The complainant Sri Ajit Pratap has filed this complaint petition against The General Manager, Aviva life Insurance Company Ltd., Jay Singh business centre persi Baha-Saharasade Andheri West Mumbai and two others (o.ps) for realization of Rs. 2 lacs ( 50% sum assured of Rs. 4 lacs ) and 50,000/- as compensation.
The brief, facts of the case is that the mother of the complainant namely Subhdra Devi alias Sumitra Devi had purchased life insurance policy from Aviva life insurance corporation company India Ltd. for Rs. 4 lacs. The further case is that the D.L.A Subhdra Devi allias Sumitra Devi died on 25-05-2012 leaving behind her two sons. The further case is that the elder brother of the complainant is Ranjeet Pratap Singh and litigation of land is going on within the complainant and his elder brother. The further case is that all the documents relating to life insurance policy is with his elder brother, so the complainant has no paper regarding the policy. The further case is that the complainant filed claim before B.M. Aviva Jeevan Life Insurance Company Ltd. Delhi, Mumbai and Gurgaon but their was no response. The further case is that the complainant serve the legal notice but only Sri Ankit Chalra advocate responded on behalf of Aviva Jeevan Life Insurance Company Ltd. in which he made a false statement with intention to grave the money. It has been further mentioned that on 18-03-2012 at about 10:AM one person, who disclosed his name as Samir Kr, an agent of Aviva Life Insurance Company, inquired him about the death of his mother. He also took an affidavit from the complainant and assure him to got provide compensation money from o.p. The further case is that the complainant also provided him photocopy of Voter I.D. card , photocopy of Bank account, and Mobile No. The further case is that the insurance company didn’t pay the insured amount.
The complainant has Filed the following documents with the complaint petition - photocopy of legal notice to General Manager Aviva Jeevan Life Insurance Company Ltd. Muzaffarpur annexure-1, photocopy of legal notice General Manager, Aviva Jeevan Life Insurance Company Ltd. Andheri West Mumbai -annexure-2, photocopy of legal notice General Manager Aviva life Insurance Company Ltd. Mithanpura Muzaffarpur -annexure-3, photocopy of affidavit of Ajit Pratap annexure-4, photocopy of reply of legal notice sent by Ankit Cholra to Mr. Bindeshwar Chaoudhary Advocate annexure-5, photocopy of postal receipts – annexure-6.
On issuance of notices o.p No.1 and 2 appeared and filed their w.s. on 26-04-2014 with prayer to dismiss the complaint with cost. It has been mentioned in the w.s. that the complainant is not nominee under the policy bearing No. TDW3102939 and as such he has no locus standi to file the present complaint and as such the complaint is not maintainable. It has been further mentioned that the complainant has no cause of action against the o.ps and he has utilized the machinery of law for determining the complicated question of fraud and cheating for which this Corum is not authorized to adjudicate the matter. It has been further mentioned that on 26-07-2011 a proposal form bearing No- NUP14560355 for “Aviva Dhan Virdhi” (hereinafter referred to as the policy) for sum assured Rs. 4 lacs/- was received for Life Insurance of D.L.A. Under the said policy a premium of Rs. 11,844/- was to be paid annually. The photocopy of proposal form has been annexed as annexure- o.p-1. It has been further mentioned that D.L.A submitted a forged school certificate with proposal form as in proof of her age. It has been further mentioned that after investigation conducted by investigator agency ‘Sharp Eagle found the same as not true. It has been further mentioned that the complainant, in his legal notice issued to the o.p under reply issued advocate Bindeshwar choudhary has also admitted that L.A. had died on 25-05-2011 that is before the proposal for insurance dated 26-07-2011. It has been further mentioned that dead person cannot be enter into a contract and as such the question of insurance of dead person does not arise. It has been further mentioned that in the proposal form, the D.LA. has mentioned her date of birth 02-02-1961 and submitted forged school certificate and as per her forged proof, her age was 50 years at the time of filing and signing of the proposal form. As per voter list she is 63 years old in 2011. As per the policy the maximum age in the policy is 55 years and wherein A.D.B rider is opted for then the maximum entry age is 50 years. Key feature of the product has been marked as annexure as o.p no.-2. It has been further mentioned that in the proposal form, D.L.A has mentioned that she read the application and furnished the information after fully understanding the contents thereof and also understood the terms and condition of the plan and had applied for the same and had made complete and true disclosure of the facts in the proposal form. Terms and condition of the policy has been annexed as annexure- O.P. No.3. It has been further mentioned that in the article-13 of the policy documents following has been provided-
“ If you or anyone acting on your behalf or at your direction or with your knowledge makes or advances any claim under this policy knowing it to be dishonest, misleading, false or fraudulent in any respect, then this policy shall be void and any amount actually paid or potentially payable shall be forfeited”. It has been further mentioned that o.p on 10-03-2012 received death claim form along with a forged death certificate from the brother of the complainant whereby it was stated that the DLA had passed away on 25-8-2011. The copy was death claim form along with death certificate has been marked as annexure- 4 & 5. respectively. It has further been mentioned that the claim being early claim an investigator agency” sharp Eagle. was appointed who perused the voter list of the village of the complainant and found that D.L.A was 63 years old in 2011. Report of the investigator has been annexed as O.P No.-6. and documents produced during investigation has been marked as o.p no-7. Copies of school certificate submitted by the D.L.A with the proposal form and affidavit and investigator report has been annexed as annexure O.P -8. It has been further mentioned that the o.ps repudiated the claim of the complainant on the ground of suppression of material fact submitting the forged documents by the diseased policy holder at the time of submission of the proposal form and due to production of forged and fabricated documents. The repudiation letter has been annexed as annexure- o.p no.-9.
On issuance of summon O.P.No.3 didn’t appear before the forum so, forum proceeded Ex. Party against him vide order dated 28-08-2015.
The submission of proposal form and issuance of policy bond in the name of the D.L.A is an admitted fact. The o.p No.1 has repudiated the claim of the petitioner brother on the ground that the school certificate submitted at proposal stage was forged and death certificate submitted by claimant’s brother namely Ranjeet Kr. Has been verified and found to be not genuine.
In the claim petition, the date of death of the D.LA. Subhadra Devi allias Sumitra Devi has been mentioned as 25-05-2012 whereas in annexure-1, notice issued by Birendra Choudhary to General Manager, Aviva Insurance Company Ltd. Muzaffarpur, date of death of D.L.A Subhadra Devi allias Sumitra Devi is mentioned as 25-05-2011. In the another notice sent by Ganga Kr. Singh advocate General Manager, Aviva Jeevan life Ltd. Andheri West Mumbai, date of death of D.L.A has been mentioned as 25-05-2012. So, on perusal of complaint petition as well as annexure submitted on behalf of complainant, there is discrepancy on the date of death of D.L.A. On behalf of o.p photocopy of death certificate of Late Subhdra Devi allias Sumitra Devi (O.P annexure-5) has been filed in which date of death of D.L.A has been mentioned as 25-08-2011. The o.p has also annexed the claim submitted by the brother of complainant and he has also mentioned date of death as 25-08-2011. The proposal form was filled up on 26-07-2011 whereas as per legal notice annexure-1 date of death of D.L.A was 25-05-2011 so on perusal of the same it transpires that the D.L.A had filed the proposal form after her death. So, it is clear that the death certificate submitted on behalf of complainant Brother’s and legal notice appeared not genuine and the complainant has neither adduced oral evidence nor documentary on this point to prove above fact. So, o.p company has rightly repudiated the claim of the complainant’s brother on the above ground.
The o.p has also repudiated the claim of the complainant’s brother on the ground that D.L.A was 63 years old and she has filed forged school certificate . The complainant has not adduced any evidence of this point. O.p has annexed the surveyor report on this points. In proposal form that is annexure, o.p annexure-1 D.L.A has mentioned her date of Birth 02-02-1961. She has declared in para-11 of the proposal form that she had signed on proposal form after considering all the facts. In the death claim submitted by complainants brother, the death of birth of the D.L.A has been mentioned as 02-02-1961. On behalf of o.ps, annexure O.p- 7 (Voter list 2011 has been filed to show that on serial No.371 name of Sumitra Devi (L.A) has been mentioned in which her age has been mentioned as 63 years.
On behalf of o.p school leaving certificate has also been annexed as annexure o.p -7 in which date of birth of D.L.A has been mentioned as 02-02-1961 and the date of admission has been mentioned as 11-01-1966. It has been also mentioned by principal of the school that he compared the registration with Admission register and found the same as untrue. The complainant has neither denied the above fact by adducing on oral and documentary evidence nor produced in any evidence to controvert the above fact. So on basis of above discussion we are of the opinion that there is no deficiency of any service on the part of the o.ps and o.ps have rightly not paid the claimed amount.
Accordingly, the claim petition is dismissed without cost. Let a copy of this order be furnished to both the parties as per rule.
