Bihar

StateCommission

A/26/2015

MD MAHMUD ALAM - Complainant(s)

Versus

CHIEF MANAGER, HEAD OFFICE BAJAJ ALLIANZ LTD. - Opp.Party(s)

ANIL KUMAR

19 Apr 2017

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION

BIHAR, PATNA

(Appeal No. 26 of 2015)

Md. Mohmud Alam,

S/o- Late Satar Ansari,

Vill.- Pipra Parsain, Tola- Ram Nagar,

P.S.- Sonbarsa, District- Sitamarhi.                                                   Appellant.         

VERSUS

Chief Manager,

Head Office Allianz Ltd.,

 Pune and others.                                                                              Respondents.

          

BEFORE

                                Hon’ble Mr. Justice S.K.Sinha, President and

                                Hon’ble Sri Upendra Jha, ADM (Rtd), Member

 

ORDER

Date of order:    19-04-2017

Upendra Jha, Member       

1.                       This appeal is directed against the order dated 22-04-2013 passed by District Consumer Forum, Sitamarhi  in Complaint Case No.10 of 2013 by which the complaint has been dismissed.   

 

2.                    Briefly stated the case of the complainant is that his father obtained an Insurance Policy on 27-10-2010 from the O.Ps.-respondents matured on 02-11-2013 paid annual premium Rs. 49,272/-( Rupees forty nine thousand and two hundred seventy two only)  for insurance amount Rs. 5,90,000/-.His father died on 27-04-2011 due to diarrhea. The complainant being nominee claimed the insurance amount with relevant documents on 29-07-2011 but it was repudiated by the O.Ps.- respondents due to fake age certificate. The complainant filed a complaint before the District Forum, Sitamarhi. The O.Ps. contested the case. The District Forum dismissed the complaint against which this appeal is preferred.

3.                          On being noticed, written notes of arguments has been filed by the respondent Company. Heard the parties.

 4.                         District Forum holding there is no deficiency on the part of the O.Ps.-respondent as the father of the complainant has committed fraud producing fake age certificate for obtaining policy has dismissed the complaint.

5.                          Grounds taken for appeal are that the District Forum and the respondents relied only on the forged and fabricated document forged by the respondents in view to grab the death claim. All these points were enquired by the respondents before issuing the Policy Bond including the age of the proposer. Madarsa Certificate has been concocted by the respondents. Similarly, School Leaving Certificate of the life assured by Laxmi High School, Sitamarhi has also been attached by the respondent which is forged. The life assured has produced and attached Matrculation Certificate issued by the Bihar Scholl Examination Board in which date of birth of the policy holder is10-08-1958.On this basis the policy was obtained and it is genuine. The death claim ought had been settled on this basis but it was wrongly repudiated by the O.Ps.- Company and the District Forum has also not considered this point before dismissing the complaint. Hence, the District Forum order be set aside and the appeal be allowed for the end of Justice.

 

6.                          The counsel for the respondent- Insurance Company submits that the father of the complainant- appellant was insured for Rs,5,90,000/-(Rupees five lacs and ninety thousand only),who died on 27-04-2011.The complainant is the nominee. After investigation it was found that the policy was obtained on  the bases of forged and fabricated document suppressing the age of proposer by 20 years. So, the respondents repudiated the claim on 02-09-2011 as the age of the life assured was suppressed. The review committee as well as Insurance ombudsman has also affirmed the repudiation of the claim. The District Forum has considered these points and has dismissed the complaint which is proper and justified. It needs no interference.

7.                           Having considered the grounds of appeal, submission of respondent-Company and on perusal of the order passed by the District Forum, it appears that the District Forum has not considered the matter in right perspective. Matriculation Certificate of the life assured is annexed with the proposal form which shows that the date of birth of the life assured is 10-08-1958. When Matriculation Certificate is available no other certificate could get more weitage for the proof of age. At the time of taking policy the age of the life assured was 52 years. It is not fake and fabricated, on this basis the death claim of the appellant ought to have been settled but it was not settled. Hence, we are not inclined to affirm the District Forum order. It is thus set aside. It needs a fresh hearing. The appeal is allowed and remanded to the District Forum, Sitamarhi for fresh hearing for adducing evidence if any and for passing a reasoned order within three months from receipt of this order.

8.                          The appeal is allowed.

 

 

 

S.K.Sinha                                                                        Upendra Jha

President                                                                           Member                                      

                                                                                                                                                                      

Anita