BEFORE THE DISTT.CONSUMER DISPUTES REDRESSAL FORUM; BHIWANI.
C.C.No.178 of 2016. Date of Instt.: 24.08.2016. Date of Decision: 25.11.2019
Narender aged 25 years son of Shri Om Parkash resident of village Kudalbas Tehsil Loharu District Bhiwani.
..Complainant
Versus
1. HDFC Standard Life Insurance Company Limited Corporate & Registered Office Lodha Excelus, 13th Floor, Apollo Mils Compound NN Joshi Marg, Mahalaxmi, Mumbai 400011, through its Managing Director. 2.HDFC Life Insurance Company Limited Branch Office Hansi Chowk City Mall 2nd floor near Adarsh Mahila College Bhiwani Tehisl & District Bhiwani through its Branch Manager. 3.Amit son of Shri Ram Bilas resident of Digawa Mandi Jatan Tehsil Loharu District Bhiwani.
..Opposite Parties
Complaint U/S 12 of the CP Act,1986
Before: Sh. Nagender Singh, President. Sh. Shriniwas Khundia, Member.
Present: Sh.Ganesh Bansal, Advocate for complainant. Sh.Aasish Goyal, Advocate for opposite parties No.1 & 2. Opposite party No.3 exparte.
ORDER
NAGENDER SINGH, PRESIDENT
The facts of the complaint are as under:
The uncle of the complainant namely Sant Lal son of Jai Lal had got himself insured with the opposite parties for sum assured of Rs.4,63,080/- vide insurance policy No.17248334 with commencement date 17.12.2014 and the complainant was appointed as nominee. The uncle of the complainant died on 03.10.2015 and he had intimated the opposite parties about the death of his uncle and also submitted all the documents as per the instructions of opposite parties for settlement of claim but instead of settling the claim the opposite parties have repudiated the claim vide letter dated 01.03.2016 on false and flimsy grounds. Due to the act and conduct of the opposite parties, the complainant has not only suffered mental agony and harassment but he has also suffered humiliation which makes the opposite parties deficient in providing service. Hence, this complaint.
3. On notice, the only opposite parties No.1 & 2 appeared and resisted the claim of the complainant by filing reply to the complaint. In the reply preliminary objections such as maintainability, locus standi and cause of action etc. have been taken. It is submitted that policy bearing No.17248334 was issued to one Sant Lal as per information supplied him. In proposal form, the life assured had disclosed his financials status very sound and had represented himself to be of an age of 37 years. After receipt of death claim of life assured within 10 months from the date of commencement of policy and during the course of investigation it was revealed that the life assured was a member of BPL category and at the time of death he was 59 years of age, which shows that the policy was obtained after concealing the true and material facts from the insurance company. Since the insured had concealed the material facts from the opposite parties, therefore, repudiation of the claim vide letter dated 01.03.2016, duly intimated to the complainant, is justified and it has been made after following the terms and conditions of the policy. There is no deficiency in service on the part of opposite parties. Other contentions have been controverted and lastly prayer for the dismissal of the complaint has been made. Opposite party No.3 did not appear before this Forum and ultimately he was proceeded against exparte vide order dated 26.04.2019.
4. The parties have led their evidence in the form of affidavit and documents. The complainant has tendered in evidence documents Annexure C1 to Annexure C5 whereas the opposite parties have tendered affidavit Ex.RW1/A and documents Annexure R1 to Annexure R7 on the case file. Thereafter, the evidence of both the parties have been closed.
5. Heard. The counsel for the complainant reiterated the averments made in the complaint and prayed for its acceptance whereas the counsel for appearing opposite parties reiterated the averments made in the reply and prayed for dismissal of the complaint.
6. It is established on the case file that the uncle of the complainant had got himself insured with the opposite parties vide policy No.17248334 for sum assured of Rs.4,63,080/- and the complainant is the nominee being nephew. It is also not disputed that the uncle of the complainant was died during the subsistence of the policy. The plea taken on behalf of the opposite parties is that the policy in question had been obtained by concealing the material facts from the insurance company as the deceased life assured was BPL card Holder but he had shown his income to the tune of Rs.1,50,000- in the proposal form and he had also represented himself as 37 years of age despite the fact that he was 59 years old at the time of obtaining the policy in question.
7. The pleas and contentions put forth by the insurance company are not tenable because if the deceased life assured had worked as labour, in that eventuality, he would have earned sufficient income to make the payment of premium to the tune of Rs.24742/- on yearly basis for the policy purchased from the opposite parties and there is every possibility that the BPL category would have been obtained by the deceased life assured for availing subsidy and other benefits of various schemes of the Government and there is general tendency that in order to get these types of facilities, BPL cards are got issued. More-so, in the illustration form the age of the deceased life assured has been mentioned as 37 years, in the ration card Annexure C3, the age of the deceased life assured has been mentioned as 38 years, in the voter card prepared on 23.11.1994, the age of the deceased life assured had been mentioned as 26 years. Though the opposite parties have mentioned in Ex. R5 that as per investigation the deceased life assured was 60 years old but there is nothing on the case file to prove that plea rather the evidence produced on behalf of the deceased life assured is more weight and enough to reach at the conclusion that the deceased life assured was 37/38 years of age at the time of obtaining the policy in question. It is strange that when the insurance company has accepted the proposal form by treating the age mentioned in the ration card and voter ID card as correct then now they cannot take the plea of incorrect/under stated age by the deceased life assured. It was for the insurance company to have asked the deceased life assured to furnish better proof regarding his date of birth/age if the insurance company was doubtful about the correctness of date of birth/age of deceased life assured. Reliance on this point can also be taken from case law titled as Life Insurance Corporation of India Vs. Balbir Singh & Anr. IV (2008) CPJ 326 wherein it has been held by Hon’ble Punjab State Consumer Disputes Redressal Commission, Chandigarh has held that Life Insurance- Repudiation of claim-Contention, wrong date of birth given in proposal form, Date of birth given from ration card, with bona fide intention-Date of birth wrong not known to insured-School leaving certificate not demanded by insurer, cannot be placed reliance to justify repudiation of claim-Payment of assured amount with interest directed-Compensation and cost awarded. The case laws titled as Gulab Singh Vs. HDFC Standard Life Insurance decided on 28.11.2018 by Hon’ble National Commission in RP No.3142 of 2018 and Satwant Kaur Sandhu Vs. New India Assurance Company decided on 10.07.2009 by Hon’ble Supreme Court of India are not applicable to the case in hand, therefore, same are being distinguished.
8. Perusal of the case file reveals that the opposite parties have not mentioned the sum assured either in written statement and in any other documents and even no photocopy and original policy has also been placed on file. The complainant in his complaint in para No.3 has mentioned that the sum assured was Rs.4,63080/- and this amount has also been mentioned in the repudiation letter Ex.C1, but the complainant has also not placed the photo copy and original policy on the case file. There are several types of policies issued by the different companies granting different benefits like as death benefit, term benefit and other benefits. In Ex.R1, the police name has been mentioned as Youngstar Udaan Academia Plan with sum assured of Rs.152623/- but in this document at page No.7 the granted death benefit after one year is mentioned as Rs.2,40,000/-. Since both the parties have not placed either the photo copy or original policy on the case file, therefore, we came to the conclusion that the complainant or LRs of the deceased life assured are entitled for the grant of guaranteed death benefit to the tune of Rs.2,40,000/-.
8. Keeping in view the facts and circumstances of the case and the case law titled as Life Insurance Corporation of India Vs. Balbir Singh & Anr. (supra) we are of the opinion that there is deficiency in service on the part of opposite parties as it had wrongly repudiated the claim of the complainant. Hence, we allow the present complaint. As per Ex.R5, investigation report, the status of the deceased life assured has been shown as married, therefore, we direct the opposite parties to release the guaranteed death benefit of Rs.2,40,000/- in favour of the LRs of the deceased life assured after obtaining the list of LRs from complainant, if any, within 15 days from the date of order and thereafter to disburse the amount to the LRs in equal share within 30 days after receiving the documents from the complainant/LRs of the deceased life assured. It is further made clear that, if the deceased life assured was unmarried, in that eventuality, the nominee/complainant will be entitled to receive the guaranteed death benefit of Rs.2,40,000/-. The awarded amount of Rs.2,40,000/- will carry interest @ 9 % per annum from the date of filing of the complaint. The opposite parties are directed to further pay Rs. 10,000/- as lump sum compensation on account of harassment, mental agony and costs of litigation charges. Copy of this order be sent to the parties free of costs. File be consigned to the record room after due compliance.
Announced in open Forum
Dated: - 25.11.2019.
(Shriniwas Khundia) (Nagender Singh)
Member President,
District Consumer Disputes
Redressal Forum, Bhiwani.
