trade?

iii.        Whether the complainant is entitled to the reliefs as claimed by her?

Issue No.ii.

Out of the three issues, Issue no.ii being the most pertinent issue is taken up first for consideration here in this case.

          Here in this case as noticed, the deceased husband of the complainant had obtained a Life Insurance  policy from the O.Ps on 17.12.12 vide policy no.15656289 wherein the assured sum was of Rs.10,00,000/-.  It is also noticed from the copies of documents as filed by both the O.Ps together with their written version that prior to taking this insurance policy from the O.Ps in fact the deceased had some mother insurance policies which he had not disclosed to the O.Ps while executing the proposal form with the O.Ps.  As per the decisions cited by both the O.Ps, it is the duty of the insured to disclose about the previous policies as obtained by him to the subsequent insurer and non-disclosure of thosetantamounts to suppression of material facts.  Thus, keeping in mind, the valuable citations as relied upon and are cited by both the O.Ps of this case, it is noticed that in the present case, the deceased insured who is the husband of the complainant, had not disclosed about his previous policies while entering into the policy with the O.Ps but had rather suppressed those.  Accordingly, this issue goes against the complainant.

 

 

Issues no.i& iii.

From the discussions as made above, it can never be said here that the case as filed by the complainant is maintainable and the complainant is entitled to any of the reliefs as claimed by her.  Hence it is so ordered;

ORDER

Case is dismissed on contest against O.Ps and as regards to the facts and circumstances of the case without any cost.

Order pronounced in the open court on the 6^thday of   December,2022 under the seal and signature of this Commission.     

                                                                                                                                Sri Debasish Nayak

                                                                                                                                            President

                       

                                                                                                                                                                Sri Sibananda Mohanty

                                                                                                                                            Member