Order by:

Sh.Amrinder Singh Sidhu,  President.

1.       The   complainants have filed the instant complaint under section 12 of  the Consumer Protection Act, 1986 (as amended upto date) on the allegations that complainants are the legal heirs of Saraj Singh son of Bohar Singh. Said Saraj Singh was insured with the Opposite Parties vide policy No. 20949384-HDFC SL ProGrowth Plus dated 12.12.2018 for a sum of Rs.10 lakhs against the paid up premium of Rs.40,000/- half yearly. Further alleges that said Saraj Singh life assured  had died on 31.12.2018. After the death of Saraj Singh life assured, the complainants being his legal heirs lodged a claim with the Opposite Parties and completed all the formalities, but the complainants received a letter dated 07.05.2019 from the Opposite Parties regarding the discontinuance of the policy on the basis of the non existent of life assured at the time of proposal stage, but said letter issued by the Opposite Parties is totally illegal., null and void. The complainants made so many visits to the office of the Opposite Parties for the claim of policy of Saraj Singh Life assured, but to no affect.  As such, there is deficiency in service on the part of the Opposite Parties. Vide instant  complaint, the complainant has sought the following reliefs.

a)       To direct the Opposite Parties to pay the insured amount of Rs.10 lakhs alongwith upto date interest and incentives against the policy and also to pay Rs.2 lakhs as compensation and damages for physical as well as mental tension and due to deficiency in service. Hence, the present complaint is filed by the Complainant  for the redressal of  their grievances.

2.       On notice, Opposite Parties No.1 and 2 appeared through counsel and contested the complaint  by filing the written version taking preliminary objections therein inter alia that the present complaint is not maintainable; that there is no deficiency in service on the part of the Opposite Party.  Brief facts are that Saraj Singh life assured  had submitted the online enrollment form/ proposal application dated 10.12.2018 for the purchase of the policy in question and accordingly, the policy bearing No. 20949384 originally commencing from 11.12.2018 was issued in his favour with the policy  term 20 years and premium amount was Rs.40,000/- half yearly with sum assured of Rs.10 lakhs. The policy documents alongwith its terms and conditions were supplied to  Saraj Singh life assured. The claim was lodged with the Opposite Parties No.1 and 2. Thereafter, the Opposite Parties No.1 and 2 hired he services of an investigation agency named Copper Cross Solutions on 06.04.2019 and said agency submitted its report that DLA was about 35-40 years old man and was working as a farmer for his living. However, a material fact came in the light  that the DLA suddenly died on 30.10.2018 at his home i.e. he was already not alive at the time of applying for the insurance policy. This fact was confirmed by Aanganwadi and Panch of the village namely Ranjit Kaur and Manjit Kaur respectively. As per his birth and death record, on 30.10.2018, the DLA died at his home. Manjit Kaur is the Panch of the area and thus provided a statement in that capacity. So, accordingly the policy was discontinued on account of  application of non existent life assured at the proposal stage. In this way, the complainants have cheated the Opposite Parties No.1 and 2 by concealing the facts that the DLA had already died before   taking the policy. The answering Opposite Party have clearly stated in the application form that if any untrue information is provided by the proposer, the answering Opposite Parties has  the right to treat the policy as null and void and hence, no illegality has been committed by the answering Opposite Parties while cancelling the policy of the DLA.  Moreover, there has bee breach of one of the basic principles of the life insurance which is of utmost good faith and the Opposite Parties had no other alternative but to repudiate the claim of the complainant after taking  into the consideration of provisions of Section 45 of the Insurance Act, 1938.     In view of the above the present complaint is liable to be dismissed. On merits, Opposite Parties No.1 and 2 took up the same and similar pleas as taken up by them in the preliminary objections and hence, it is prayed that the complaint of the complainant is liable to be dismissed against Opposite Parties.

3.       Opposite Party No.3 appeared through counsel and contested the complaint  by filing the written version taking preliminary objections therein inter alia that the present complaint is not maintainable and that there is no deficiency in service on the part of the answering Opposite Party.  The complainants in order to succeed their nefarious designs and to cover up the present complaint under the jurisdiction of this District Consumer Commission by levelling false allegations against the answering Opposite Party have filed the present complaint before this District Consumer Commission. Moreover, there is no evidence documentary or otherwise which points out any fault on the part of the answering Opposite Party. Moreover, ther eis no commission of deficiency in service and Unfair Trade Practice on the part of Opposite Party No.3. Opposite Party No.3 has been impleaded as party to the present complaint to file the present complaint before this District Consumer Commission. Nothing stated in the complaint shall be deemed to be admitted by the answering Opposite Party on account of non traverse.   On merits, Opposite Party No.3 took up the same and similar pleas as taken up by them in the preliminary objections and hence, it is prayed that the complaint of the complainant is liable to be dismissed against Opposite Party No.3. 

4.       In order to prove their case, the complainant has tendered into evidence  affidavit  of Jasvir Kaur Ex.CW1/A alongwith copies of documents Ex.C1 to Ex.C11 and closed their evidence.

5.       On the other hand, to rebut the evidence of the complainant, Opposite Parties No.1 and 2  tendered  into evidence affidavit of  Sh.Arpit Higgans Ex.Ops1 & 2/1 alongwith copies of documents Ex.Ops1&2/2 to Ex.Ops1 & 2/7 and similarly, Opposite Party No.3 tendered into evidence the affidavit of Sh.Ankur Mittal Ex.OP3/1. 

6.       We have heard the ld.counsel for the parties and also gone through the documents placed on record.

7.       During the course of arguments, ld.counsel for the Complainant as well as Opposite Parties have  mainly reiterated the facts as narrated in the complaint as well as in the written statements  respectively. We have perused the rival contentions of  the parties and also gone through the record on file. The main contention of the ld.counsel for the complainant is that after the death of Saraj Singh life assured, the complainants lodged the claim for the insured amount with the Opposite Parties No.1 and 2, but the Opposite Parties No.1 and 2 illegally and wrongly repudiated the claim of the complainant. On the other hand, the contention of the Opposite Parties No.1 and 2 is that admittedly Saraj Singh life assured  had submitted the online enrollment form/ proposal application dated 10.12.2018 for the purchase of the policy in question and accordingly, the policy bearing No. 20949384 originally commencing from 11.12.2018 was issued in his favour with the policy  term 20 years and premium amount was Rs.40,000/- half yearly with sum assured of Rs.10 lakhs. The policy documents alongwith its terms and conditions were supplied to  Saraj Singh life assured. The claim was lodged with the Opposite Parties No.1 and 2. Thereafter, the Opposite Parties No.1 and 2 hired he services of an investigation agency named Copper Cross Solutions on 06.04.2019 and said agency submitted its report that DLA was about 35-40 years old man and was working as a farmer for his living. However, a material fact came in the light  that the DLA suddenly died on 30.10.2018 at his home i.e. he was already not alive at the time of applying for the insurance policy. This fact was confirmed by Aanganwadi and Panch of the village namely Ranjit Kaur and Manjit Kaur respectively. As per his birth and death record, on 30.10.2018, the DLA died at his home. Manjit Kaur is the Panch of the area and thus provided a statement in that capacity. So, accordingly the policy was discontinued on account of  application of non existent life assured at the proposal stage. In this way, the complainants have cheated the Opposite Parties No.1 and 2 by concealing the facts that the DLA had already died before  taking the policy. In this way, the complainant have cheated with the Opposite Parties and got issued the policy in question after the death of Saraj Singh after forging the signatures of Saraj Singh life assured after his death. In this way, the complainant have not only cheated the Opposite Parties but also committed forgery with the Opposite Parties while purchasing the policy in question in the name of Saraj Singh life assured after his death.  Perusal of the record shows that not even a single document has been placed on record by the complainant to prove any deficiency,  imperfection, shortcoming or inadequacy in the quality, nature and manner of performance which is required to be performed by the Opposite Party in pursuance of a contract or otherwise in relation to any service. The burden of proving the deficiency in service is upon the person who alleges it. In the case of Ravneet Singh Bagga Vs. KLM Royal Dutch Airlines (2000) 1 SCC 66 the Hon'ble Supreme Court has laid down the test of deficiency in service by stating that:-

“The deficiency in service cannot be alleged without attributing fault, imperfection, shortcoming or inadequacy in the quality, nature and manner of performance which is required to be performed by a person in pursuance of a contract or otherwise in relation to any service. The burden of proving the deficiency in service is upon the person who alleges it. The complainant has, on facts, been found to have not established any wilful fault, imperfection, shortcoming or inadequacy in the service of the respondent. The deficiency in service has to be distinguished from the tortious acts of the respondent. In the absence of deficiency in service the aggrieved person may have a remedy under the common law to file a suit for damages but cannot insist for grant of relief under the Act for the alleged acts of commission and omission attributable to the respondent which otherwise do not amount to deficiency in service. In case of bona fide disputes no wilful fault, imperfection, shortcoming or inadequacy in the quality, nature and manner of performance in the service can be informed (sic). If on facts it is found that the person or authority rendering service had taken all precautions and considered all relevant facts and circumstances in the course of the transaction and that their action or the final decision was in good faith, it cannot be said that there had been any deficiency in service. If the action of the respondent is found to be in good faith, there is no deficiency of service entitling the aggrieved person to claim relief under the Act. The rendering of deficient service has to be considered and decided in each case according to the facts of that case for which no hard and fast rule can be laid down. Inefficiency, lack of due care, absence of bona fides, rashness, haste or omission and the like may be the factors to ascertain the deficiency in rendering the service.”

8.       Hence, we are of the view that intricate questions of law and facts are involved in the present complaint which require voluminous documents and evidence for determination which is not possible in the summary procedure  under the Consumer Protection Act and appropriate remedy, if any, lies only in the Civil Court. Not only this,  the nature of the dispute, in the present complaint, is squarely covered by the law laid down by their lordships of the Hon'ble Supreme Court in various judgements.  Further in case Oriental Insurance Company Ltd. Vs. Munimahesh Patel 2006(IV) CPJ page 1, wherein the Hon'ble Supreme Court has held that :-

“Proceedings before the commission are essentially summary in nature and adjudication of issues which involve disputed factual questions should not be adjudicated. It is to be noted that commission accepted that insured was not a teacher. Complainant raised dispute about genuineness of the documents (i.e. proposal forms) produced by the appellant.”

Their lordships have further held that :-

“The nature of the proceedings before the commission as noted above, are essentially in summary nature. The factual position was required to be established by documents. Commission was required to examine whether in view of the disputed facts it would exercise the jurisdiction. The State Commission was right in its view that the complex factual position requires that the matter should be examined by an appropriate court of Law and not by the Commission.”

A similar view has been taken by the Hon'ble National Consumer Disputes Redressal Commission in 1(2004) CPJ page 101 wherein it has been held by the Hon'ble National Commission in a revision petition titled as R.D. Papers Ltd. Vs. New India Assurance Co. Ltd. & Ors. in para No.7 of the judgement  which reads as under:-

“After going through the complaint and the written version, it appears to us that the complaint raises complicated questions of facts which cannot be decided by us in our summary jurisdiction.”

9.     Keeping in view the aforesaid facts and circumstances of the case, the instant complaint is not maintainable in this District Consumer Commission for its proper adjudication and the same stands dismissed. However, the complainants can get redressal of their grievance from the Civil Court/ or any other  competent authority, in accordance with law, for which the time spent before this District Commission shall stand excluded under Section 14 of the Limitation Act in the light of the judgment of the Hon'ble Supreme Court in case titled 'Lakshmi Engineering Works vs PSG Industrial Institute reported in 1995(3) SCC 583'. However, keeping in view the peculiar circumstances of the case, the parties are left  to bear their own costs. Copies of the order be furnished to the parties free of costs. File is ordered to be consigned to the record room.

10.     Reason for delay in deciding the complaint.

          This complaint could not be decided within the prescribed period because the State Government has not appointed any of the Whole Time Members in this Commission for about 3 years i.e. w.e.f. 15.09.2018 till 27.08.2021 as well as due to pandemic of COVID-19.

Announced in Open Commission.

Dated:07.06.2022.