Presented by Sri P.K.Dash, Member .
The Complaint pertains to deficiency in service enumerated under the provisions of Consumer Protection Act-1986.
The brief fact of the complaint is described here under.
The Complainant is the grandson and nominee of late Netrabati Panda had taken a Reliance Term Policy with the Opposite Party i.e. Reliance Life Insurance Company limited at Bargarh branch office located at Canal Avenue, Bargarh vide Policy No. 1506498 on Dt.13/08/2009. The basic sum assured value of the Policy is Rs.5,00,000/-(Rupees five lakh) only and the premium installment for Rs.4,283.29/-(Rupees four thousand two hundred eighty three and twenty nine paise)only was paid while opening the policy. The Opposite Party for the promotion of its business assured the sum assured value along with top up amount to the Complainant in case of the death of the policy holder.
Further contention of the Complainant is that during subsistence of the policy. Netrabati Panda died on Dt.30/09/2009 living belong him as her nominee for the term policy which fact was intimated to the Opposite Party on Dt.27/02/2009. The Opposite Party repudiated the claim of the Complainant vide intimation letter Dt.28/12/2009 and hence this complaint.
Such act of the Opposite Party amounts to deficiency in service towards the Complainant and the Complainant seek redressal of the Forum for a direction to Opposite Party to pay Rs.5,00,000/-(Rupees five lakh)only towards the sum assured value of the policy, Rs.50,000/-(Rupees fifty thousand)only towards the top up Rs.25,000/-(Rupees twenty five thousand)only towards the interest on the sum assured and Rs.20,000/-(Rupees twenty thousand)only for mental agony and Rs.5,000/-(Rupees five thousand)only towards litigation expenses.
The Complainant relied upon the xerox copies of the following documents in testimony of his claim.
Original Postal Order.
Voter Identity card of Netrabati Panda.
Receipt No.4649512A issued by Reliance Life Insurance.
Xerox copy of death certificate of Netrabati Panda.
Xerox copy of Medical Prescription.
Copy of claim form-B medical attendance certificate of Netrabati Panda.
Letter of Reliance Life Insurance to Netrabati Panda
S.L.C of Jampali.
Having been noticed the Opposite Party appeared before the Forum and filed his version, denying the allegations of the complaint.
The Opposite Party contends that the grand mother of the present Complainant availed a Reliance Term Plan Policy on Dt.12/08/2009 on payment of first installment of Rs.4,283/-(Rupees four thousand two hundred eighty three)only towards premium amount. Netrabati Panda filed one school leaving certificate issued by Head Master, N. Jampali where in her date of birth was shown to be Dt.01/04/1960 and according to this S.L.C. She was 49(forty nine) years of old while availing the policy. After the death of Netrabati Panda on Dt.30/09/2009 the claim statement was filed before the Opposite Party and the Opposite Party made an inquiry into the age of the policy holder and the Head Master by his letter Dt.24/12/2009 intimated the Opposite Party that, the serial No. 9647 in the admission Register in the name of Netrabati Panda was incorrect and the SLC issued was false and fabricated. Another inquiry as to the age of the policy holder was made from Panchayat Office, Dhanger. Sarpanch of the Dhanger panchayat supplied the Opposite Party, voter list prepared by the Election Commission of India where in at serial No.806 Netrabati Panda was assigned Electoral Identity No. OR/17/127/152227 and her age in the year 2009 was shown to be 67(sixty seven) years. As per the term and condition of the. Term plan policy the age of the policy holder should not be more than 65(sixty five) years.
The Opposite Party further contends that the Complainant violated the terms and condition of the policy by concealment of material fact and by doing so the policy holder is guilty of fraud and misrepresentations of facts and for which the contract between the Insurance Company and policy holder became void and the Opposite Party finding no way out repudiated the claim of the Complainant.
The Opposite Party relied upon some case laws like (i) 2007 (13) Scale 329 (ii) AIR 1937 Nag 270 at 272 and (2009) 8CC 316, although the case laws are not field except its material contentions while justifying its decision to repudiate the claim of the Complainant basing on the provisions of Sec 2(d) of the Protection of policy holders Interests Regulation-2002 and Sec 45 of the Insurance Act-1938 where in it is explained that if the insured at the time of filing proposal form misrepresented the material facts which were well within his knowledge, which ought to have dischosed to the insurer to exercise its right to repudiate/discharge the claim of the Complainant and in the instant case policy holder deliberately concealed her age for which the claim of nominee was rejected and the Opposite Party is no way liable for deficiency in service towards the Complainant and the Opposite Party prayed before the Forum to dismiss the complaint.
The Opposite Party in his defense relied upon the xerox copies of the following documents.
Proposal form (four sheets)
School Leaving Certificate of Netrabati Panda (one sheet).
Complainant filed no step and absent on call on the date of hearing. Heard arguments from the side of Opposite Party, gone through the documents annexed to the case record, the issue likely to be decided as follows:-
Where the policy holder Netrabati Panda made fraud and misrepresentation of facts, while availing policy from the Opposite Party ?
By repudiating the claim of the Complainant, whether the Opposite Party committed any deficiency in service towards the Complainant ?
What relief the Complainant is entitled for ?
Answering Issue No.1(one).
The Complainant filed before the Forum one school leaving certificate issued in favour of the Netrabati Panda (Maiden Name Netrabati Dash) by the Head Mastger, Primary School Jampali. Wherein date of birth of the policy holder Netrabati Panda is being shown to be Dt.01/04/1960 (Ist April Nineteen Sixty) and the authenticity of the SLC issued infavour of the policy holder is challenged by the Opposite Party. But neither the Complainant by producing the school admission register of the concerned year i.e. 1965 of Primary School, Jampali could establish the genuity of the document nor the Opposite Party filed the letter Dt.24/12/2009 received from the Head Master, Jampali and the voter list of the year 2009 of Dhanger Panchayat before the Forum to disprove the authenticity of the School Leaving Certificate of the policy holder.
The Forum vide its order Dt.15/07/2013, issued a letter to the Circle Inspector, Bargarh seeking information as to genuity of the School Leaving Certificate issued by the Head Master Primary School, Jampali vide letter No.37 Dt.18/06/1970 infavour of the policy holder Netrabati Panda (maiden name Netrabati Dash). In pursuance to the letter Dt.31/08/2013 of the DCDRF, Bargarh, the District Education Officer, Bargarh caused an inquiry through Block Education Officer, Bargarh and submitted information vide No. 5896 Dt.12/09/2013 that the T.C. Issued by the Head Master, Primary School, Jampali infavour of Netrabati Dash was not genuine.
As per the term and condition of the Term plan policy the age of the policy holder should not be more then sixty five years. The policy holder Netrabati Panda to avail the said policy filed the fake school leaving certificate of Primary School, Jampali and by doing so the policy holder made fraud and misrepresentation of facts violating the provisions of Sec 45 of Insurance Act-1938 as well as the terms and conditions of contract while availing policy.
Answering Issue No.2(two).
As per the provisions of Sec 45 of the Insurance Act 1938, Sec 2(d) of the Protection of policy holder interests Regulation 2002 as well as the terms and conditions of the Term plan policy and for the violation the contract between the insure and insurer became void and abinitio and by repudiating the claim of the complaint the Opposite Party is not liable for any deficiency in service towards the Complainant.
Answering Issue No.3(three).
In the circumstance discussed above the Complainant is not fair enough to bring a complaint having allegation of deficiency in service against the Opposite Party and the present complaint is not maintainable against the Opposite Party.
O R D E R
Considering all the facts, evidence in record, assertion and counter assertions of the Parties the Forum dismiss the complaint without cost and disposed off accordingly.
The complaint is disposed off accordingly.
Typed to my dictation
and corrected by me.
I agree, I agree, I agree (Sri Pradeep Kumar Dash) ( Smt. Anjali Behera) (Miss Rajlaxmi Pattnayak)
M e m b e r. M e m b e r. P r e s i d e n t.
