Heard learned counsel for the appellant.

            None appears for the respondent.

2.        Captioned appeal is filed u/s 15 of the erstwhile Consumer Protection Act, 1986 (hereinafter called the ‘Act’). Parties to this appeal shall be referred to with reference to their respective status before the District Forum.

3.        The case of the complainant is that one Mangala Naik, the Policy Holder  had made a proposal for life insurance for Rs. 9,00,000/- on 13.12.2003 by filling up the proposal form. It is alleged that the Policy Holder became ill and subsequently died on 15.10.2005 after discharge from the hospital. Thereafter, the adopted daughter of the Policy Holder made claim for availing the death benefit of the

policy in question. But it was repudiated because the Policy Holder had a fake identity. Challenging the deficiency in service, complaint was filed.

4.        The opposite party filed the written version stating that they have issued the policy in favour of the complainant on 13.12.2003 but the policy holder died on 15.10.2005. After raising the claim, the opposite parties have enquired into the matter and found that the photograph of the Policy Holder does not tally with the photograph pasted in the Pan Card and Driving Licence. So, they repudiated the claim.

5.        After hearing the parties, learned District Forum passed the following order:-

          “xxxxxxxxx

         In the result, we direct the opposite parties who are jointly and severally liable to pay sum assured of Rs.8,00,000/-

        (Rupees Eight Lakhs) only together with cost of Rs. 1000/- to the complainant with one month of receipt of this order.”

6.        Learned counsel for the appellant submits that learned District Forum committed error in law by not considering the written version filed by it with proper perspectives. According to it, on the date of filling up the insurance proposal form, the Policy Holder has not proved the identity. Later, they also found that the photograph of the Policy Holder does not tally with the photograph pasted in the Pan Card and Driving Licence. Therefore, they have repudiated the claim. There is no deficiency on their part.

7.        Considered the submissions, perused the DFR including the impugned order.

8.        It is admitted fact that the complainant has purchased the policy from the opposite party for a sum assured at Rs. 8,00,000/-. It is also not in dispute that the Policy Holder died on 15.10.2005. The only question that arises in this case is whether the complainant had suppressed the identity while filling up the proposal form for getting the policy.

9.        Be that as it may, as per Section 45 of the Insurance Act, 1938, the Policy can be called in question on the following three grounds:-

           (a)  the statement must be on a material matter or must suppress facts which it was material to disclose;

           (b)  the suppression must be fraudulently made by the policy holder; and

           (c)  the policy holder must have known at the time of making the statement that it was false or that it suppressed facts which it was material to disclose.

10.     The Insurer has to prove the fake identity of the Policy Holder. In support of his submission, it filed Pan Card and the D.L. which belongs to one Mangala Naik. No other documents filed by the opposite party. 

11.     Learned counsel for the respondent relied on a decision of the Hon’ble Apex Court in the case of Mithoolal Nayak vrs. Life Insurance Corporation of India, AIR 1984 SC 814, where Their Lordships have observed that it is for the insurer to prove the three pre-conditions to call the Policy in question.

12.     Since the opposite party has failed to prove the three ingredients, we have to hold that the complainant has proved the deficiency in service on the part of the opposite party. We find no error in the impugned order passed by the learned District Forum. Hence the order of the learned District Forum is confirmed.

13.     The appeal stands dismissed. No Cost.

DFR be sent back forthwith.

Supply free copy of this order to the respective parties or the copy of this order be downloaded from Confonet or Website of this Commission to treat same as copy supplied from this Commission.