DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION CAMP COURT AT LUDHIANA
Received by way of transfer Consumer Complaint No.17 of 2018
Date of institution: 05.01.2018
Date of Decision:18.07.2022
Lukesh Kumar Sharma son of Late. Shri Ramesh Chander, resident of 2873, Gali No.7, New Janta Nagar, Ludhiana, Now residents of 110/4, Krishna Nagar, Jalandhar,
…….Complainant
Versus
HDFC Standard Life Insurance Company Limited, 126-127, 1st Floor, Kalinga Towers, Feroze Gandhi Market, Ludhiana, Punjab, (through authorised Manager/Representative)
……..Opposite Party
QUORUM:
HON’BLE MR. RANJIT SINGH, PRESIDENT.
HON’BLE MRS. RANVIR KAUR, MEMBER
PRESENT:
Sh.C.S. Chopra, Adv. counsel for complainant
Sh. Nitin Kapila, Adv. For OP
ORDER
SH. RANJIT SINGH, PRESIDENT
The present order of ours will dispose of the above complaint filed under Consumer Protection Act, by the complainant against the Opposite Party on the ground that the complainant after the death of his father Sh. Ramesh Chander, on 11.4.2005 and thereafter his mother Mrs. Anita Rani on 17.3.2007, when the complainant was minor at the age of 11 years, was taken by his maternal uncle to his residence at Jalandhar, as the relatives on the side of the father side of the complainant refused to take care of the complainant and thereafter till date the complainant is living with his maternal uncle at Jalandhar. It is alleged that few days back, when the complainant went to his father’s home to get his date of birth certificate and other documents which were lying in the parental house of his late father and he came to know from the documents that his father had taken a life insurance policy from the OP in which first premium was paid on 26.3.2004 and thereafter regular premium was being paid quarterly upto the death of his father on 11.4.2005 then the complainant lodged the claim with the OP but instead of settling the claim of the complainant the OP had rejected the claim. His mother was persuing the matter but she could not persue the same as she also died on 17.3.2007. So, due to not settling the claim of the complainant the complainant has filed the present complaint. Vide instant complaint, the complainant has sought the following reliefs:-
- To pay the claim amount of Rs.5,00,000/- along with compensation and litigation cost.
- In reply, the OP has filed written reply taking preliminary objections; that complaint is not maintainable ; that the complainant has not come to this Commission with clean hands; that the complainant has suppressed the material facts from this Hon’ble Commission. On merits, it is stated that Shri Ramesh Chander (father of the complainant) had obtained policy No.00348040 for a tenure of 20 years starting from 01.03.2004 against a sum assured of Rs.2,00,000/-. Shri Ramesh Chander was liable to pay the premium of Rs.2820/- payable quarterly and final premium was due on 01.12.2023. The mother of the complainant had lodged her claim under the said police with the OP and in terms of the said policy, the OP duly registered, entertained and processed the claim of the complainant and from the investigation, it was established that the life assured was suffering from TB due to the policy issuance and the said fact was not disclosed by Sh. Ramesh Chander in proposal form. Had this information been provided to the company at the time of applying for insurance policy, the policy could not have been issued and accordingly, the claim of the complainant was repudiated after due consideration and intimation regarding that was given to the mother of the complainant vide letter dated 13.1.2006. It is further stated that after the death of mother of the complainant i.e. Anita Rani, complainant again moved an application to the OP on 24.1.2008 which was duly signed by the complainant and Sh. Vijay Kumar Sharma as his guardian for reconsideration of the claim and the same was duly replied by the OP on 23.2.2008 in terms of the repudiation letter dated 13.1.2006. The OP has rightly repudiate the claim of the complainant. Rest of allegations leveled by the complainant against the answering OP have been denied and prayed for dismissal the complaint.
3. In support of the complaint, the complainant has tendered various documents. On the other hand, the OP also tendered certain documents in support of their version.
4. We have heard the learned counsel for the parties and have gone through the record of the file, carefully.
5. The Hon’ble State Consumer Disputes Redressal Commission, Punjab, Chandigarh, vide its order dated 3.5.2017, after condoning the delay in favour of the complainant, has remanded back the present complaint to decide it on merits.
6. The factum of insurance the death of the deceased during the substance of the policy and the complainant being legal heir of the deceased are not disputed. The issue has been narrowed down to the point of the rejection of the claim due to non disclosure of suffering from TB by the deceased at the time of effecting the contract of insurance. However, the repudiation of insurance of aforesaid ground is not justified due to following reasons:-
1. Ex.R17, has been made the basis of proof of the deceased being effected by TB at the relevant time. Its worth mentioning that, it is a document dated 21.10.2005 which makes the running reference of deceased being effected by TB in past. Meaning thereby that its an indirect or secondary document allegedly proving the relevant issue.
7. The OP i.e. Insurance Company has not proved on record through primary and best evidence through any document of the time of entering into insurance contract proving that the deceased was/is suffering from TB at that time.
8. Presently TB is a curable decease so even the relevant condition of repudiating the insurance policy on its basis inherently seems to be unjustified and unreasonable.
9. Consequently, the complaint of the complainant is decided in his favour. Complainant is awarded Rs.2,00,000/- as insurance amount along with interest @ 12% per annum from the due date till its payment. The complainant is also awarded Rs.1,00,000/- as compensation on account of mental and physical harassment with Rs.33,000/- as litigation expenses. The OP is further directed to comply with the said order within a period of 30 days from the date of receiving the certified copy of this order. Free certified copies of this order be sent to the parties, as per rules. The file be sent back to the District Consumer Commission, Ludhiana, for consigning the same to the Record Room.
July 18, 2022
(Ranjit Singh)
(Ranvir Kaur)
RBT/ CC No.17 of 2018
Present: Sh.CS Chopra, Adv. counsel for complainant
Sh. Nitin Kapila, Adv. For OP
Vide our separate detailed order of today, the complaint stands allowed. Free certified copies of this order be sent to the parties, as per rules. The file be sent back to the District Consumer Commission, Ludhiana, for consigning the same to the Record Room.
July,18 2022
(Ranjit Singh)
(Ranvir Kaur)
