The complainant, Palwinder Kaur, has filed this complaint under Section 17(1)(a)(i) of the Consumer Protection Act, 1986 (in short, “the Act”) for directing the opposite party to settle her claim at Rs.25,25,000/- under the Policy; to pay interest at the rate of 18% per annum from the due date; to pay compensation for the unnecessary harassment, mental tension and torture suffered by her on account of deficiency in service and unfair trade practice on its part and the litigation expenses.  She alleged in the complaint that the Sales Manager of the opposite party approached her in her Village Aujla Banwali, District Kapurthala and sold Policy No.000148374 for a sum of Rs.25,25,000/- against which she was entitled to get the claim from the opposite party in case of death of her husband, Paramjit Singh/insured.  Her name was wrongly mentioned as Kulwinder Kaur.  The insured paid the first instalment of Rs.16,528/- against the premium by way of cheque/DD No.344987 dated 26.4.2012 and the next instalment of Rs.16,824/- was paid on 24.4.2013 by way of cheque/DD No.649142.  Unfortunately, he died on 22.5.2013 as a result of snake bite and intimation was given to the opposite party.  Thereafter it started demanding some documents to complete the formalities to proceed with her claim.  She fully complied with those demands but it repudiated her claim, vide letter dated 16.10.2013, on flimsy grounds that the deceased had misrepresented his age at the time of getting the insurance policy and that the proof of age submitted by him was fabricated.  The correct date of birth of the deceased/insured was 2.8.1957 and was mentioned in his driving licence issued by the Licensing Authority, DTO Office, Kapurthala.  That driving licence was original and not a fake document.  This act of the opposite party in repudiating her claim amounts to deficiency in service and adopting of unfair trade practice.  No misrepresentation regarding the date of birth was ever made by the insured at any point of time and, as such, the opposite party was not competent to repudiate her claim on that ground.

2.      The complaint was contested by the opposite party.  It filed written reply, in which it admitted that Paramjit Singh, insured, obtained the Policy mentioned in the complaint, in which the sum assured was Rs.25,25,000/-.  It also admitted that after the death of the insured, the claim was made by the complainant, which was repudiated, vide letter dated 16.10.2013, on the ground that at the time of submission of the proposal form the insured made misrepresentation regarding his age.  It did not dispute the fact that the first two premiums had been paid by the insured by way of cheques/demand drafts, as mentioned in para no.2 of the complaint and that he died on 22.5.2013.  While denying the other allegations made in the complaint, it pleaded that the insured himself purchased the Policy after due deliberations and understanding all the terms and conditions of the product and under that Policy the model premium was Rs.16,515/-; which was to be paid annually for 11 years.  At the time of obtaining the Policy, he provided his date of birth as 2.8.1960 i.e. around 52 years, by submitting his driving licence in proof of that age.  He duly signed the declaration and authorization contained in the proposal form after duly complying with the same and declaring that the disclosures made by him were true and correct.  He misrepresented his age at that time; as his date   of birth was recorded as 2.8.1957 in the original driving licence and that fact was confirmed during investigation.  Even in the death certificate his date of birth is recorded as 2.8.1957.  The maximum age for obtaining the product in question was 55 years and thus the insured played a fraud with it by misrepresenting his age and by concealing the fact that his age at that time was 56 years.  During investigation, it also revealed that he was an agriculturist with an annual income of Rs.1,60,000/-, whereas in the proposal form he mentioned himself as proprietor of Aujla Trading Company having annual income of Rs.2,75,000/-.  It also shows that he had the intention to play fraud and taking undue advantage and by misrepresenting the material facts obtained the Policy.  It was only after the submission of the claim form by the complainant that they came to know that the insured died on 22.5.2013 due to snake bite.  After the receipt of that claim, it issued the condolence letter dated 31.5.2013 and requested the complainant to provide the necessary documents for processing her claim.  It was only after the receipt of those documents that her claim was processed and was repudiated on the above said ground.  On 18.11.2013 a request was received from the complainant to reconsider her claim upon which the matter was again investigated and it came to the conclusion that the claim had been rightly repudiated on valid grounds and no amount was payable as per the terms and conditions of the Policy.  That decision was duly communicated to the complainant, vide reply dated 6.12.2013.  The contract of insurance being of utmost good faith, the insured was under an obligation to disclose all the material details in the proposal form, which were necessary for the purpose of determining the risk under the Policy.  He intentionally gave false information by suppressing and misrepresenting the facts.  In these circumstances, the complainant has no locus-standi to claim the alleged amount under the Policy.  She has not approached this Commission with clean hands.  The complaint lacks of cause of action and is based on surmises and conjectures.   The complainant has tried to deceive the Commission by stating wrong facts.  From the very beginning, there has been no such negligence or deficiency in service on its part.  It prayed for the dismissal of the complaint under Section 26 of the Act; being false, frivolous and malicious, having been filed to avail undue advantage. 

3.      To succeed in the complaint, the complainant proved on record her affidavit Ex.CA and documents Ex.C-1 to Ex.C-12.  On the other hand, the opposite party proved on record the affidavit of Sujata Bhaduri, Senior Vice President, Ex.OP-A and documents Ex.OP-1 to Ex.OP-8.

4.      We have heard learned counsel for both the sides and have carefully gone through the records of the case.

5.      It has been submitted by the learned counsel for the complainant that the date of birth of Paramjit Singh, insured, as alleged by the opposite party itself, was mentioned in the proposal form and in proof thereof the driving licence having the same date of birth was submitted by the insured.  In these circumstances, it cannot be held that he misrepresented his date of birth or that he defrauded the opposite party by misrepresenting the facts.  It was the opposite party, who itself changed the date of birth from 2.8.1957 to 2.8.1960 in the proposal form Ex.OP-1 and the driving licence; which forms part of that proposal form.  The fact that date of birth was given as 2.8.1957 in the driving licence of the insured stands proved from the driving licence proved on the record by the opposite party itself as Ex.OP-6 and by the complainant as Ex.C-5.  From the evidence produced on record, it stands proved that it is the opposite party, who has committed a fraud by changing the date of birth in the proposal form in order to wriggle out of its liability to pay the assured sum.

6.      On the other hand, it has been submitted by the learned counsel for the opposite party that it is very much clear from the perusal of the proposal form Ex.OP-1 that the complainant himself disclosed his date of birth as 2.8.1960 and the correction made in the date of birth was duly signed by him.  Same date of birth was mentioned in the driving licence, which was submitted by him as proof of date of birth/age.  In fact, the correct date of birth of the insured was 2.8.1957 and by misrepresenting his date of birth obtained the product wrongly.  He committed a fraud on the opposite party to obtain that product to which he was not entitled to, being above 55 years of age at that time.  The contracts of insurance are based upon the doctrine of utmost good faith and, as such, the insured was required to disclose his correct date of birth and by misrepresenting his date of birth to be 2.8.1960, he committed the breach of the insurance contract; as a result of which this contract of insurance became void and no illegality was committed by the opposite party by repudiating the claim of the complainant on that ground.

7.      In support of the allegations made in the complaint, the complainant proved on record her affidavit Ex.CA, in which she deposed about each and every allegation made in the complaint.  No doubt, the opposite party proved on record the affidavit of Sujata Bhaduri Ex.OP-A, in which she deposed that she is the authorized representative of the opposite party and is well conversant with the facts and circumstances of the case.  In that affidavit, she deposed about the facts as stated in the written reply of the opposite party.  She deposed that at page 1 of the Application, the insured provided his date of birth as 2.8.1960 around 52 years and at the time of signing of the proposal form submitted his driving licence in proof of that age.  It is very much clear from the contents of her affidavit that she made her deposition on the basis of the documents but in the verification she stated the facts to be true and correct to the best of her knowledge and information based on the records maintained with the opposite party.  As per the Rules, she was required to state in the verification as to which particular paras of her affidavit are true and correct as per her knowledge and which specific paras are true and correct as per the information based on the record maintained by the opposite party.  As a result of this defective verification, this affidavit cannot be considered as valid evidence.

8.      The main question to be decided is, as to what date of birth was mentioned by the insured in the Proposal Form, Ex.OP-1?  The date of birth is mentioned in that Proposal Form at two places and at both these places the year of birth has been changed to 1960 by way of overwriting.  In order to make out that this correction was made by the insured himself, it is made to appear that he appended his signature on those corrections.  We have carefully compared those signatures with the signatures of the insured in the requisite columns and we find that those do not tally with each other.  There are a number of dissimilarities.  The admitted signatures appear to have been put with somewhat trembling hand, whereas the disputed signatures appear to have been put with a consistent hand.  The formation of all the Punjabi alphabets in those signatures is different.  Those dissimilarities would not have been there, if the alleged signatures on the corrections had been put by the insured himself.  The photostat copy of the driving licence of the insured, which was produced by way of evidence in proof of age, was filed by the opposite party along with his proposal form.  The photostat copy has been prepared in such a manner that the year of birth is not at all legible.  In the other two photostat copies of the driving licence proved by the parties as Ex.C-5 and Ex.OP-6 it is very much clear that this date of birth is recorded therein as 2.8.1957.  It is very much clear from the comparison of all these photostat copies of the driving licence that those photostat copies are of one and the same driving licence.  Had the year of birth been changed from 1957 to 1960 in the driving licence of the insured, there was no possibility of the opposite party getting the photostat copy of that driving licence Ex.OP-6 with date of birth as 1957.  That absolutely makes it clear that the insured had given his date of birth correctly as 2.8.1957 in the proposal form and in proof thereof had submitted his driving licence containing that date.  It is the opposite party, who has committed a mischief and fraud by changing that date of birth in the proposal form and the photostat copy of the driving licence from 2.8.1957 to 2.8.1960.

9.      In these circumstances, the opposite party was not justified in repudiating the claim of the complainant on the ground mentioned in the repudiation letter i.e. the insured had misrepresented his age at the time of obtaining the insurance policy.  Therefore, the complaint is allowed.  The opposite party is directed to pay the sum assured (Rs.25,25,000/-) to the complainant along with interest at the rate of 18% per annum from the date of submission of the claim till the payment thereof.  We are allowing this interest at the rate of 18% per annum keeping in view the fraud committed by the opposite party in order to make out a case for repudiation of the claim of the complainant and also keeping in view the harassment and mental agony caused to the complainant; as a result of this act of the opposite party; which clearly amounts to unfair trade practice.  The complainant is also allowed litigation costs of Rs.11,000/-.  The opposite party is directed to pay all these amounts to the complainant within 30 days of the receipt of the certified copy of the order.           

10.    The complaint could not be decided within the statutory period due to heavy pendency of court cases.