BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SIRSA.
Consumer Complaint no.239 of 2018
Date of Institution : 25.09.2018
Date of Decision : 04.09.2019.
Hardeep Singh, aged 35 years son of late Shri Jagsir Singh, resident of village Lehengewala, Tehsil Kalanwali, District Sirsa.
….Complainant.
Versus
1. HDFC Standard Life Insurance Company Limited, 1st Floor, Classic Auto Care Shop, Dabwali Road, Sangwan Chowk, Opp. Sharma Petrol Pump, Sirsa, District Sirsa, through its Branch Manager.
2. HDFC Standard life Insurance Company Limited, Regd. Office: Lodha Excelus, 13th Floor, Apollo Mills Compound, N.M. Joshi Marg, Mahalaxmi, Mumbai- 400 011, through its Manager/ authorized signatory.
… Opposite parties.
3. Chhinderpal widow of Shri Jagsir Singh, resident of village Lehengewala, Tehsil Kalanwali, District Sirsa.
4. Lovepreet daughter of Shri Jagsir Singh (wife of Shri Nirmal Singh), resident of village Bhima, Tehsil Kalanwali, District Sirsa.
5. Gurjeet Kaur daughter of Shri Jagsir Singh (wife of Shri Satnam Singh), resident of Budhladha, District Mansa.
..…Proforma Opposite parties.
Complaint under Section 12 of the Consumer Protection Act,1986.
Before: SHRI R.L. AHUJA………………………..PRESIDENT
SHRI ISSAM SINGH SAGWAL…………MEMBER
SMT. SUKHDEEP KAUR………….……MEMBER.
Present: Sh. Rakesh Bajaj, Advocate for the complainant.
Sh. A.S. Kalra, Advocate for opposite parties no.1 and 2.
Sh. K.C. Yogi, Advocate for proforma opposite parties no. 3 to 5.
ORDER
Case of complainant, in brief, is that father of complainant Shri Jagsir Singh son of Shri Gurdev Singh had availed agricultural loan from HDFC Bank Ltd., Sirsa Branch and against this agricultural loan, the ops no.1 and 2 issued two policies in the name of his father bearing No.17796683 on 13.7.2015 for sum assured of Rs.3,14,113/- and policy No.18648415 on 12.9.2016 for sum assured of Rs.1,75,000/- and complainant was shown as nominee in these policies. It is further averred that Shri Jagsir Singh died on 3.5.2018 and after his death, complainant lodged his claim with the ops and provided all the required documents and information to the ops. The ops (it should be ops no.1 and 2) settled the claim of complainant in respect of policy No.17796683 dated 13.7.2015 and credited a sum of Rs.3,47,094.96 in account of complainant bearing No.36544085560 with State Bank of India, Hisar road, Sirsa, whereas in respect of other policy No.18648415 dated 12.9.2016, the ops credited a sum of Rs.45,291.31 i.e. premium amount. The premium amount for policy No.18648415 dated 12.9.2016 was Rs.25,000/- per annum and the deceased had deposited two installments of premium i.e. Rs.50,000/- with ops no.1 and 2, but the ops refunded only a sum of Rs.45,291.31. It is further averred that complainant was highly shocked and surprised to see that ops did not settle the claim in respect of said policy and refunded the premium amount and that too after making unnecessary deductions therein. That complainant approached the op no.1 and lodged a protest in this regard and requested to settle the claim as settled in respect of policy no.17749683 dated 13.7.2015, but op no.1 did not pay any heed to the same, rather bluntly refused to admit the claim of complainant. It is further averred that complainant is legally as well as factually entitled to get the sum assured, interest and other benefits in respect of above said policy from ops. It is further averred that although, proforma ops were not nominated as nominee by the deceased, but they being legal heirs of deceased are being impleaded as parties. That the ops have been indulged in unfair trade practice and have also committed gross deficiency in service towards the complainant due to which he has suffered unnecessary harassment, as such he also is entitled to compensation of Rs.1,00,000/- from the ops. Hence, this complaint.
2. On notice, opposite parties appeared. Ops no.1 and 2 filed reply raising certain preliminary objections. It is submitted that life insured Jagsir Singh had submitted to the op no.1, a proposal/ application for the purchase of life insurance policy “HDFC SL Pro Growth Supper-II” and based on the answers and disclosures given by him, said proposal for issuance of the said plan was accepted on standard rate by op no.1 and consequently a policy was issued on 12.9.2016 for sum assured of Rs.1,75,000/- and thereafter the policy bond containing complete terms and conditions was sent to the policy holder. It is further submitted that deceased Jagsir Singh LA at the time of making the said proposal had misrepresented about his health as the deceased was suffering from Hypertension, Diabetes Mellitus, Chronic liver disease and depression prior to the issuance of the policy and was under regular medication and the suppression of this material fact amounts to suppression of true and material facts. This very fact is very much evident from the medical records obtained by op no.1, in which the deceased was diagnosed with Viral Hepatitis, Hypertension, Diabetes Mellitus, Chronic Liver Disease and depression. The life insured while applying for the policy gave wrong information pertaining to his health. In specific questions vide columns no.12 to 23 put to him that have you ever suffered from diabetes/ high blood sugar/ sugar in urine, high blood pressure/ hypertension, heart disease, stroke, he replied in negative i.e. NO. Thus, based on the above said facts and circumstances, the op no.1 rightly repudiated the claim of complainant vide letter dated 2.8.2018 on the ground of suppression of material facts by the life assured as per terms and conditions of the policy and op no.1 has acted as per IRDA rules and regulations. The op also credited an amount of Rs.45,291.31 to the account of complainant. With these averments, dismissal of complaint prayed for.
3. Proforma opposite parties no.3 to 5 made a statement through counsel that they do not want to file written statement and they have no objection if the complaint is allowed.
4. The complainant as well as ops no.1 and 2 then led their respective evidence.
5. We have heard learned counsel for the parties and have perused the case file carefully.
6. The complainant in order to prove his complaint has furnished his affidavit Ex.C1 in which he has deposed and reiterated all the averments made in his complaint. He has also furnished copy of letter dated 13.9.2018 Ex.C2, copies of policies documents Ex.C3 and receipts and letters Ex.C3 to Ex.C15, copy of death certificate Ex.C16, copy of death claim Ex.C17 and copy of statement of account Ex.C18.
7. On the other hand, ops no.1 and 2 have furnished affidavit of Sh. Gurpreet Singh, Deputy Manager Legal as Ex.RW1/A in which he has deposed and reiterated all the averments made in the written statement and ops have tendered copies of documents Ex.OP-1 to Ex.OP-7.
8. Admittedly, father of complainant namely Jagsir Singh had availed agricultural loan from HDFC Bank and in order to secure its loan, HDFC Bank got insured the borrower Jagsir Singh vide two policies bearing Nos. 17796683 on 13.7.2015 for sum assured of Rs.3,14,113/- and policy No.18648415 on 12.9.2016 for sum assured of Rs.1,75,000/-. The aforesaid Jagsir Singh died on 3.5.2018. After death of Jagsir Singh, present complainant had lodged claim with the ops no.1 and 2, but however, claim of complainant qua policy No.17796683 dated 13.7.2015 was settled and an amount of Rs.3,74,094-96 was credited in the account of complainant whereas the claim qua policy No.18648415 dated 12.9.2016 was declined, but however, a sum of Rs.45,291.31 was credited in the account of complainant as fund value of this policy.
9. During the course of arguments, though learned counsel for complainant has contended that out of two policies, the ops had paid the insured claim qua policy No.17796683, but however, declined the claim qua second policy No.18648415 and the ops have wrongly taken the plea that deceased Jagsir Singh was having a pre-existing disease of hypertension, diabetes mellitus, chronic liver disease and depression prior to the issuance of the policy and was under regular medication. On the other hand, there is specific contention of learned counsel for ops that since deceased Jagsir Singh was suffering from hypertension, diabetes mellitus, chronic liver disease and depression from the last many years, but however, in the proposal form, he concealed all these facts and referred that he was not suffering from any disease. Non disclosure of material facts by deceased life assured is sufficient ground for dismissal of the complaint as well as for cancellation of the policy. The ops have already cancelled the policy and have made refund of Rs.45,291.31 on account of refund value of the amount deposited by deceased Jagsir Singh and claim of complainant was repudiated.
10. The perusal of the affidavit of complainant Sh. Hardeep Singh Ex.C1 reveals that though he has deposed that his father had obtained two policies i.e. on 13.7.2015 and on 12.9.2016 and he died on 3.5.2018 and claim was lodged and claim amount of first policy was paid, but however, claim qua second policy was declined. The complainant has not uttered even a single word in his affidavit that his father was not suffering from disease namely Hypertension, Diabetes Mellitus, Liver problem and depression. On the other hand, official of the ops namely Sh. Gurpreet Singh, Deputy Manager Legal has categorically deposed in his affidavit Ex.RW1/A that deceased Jagsir Singh was suffering from Hypertension, Diabetes Mellitus, Chronic liver disease and depression prior to issuance of the policy in question and was under regular medication. This fact was concealed by deceased LA Jagsir Singh. In order to prove this plea, ops have also placed on record copy of proposal form Ex.OP1 which bears the photo and signatures of Jagsir Singh. In a letter Ex.OP3 it has categorically been mentioned that policy was issued on the basis of proposal dated 23.8.2016 made to HDFC Standard Life Insurance Company Limited for purchase of UNI HDFC SL ProGrowth Super II for sum assured of Rs.1,75,000/-. The proposal was accepted on the basis of information provided in the proposal form with the policy being issued on September 12, 2016 and they have referred to the personal details of life to be assured in the said application in which the deceased LA had denied that he was suffering from Diabetes/high blood sugar/ sugar in urine, High blood pressure/ hypertension, heart disease, stroke, liver disorder, kidney disorder etc. The ops have also got investigated the matter from the investigating agency i.e. Centre Point Services, report of which is Ex.OP4 on the record by which it has been reported that “An extensive investigation was carried out and it was revealed that LA was patient of Diabetes Mellitus Type-II for the past 3-4 years. So we note this case as a pre-policy case as this policy commenced from 12-Sep-16 whereas LA was diagnosed with Diabetes 3-4 years back.” Further, the ops have also placed on record copy of doctor certificate dated 4.6.2018 in which it is mentioned that “Certified that Sh. Jagsir Singh s/o Sh. Gurdev Singh Lehengewala (Sirsa) (Hry.) age 55 years is suffering from viral hepatitis, Diabetic 1+4 past 10 yrs and depression was treated by me for last 3 years.”
11. So, it appears from the evidence of ops no.1 and 2 that deceased Jagsir Singh was suffering from aforesaid disease namely Diabetes, hepatitis and depression prior to the issuance of the policy in question and this fact was concealed by him while furnishing his proposal form on the basis of which policy was issued. The ops have rightly cancelled the policy in question and refunded the amount of Rs.45,291.31 as fund value of the policy to the complainant and have rightly repudiated the claim of complainant.
12. In view of our above discussion, the complaint of complainant is hereby dismissed being devoid of any merit, but with no order as to costs. A copy of this order be supplied to the parties free of costs. File be consigned to the record room.
Announced in open Forum. Member Member President,
Dated:04.09.2019 District Consumer Disputes
Redressal Forum, Sirsa.
