Haryana

StateCommission

A/465/2022

ANIL KUMAR - Complainant(s)

Versus

HDFC STANDARD INSURANCE COMPANY LTD. - Opp.Party(s)

RAJVIR SINGH SIHAG

16 Sep 2024

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION,

HARYANA, PANCHKULA

 

First Appeal No.465 of 2022

                   Date of Institution:12.09.2022

Date of Decision:16.09.2024

 

Anil Kumar S/o Dhoop Singh R/o Village Madanpura, Tehsil Uklana Mandi, District Hisar.

 

..…Appellant

Versus

 

 

HDFC Standard Life Insurance Company Ltd., Branch Office, HDFC SL, Hisar Branch, 1^st Floor, Kamla Palace, 57-60, Red Square Market, Hisar-125001 through its Branch Manager.

 

..…Respondent

 

CORAM:   Hon’ble Mr. Justice T.P.S Mann, President.

                   Mr.S.P.Sood, Judicial Member

                   Mrs.Manjula, Member

Present:-    Shri  Nikhil Sharma proxy counsel for Shri Rajvir Singh Sihag,  counsel for the appellant.

                   Shri S.C.Thatai,  counsel for the respondent.

 

O R D E R

T.P.S. MANN J.

 

          Initially, the complainant-appellant filed consumer complaint bearing No.61 of 2016 before the learned District Consumer Commission, Hisar, which was  dismissed on 06.11.2017. Feeling aggrieved therefrom, the complainant-appellant filed the First Appeal No.55 of 2018 against the order dated 06.11.2017 beforethis Commission, which was disposed of by setting aside the impugned order and remanded the matter to the learned District Consumer Commission, Hisar to decide the complaint after calling parties to lead evidence and parties were directed to appear before the learned District Consumer Commission, Hisar on 05.04.2019. The parties appeared before the District Consumer Commission and again, the learned District Consumer Commission dismissed the consumer complaint bearing No.61 of 2016 of the complainant on 04.07.2022.  The Complainant-Appellant-Anil Kumar again, filed the instant appeal under Section 41 of the Consumer Protection Act, 2019 for challenging the order dated 04.07.2022 passed by learned District Consumer Disputes Redressal Forum, Hisar(In short “District Consumer Commission”) whereby complaint filed by complainant-Anil Kumarwas dismissed.

2.      The brief facts of the case as set out in the complaint are that the father of the complainant-appellant namely Dhoop Singh S/o Rati Ram R/o Madanpura,Uklana, District Hisar had obtained insurance policy from the opposite party for sum assured of Rs.3,90,273/- vide insurance policy No.16017136 dated 12.04.2013. He paid the insurance premium to the opposite party.  Dhoop Singh S/o Rati Ram died on 28.07.2013. Being a nominee, the complainant-appellant submitted the claim form with the OP. The complainant-appellant completed all the requisite formalities of the OP. Instead of settling the claim and making payment of the insurance benefits, the OP wrongly repudiated the claim of the complainant vide letter dated 03.04.2014 on the ground that incorrect information was furnished by the life assured regarding his age. Thus there was deficiency in service on the part of the OP.The complainant prayed that OP be directed to settle the claim of the complainant immediately without any further delay and to release to the complainant the payment of insurance benefits amounting to Rs.3,90,273/- along with interest @ 18% per annum w.e.f. due date 28.07.2013 the date of death of life assured to the date of actual payment to the complainant.  The complainant may also be awarded a sum of Rs.25,000/- as compensation on account of mental agony, harassment and humiliation undergone by the complainant.

3.      Notice being issued, opposite party appeared and filed its reply.  Preliminary objections about maintainability of complaint, complaint was false, frivolous and vexatious, complaint was vague, baseless and ambiguous, complainant is not consumer, etc. were also raised and requested to dismiss the complaint.  It was further submitted that at the time of applying for a policy by the LA, the LA had represented his date of birth to be 03.04.1964, and life  assured in support of the same, had also submitted his affidavit in support of his declaration and the answering OP believing the said document to be true, had issued the policy with such a high sum assured as demanded by the LA. The forgery of the LA had come into the knowledge of the OP after receipt of the claim form.  As per the false declaration, the LA tried to establish his age as 49 years by showing his date of birth as 03.04.1964, but during the course of investigation, the actual  age proof of the life assured was collected and as per the said document, the life assured was having age of 61 years.

4.      On merits, it was submitted that the present policy was an outcome of fraud so played upon the respondent by the life assured  at the time of purchase of policy.   It was further submitted that after receipt of the death claim intimation, had processed the case for conducting necessary investigation and during the course of investigation, it revealed to the answering OP that life assured had grossly understated his age with a malafide view to cover himself under the policy in question and if the life assuredcorrectly told his true age, then the OP definitely would not have issued the policy in favour of the life assured and nor the plan in question would be admissible to the life assured.  As per the investigation report, the claim of the complainant was repudiated vide repudiation order dated 03.04.2014. The complainant was not entitled to receive any benefit from the OP.  Thus there was no deficiency in service on the part of the OP and prayed for dismissal of the complaint.

5.      After hearing both the parties, the learned District Consumer Commissionhas dismissed the complaint twice vide impugned order dated 06.11.2017 &04.07.2022.

6.      Feeling aggrieved therefrom, complainant-appellant has preferred this appealseeking setting aside of the impugned order dated 04.07.2022.

7.      We have heard learned counsel for the appellant as well as learned counsel for the respondents.With their kind assistance the entire record of appeal and that of complaint alongwith Ex.C-1 to C-4 and Ex. R-1 to R-7 werethoroughly perused andexamined.

8.      Learned counsel for the complainant-appellant has vehemently argued thatduring the subsistence of the life insurance policy, the life assured had died and being a nominee, the complainant was entitled for the insured amount as prayed for. The OP-respondent has illegally repudiated the claim of the complainant.

9.      On the contrary, learned counsel for the OP-respondent has vehemently argued that at the time of obtaining the life insurance policy, the father of the complainant (LA) had declared that:  he was 49 years old by showing his date of birth as 03.04.1964 in the declaration form, but during the course of investigation, the actual age proof of the life assured was collected and as per the said documenti.e.list of voters, the life assured was having age of 61 years. The declaration regarding age given by the complainants was found to be false as he had relied upon the policy on the basis of false documents.  The claim of the complainant was rightly repudiated vide letter dated 03.04.2014. The complainant was not entitled for the claim amount as prayed for. Learned District Consumer Commission has rightly dismissed the complaint of the complainant and prayed for dismissal of the appeal. 

10.    It is admitted that complainant’s father was insured with theOP vide policy dated 12.04.2013 with a sum assured of Rs.3,90,273/-.  It is also admitted that during the subsistence of life insurance policy, the father of the complainant died.  The plea of the OP was that the complainant was not entitled for the claim amount, is relevant because at the time of obtaining the insurance policy, the complainant declared in the declaration form that he was 49 years old, whereas as per the investigation report, which revealed that policy holder was more than 61 years old in the year 2014.  Perusal of the file shows that during the investigation OP has placed on record Vidhan Sabha electoral role of Uklana (Ex.R-7) which shows that at Sr. No.748 Dhoop Singh S/o Rati Ram was shown 61 years of age. The complainant-appellant has placed on record copy of pan card, which reflected the date of birth of the life assured as 10.01.1964, it means that at the time of death, LA age was more than 49 years. The additional document can be placed on record at any stage of the case,  which is taken on record, but, perusal of ration card shows that on 17.07.2008, LA age was 45 years, it means that at the time of death, his age was more than 50 years.  Since, the father of the complainant has made false declaration, hence, the complainant-appellant is not entitled for claim amount. The life assured did not declare the correct information at the time of obtaining the insurance policy and the insurance company/respondent has rightly repudiated the claim of the complainant. The learned District Consumer Commission has rightly dismissed the complaint of the complainant. The State Consumer Commission finds no reason or ground to interfere with the order of learned District Consumer Commission. Hence the appeal being devoid of merit stands dismissed.

11.  

12.    A copy of this judgment be provided to all the parties free of cost as mandated by the Consumer Protection Act,1986/2019. The judgment be uploaded forthwith on the website of the Commission for  perusal of the parties.

13.    File be consigned to record room.

 

16^thSeptember, 2024          Manjula                     S.P.Sood                  T.P. S. Mann

                                                Member                     Judicial Member     President

 

S.K

(Pvt. Secy.)