Madhya Pradesh

StateCommission

A/17/956

RELIANCE LIC LTD. - Complainant(s)

Versus

GOPAL - Opp.Party(s)

SH.GARVESH BARJATYA

16 May 2023

ORDER

M. P. STATE  CONSUMER  DISPUTES  REDRESSAL  COMMISSION,                         

                             PLOT NO.76, ARERA HILLS, BHOPAL

 

                                      FIRST APPEAL NO. 956 OF 2017

(Arising out of order dated 04.04.2017 passed in C.C.No.120/2015 by District Commission, Mandsaur)

 

RELIANCE LIFE INSURANCE CO.LTD.

REGISTERED OFFICE- H-BLOCK,

FIRST FLOOR, DHIRUBHAI AMBANI

KNOWLEDGE CITY, NAVI MUMBAI

NIRIN COMPOUND, GOREGAON, MUMBAI

THROUGH BRANCH MANAGER,

BRANCH OFFICE- STATION ROAD,

MANDSAUR (M.P.)                                                                                     ….           APPELLANT.

 

                       Versus

 

GOPAL S/O KANIRAM,

ALIAS KANHAIYALAL BHEEL,

R/O VILLAGE-KUCHDOD, TEHSIL-JIRAN,

DISTRICT-NEEMUCH (M.P.)                                                                      ….           RESPONDENT.                                

 

BEFORE :

            HON’BLE SHRI JUSTICE SHANTANU S. KEMKAR   :  PRESIDENT

           HON’BLE DR. (MRS) MONIKA MALIK                         :  MEMBER

                     

COUNSEL FOR PARTIES :

                Shri Ajay Dubey, learned counsel for the appellant.

           Shri K. K. Kala, learned counsel for the respondent.

          

 

                                                  O R D E R

                                       (Passed on 16.05.2023)

                   The following order of the Commission was delivered by Dr.(Mrs) Monika Malik, Member:

           

                   This appeal by the opposite party/appellant-Reliance Life Insurance Company Limited (hereinafter referred to as ‘insurance company’) is directed against the order dated 04.04.2017 passed by the District Consumer Disputes Redressal Commission, Mandsaur (for short ‘District Commission’) in C.C.No.120/2015 whereby the District Commission

 

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has allowed the complaint filed the complainant/respondent (hereinafter referred to as ‘complainant’).

2.                Briefly put, facts of the case are that the complainant’s father Late Shri Kaniram alias Kanhaiyalal Bheel (hereinafter referred to as ‘deceased-insured’), during his life time had taken a ‘RLIC Classic Plan Regular’ policy no. 50077084 for sum assured of Rs.2,00,000/- for which premium of Rs.10,000/-, as six monthly instalment was to be paid. Similarly, he had taken an another ‘RLIC Classic Plan Regular’ policy no. 50411517 for sum assured of Rs.4,00,000/- regarding which premium of Rs.20,000/- was to be paid. The duration of the both the policies was 15 years.  During the currency of the policy cover, on 31.05.2014, the deceased-insured died. Claim form along with requisite documents was submitted with the insurance company.  It is alleged that despite fulfillment of all the formalities, the insurance company rejected the claim stating therein that in the proposal form, the deceased-insured had given incorrect information about his occupation and income. Therefore alleging deficiency in service against the insurance company, the complainant approached the District Commission, seeking relief.

3.                The District Commission closed the right of the insurance company to file reply and therefore the documents filed by the insurance company were not considered by the District Commission.

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4.                The District Commission allowed the complaint directing the insurance company to pay sum assured of Rs.2,00,000/- under the policy no.50077084 and Rs.4,00,000/- under the policy no.50411517 i.e. sum total of Rs.6,00,000/-, with interest @ 7% from the date of repudiation of claim i.e. 05.12.2014 till payment, to the complainant within a period of one month. In addition, compensation of Rs.10,000/- with another sum of Rs.2,000/- as costs is also awarded.

5.                Heard.  Perused the record.

6.                Learned counsel for the appellant-insurance company argued that the deceased-insured was a member of ‘Mukhyamantri Majdoor Suraksha Yojna-2007’ and ‘Deendayal Antodaya Upchar Yojna’. He was a Below Poverty Line (BPL) card holder but in the proposal form, he had mentioned his occupation as business. He further argued that the paying capacity of the deceased-insured as mentioned in the proposal form was Rs.35,000/- which is not possible considering his economic status. He argued that there is misrepresentation of facts on part of the deceased-insured, in order to obtain the subject policies and therefore his claim is not payable. It is thus prayed that the impugned order be set-aside.

7.                Learned counsel for the complainant/respondent argued that the deceased-insured was an illiterate person and he could not give aforesaid information to the insurance company.  The insurance company has no case

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to argue in the matter when the written statement filed by the insurance company is not taken on record and the accompanying documents were not considered by the District Commission, the mention of which is also lacking in the impugned order. He argued that the District Commission has rightly passed the impugned order and this appeal deserves to be dismissed.

8.                It is an admitted position that the insurance company appeared before the District Commission but did not file reply within the stipulated time period.  Therefore, the version of the insurance company has rightly not been considered by the District Commission.  We also find that documents which were annexed by the insurance company before the District Commission are only premium receipts.  The proposal form and the investigation report on the basis of which the insurance company has stated to have denied the claim of the deceased-insured are not available on record of the District Commission.

9.                It is pertinent to mention that even though the District Commission had closed the right of the insurance company to file reply to the complaint, the complainant had moved an application before the District Commission requesting obtaining proposal form from the insurance company. The credibility of the complainant is unquestionable.

10.              At the same time, we find that the proposal form, investigation report and other documents which are filed for the first time in this appeal,

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are not supported with any application under Order 41 Rule 27 of CPC and are filed without defining reasons, for their non-production before the District Commission, more particularly when, the insurance company was represented before the District Commission. The documents so filed, at belated stage and without any application, do not deserve consideration.

11.              In view of the above, considering the facts and circumstances of the case, we are of a considered view that the District Commission has committed no error or irregularity in passing the impugned order. Accordingly, the impugned order is affirmed.

12.              As a result, the appeal being devoid of any merit is dismissed with no order as to costs.

                  

              (JUSTICE SHANTANU S. KEMKAR)          (DR. MONIKA MALIK)                     

                                 PRESIDENT                                         MEMBER