District Consumer Disputes Redressal Commission ,Faridabad.
Consumer Complaint No2/2021.
Date of Institution: 05.01.2021.
Date of Order: 05.09.2022.
Tek Chand S/o late Shri Chinta Ram R/o Village – Atohan, Tehsil & District Palwal.
…….Complainant……..
Versus
1. HDFC Life
Registered Address: Lodha Excelus, 13th floor, Apollo Mills Compound, N.M.Joshi Marg, Mahalaxmi, Mumbai – 400 011 through its Director/Authorized Signatory.
And/Or
Claims Review Committee, HDFC Life Insurance Company ltd., 5th floor, ILFS Building plot No. C-22, G-Block, Bandra – Kurla Complex, Bandra (E), Mumbai – 400 051.
2. HDFC Life
Branch Office: HDFC SL Faridabad – NIT Branch, Ist floor Block No. 5R-1A, NIT, B.K.Chowk, Above Bharti Gupta Eye Clinic, Faridabad through tis Divisional Manager.
…Opposite parties……
Complaint under section-12 of Consumer Protection Act, 1986
Now amended Section 34 of Consumer protection Act 2019.
BEFORE: Amit Arora……………..President
Mukesh Sharma…………Member.
PRESENT: Sh. Kuldeep Poswal, counsel for the complainant.
Sh. Sagar Bhatia, counsel for opposite parties Nos.1 & 2.
ORDER:
The facts in brief of the complaint are that the father of the complainant was the Life Insurance Policy holder vide policy NO. 20127859-HDFC SL ProGrowth Flexi, Client ID: G7494514 of Rs.15,16,561/- policy term-20 years date of issue 27.02.2018 for a period for 2038 provided by the opposite parties. At the time of taking/obtaining the said policy by the father of the complainant, agent namely Deepak of the opposite parties being License No. HDF 00718230 agent NO. 00718230 address: 266, village Mujessar, Koli Mohalla, Sector-22, Faridabad had done the due verification which was purchased by the father of the complainant as such the father of the complainant was an agriculturist and having agricultural land on his own name in village Atohan Tehsil & District Palwal and father of the complainant was having a tractor on his own name and number of the said tractor was : HR-30M-8923 for cultivating purpose of his land and also produced/submitted the copy of jamabandi of his agricultural land and other necessary record and R.C of his tractor and the same were accepted by the agent of the opposite parties. Father of the complainant paid the first installment of Rs.30,000/- to the opposite parties on 27.02.2018 and in the said policy, the complainant being the son/legal heirs of deceased Chinta Ram was a nominee. On 10.01.2020 the father of the complainant expired and his death certificate had issued by the Registrar (Birth & Death) Community Health centre, Aurangabad on 15.02.2020. The father of the complainant had regularly paying the installment of Rs.30,000/- half year to the opposite parties as per the terms and conditions of the said policy till his death i.e. December, 2019. Thereafter, the complainant informed the above said agent of the opposite party about the death of the father of the complainant and also produced/submitted the documents to the agent of the opposite parties regarding to sum assured amount of his father. The complainant went to the office of opposite party No.2 alongwith all records and form and asked the opposite party No.2 to release the sum assured amount but the opposite aprty No.2 instead of releasing the claim amount declined the claim of the complainant pertains to the father’s Life Insurance policy vide letter dated 31.03.2020 on account of LA had declared himself as an Agricultural However LA was found to be a labhour Class Category. From investigation: it was established that the Life Assured had declared as an agriculture however LA was found to be a labour class category. This was not disclosed in the application dated 03.02.2018. The complainant sent legal notice dated 24.09.2020 to the opposite parties but all in vain. The aforesaid act of opposite parties amounts to deficiency of service and hence the complaint. The complainant has prayed for directions to the opposite parties to:
a) pay the sum assured amount of Rs.15,16,561/- alongwith interest @ 24% p.a. from 27.02.2018 till its realization to the complainant.
b) pay Rs. 3,00,000/- as compensation for causing mental agony and harassment .
c) pay Rs. 11,000 /-as litigation expenses.
2. Opposite parties put in appearance through counsel and filed written statement wherein Opposite parties refuted claim of the complainant and submitted that Shri Chinta Ram had applied to the opposite parties for an Unit Liked Insurance Plan “HDFC SL ProGrowth Flexi” vide Electronic Proposal Form NO. 13448716212 on 03.02.2018 for total sum assured of Rs.15,16,561/- on his own life by paying premium of Rs.30,000/- under Half Yearly payment mode. The Policy term and premium paying term opted was 20 years. Alongwith the proposal form, the deceased life assured had also submitted copies of authoritative documents in proof of the insured’s age, income, address and identification in support of the information provided in proposal form. Opposite party company processed the proposal for insurance of the Deceased Life Assured at Standard Rates by taking into consideration the facts disclosed by Deceased Life Assured in the proposal form as true and correct. Thereafter, policy No. 20127859 was issued in the name of Deceased Life Assured with risk commencement from 27th February 2018 having Half Yearly premium of Rs.30,000/- for 20 years with sum assured of Rs.15,16,561/- and the policy alongwith Free Look Period Intimation and copy of proposal form was duly delivered to the insured. The Insurance policy had Freelook period of 15 days wherein the insured had option to cancel the policy in case of any discrepancies in the terms and conditions of the policy including the details in the policy. In present case, the DLA did not raise any concern regarding the policy features, its terms and conditions and details filled in proposal form, within the said period of 15 days of receipt of policy documents. The complainant informed the opposite party about the sad demise of deceased life assured and death claim was lodged under the aforesaid insurance policy. In furtherance of the claim and in compliance of statutory provisions, an investigation was conducted for the disposal of the claim lodged but during course of investigation it was revealed that the Deceased Life Assured had obtained the aforementioned insurance policy by misrepresenting and concealing his Occupation and Gross Annual Income. The DLA in proposal from mentioned his occupation as agriculture and gross annual income as Rs.2,50,000/- from investigations, it was established that the life assured was a laborer and daily wage earner. The DLA had worked under”Mahatma Gandhi National Rural Employment guarantee act” for the period 02.08.20-16 to 24.01.2018. The opposite party had issued the aforesaid insurance policy to the Deceased Life Assured on the basis of facts disclosed and information provided by DLA in the said proposal form but since the DLA obtained he aforementioned insurance policy by misrepresenting and concealing his occupation and gross annual income leading to fraudulent suppression of material information, thereby affecting the solicitation of the opposite party. Thus, the contract stands vitiated at the opposite party’s end on the grounds of Fraudulent Suppression of Material Information, as the policy in question was obtained by paying fraud by DLA concealing the true, material and actual facts as mentioned. Since policy in question was obtained by concealing & misrepresenting the material facts with regard to profession and Income, therefore, the opposite party, in the light of claim investigation and facts and circumstances, rightfully repudiated the claim of the complainant vide letter dated 31.03.2020 which was just and reasonable as per the insurance laws as well as the terms and conditions of the said policy. However, as per terms & conditions of the policy governing benefits under the policy in case of death, the opposite party released an amount of Rs.1,05,738/- i.e. fund value of the policy on the date of death of LA, to the nominee of the LA i.e the complainant. Opposite parties denied rest of the allegations leveled in the complaint and prayed for dismissal of the complaint.
3. The parties led evidence in support of their respective versions.
4. We have heard learned counsel for the parties and have gone through the record on the file.
5. In this case the complaint was filed by the complainant against opposite parties– HDFC Life Insurance Co. Ltd. & Another with the prayer to: a) pay the sum assured amount of Rs.15,16,561/- alongwith interest @ 24% p.a. from 27.02.2018 till its realization to the complainant. b)pay Rs. 3,00,000/- as compensation for causing mental agony and harassment . c) pay Rs. 11,000 /-as litigation expenses.
To establish his case the complainant has led in his evidence, Ex.CW1/A – affidavit of Shri Tek Chand, Ex.C-1 – copy of jamabandi, Ex.C-2 – copy of sale dee
d, Ex.C-3 – Delivery receipt, Ex.C-4 – insurance policy, Ex.C-5 – RC, Ex.C-6 – Death certificate, Ex.C-7 – card of Krishi (Agricultural Development and farmers Welfare Department of Govt. of India bearing its No.HR63727/2016-17/28490241, Ex.C-8 , 9 & 10 – legal notice alongwith postal receipts, Ex. C-11 – Adhaar card, Ex.C-12 – PAN Card, Ex.C-13 – policy, Ex.C-14 – Register Intkal.
On the other hand counsel for the opposite parties strongly agitated
and opposed. As per the evidence of the opposite parties, Ex. OP1/A – affidavit of Shri Kunal Aurora, deputy Manager – legal HDFC Standard Life Insurance Co. Ltd., having its office at 4th floor, Vijaya Building, 17, Barakhamba Road, New Delhi Ex.OP-1 - Proposal form/Electronic Proposal Form for Single Life, Ex.OP-2 – letter dated 28.02.2018, Ex.OP-3 – job card,, Ex.OP-4 – Death claim decision letter.
6. It is evident from Death Claim Decision Letter vide Ex.OP 4 that the opposite party has repudiated the claim of the complainant on the ground that LA had declared himself as an agriculture however LA was found to be a labour class category. For this opposite parties have proved that Chinta Ram was working on Mahatma Gandhi National Rural employment Guarantee Act vide Ex.OP3. Opposite parties have sanctioned the claim of the complainant as a labour class category and allowed Rs.1,05,738/- as compensation.
7. As per Ex.C1 Zamabandhi which belongs to the deceased and Ex.C14 & C2 is the registration of land in the name of his wife vide Sale Deed document NO. 656 dated 17.10.2011 and also pleading in his evidence Delivery Receipt vide Ex.C3 which is the registration of the tractor which was brought by the deceased earlier. It is also evident from RC vide Ex.C5 which was in the name of Chinta Ram bearing RC No. HR30M-8923.
8. After going through the evidence led by both the parties, the Commission is of the opinion that the complaint is allowed. Opposite parties are directed to process the claim of the complainant within 30 days of receipt of the copy of order and pay the due amount to the complainant along with interest @ 6% p.a. from the date of filing of complaint till its realization. The opposite parties are also directed to pay Rs.5500/- as compensation on account of mental tension, agony and harassment alongwith Rs.5500/- as litigation expenses to the complainant. Copy of this order be given to the parties concerned free of costs and file be consigned to record room.
Announced on: 05.09.2022 (Amit Arora)
President
District Consumer Disputes
Redressal Commission, Faridabad.
(Mukesh Sharma)
Member
District Consumer Disputes
Redressal Commission, Faridabad.
