BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SIRSA.
Consumer Complaint no. 269 of 2018
Date of Institution : 31.10.2018
Date of Decision : 30.04.2019
Lilu Ram son of Mool Chand resident of Dhani Sanchla Tehsil Tohana District Fatheabad.
……Complainant.
Versus.
- HDFC Standard Life Insurance Company Limited, Corporate & Registered Office : Lodha Excelus, 13th Floor, Apollo Mills Compound, N.M.Joshi Marg, Mahalaxmi, Mumbai-400011 through its Chaiman-cum-Managing Director/Managing Director/competent and Authorized person.
- Branch Manager, HDFC Standard Life Insurance Company Limited, Ist Floor, Classic Auto Care Shop, Dabwali Road, Sangwan Chowk, Opposite Sharma Petrol Pump, Sirsa 125055.
...…Opposite parties.
Complaint under Section 12 of the Consumer Protection Act,1986.
Before: SH. R.L.AHUJA………………. ……PRESIDENT.
SH. ISSAM SINGH SAGWAL ………MEMBER.
MRS. SUKHDEEP KAUR……………..MEMBER.
Present: Sh.Sukhbir Dhaka, Advocate for complainant.
Sh. A.S.Kalra, Advocate for opposite parties.
ORDER
The case of the complainant, in brief, is that the brother of the complainant Rajender Kumar had purchased an Insurance policy No.16877866 valid from 28.03.2014 to 28.05.2034 for sum assured of Rs.9,85,867/- on payment of premium amount of Rs.29,101/-. The brother of the complainant Rajender Kumar died on 12.06.2017 and the complainant has approached to the Ops and lodged death claim of his brother being nominee besides submitting the all the requisite documents but the Ops initially avoided the claim and lastly repudiated the claim of the complainant wrongly and illegally. The act and conduct of the Ops clearly amounts to deficiency in service on their part. Hence, this complaint.
2. On notice, Ops appeared and filed their joint reply, whereby it has been submitted that the complaint of the complainant is not maintainable; that the complainant has no cause of action to file the present complaint and that the life assured had concealed the material facts from this Hon’ble Forum and from the Ops before purchasing the policy in question. The policy in question was issued on the answers and disclosure made in the said proposal form. The life assured had concealed the fact that he had obtained various polices from different insurance companies as well as his medical history before the issuance of the policy in question. The life insured had purchased the present policy by committing fraud with the Ops, therefore, there arises o question of to complainant for settlement of the claim. In fact, the said policy has been discontinued and has been cancelled by the Ops vide letter date 31.05.2017 before the death of life insured. There is no deficiency in service and unfair trade practice on the part of Ops. Other contentions have been controverted and prayer for dismissal of the complaint has been made.
3. Thereafter, both the parties have led their respective evidence.
4. We have heard the complainant in person and learned counsel for the Ops and have perused the case file carefully.
5. The complainant in order to prove his case has furnished his affidavit Ex.CW1/A, wherein he has reiterated all the averments made in his complaint. He has specifically deposed that his brother had taken the policy for period from 28.03.2014 to 28.05.2034 for a sum of Rs.9,85,867 on making the payment of premium to the tune of Rs.29,101/-. Rajender Kumar, brother of the complainant died on 12.06.2017 and after his death claim was lodged by the complainant being his nominee. The complainant requested the OPs to settle the claim and to release the amount of insurance to the complainant, but however, the Ops avoided the same but lateron they repudiated the claim. The complainant has tendered documents such as thanks letter Ex.C1 and death certificate of Rajender Kumar Ex.C2.
6. On the other hand, the Ops have tendered affidavit of Sh.Arpit Higgins, Manager Ex.R1, who has deposed in terms of the pleas taken in the reply. He has specifically deposed that the life insured has submitted to the Ops, a proposal application for the purchase of the life insurance policy. That based on the answers and disclosure given by the life insured, proposal form was accepted on standard rate and consequently a policy bearing No.16877866 dated 28.03.2014 was issued alongwith the terms and conditions. The life insured had concealed the material facts and documents from this Forum and the fact that he has obtained the various policies from different insurance companies before the issuance of the life insurance policy and further about the past medical history from the Ops. As per the proposal form of life insured/deceased vide column No.5 of the personal details of life so assured, is as under :
5. Has any proposal for insurance on your life eve been declined, postponed, accepted at extra premium, accepted on special terms, accepted with reduced premium cover or withdrawn by yourself... NO
He has further deposed that it is quite evident that DLA had taken 7 polices with high insurance premium and with high sum assured in a planned manner with a definite plan in his mind to defraud the opposite parties. Had the information regarding the other insurance policies or simultaneous applications being filed by him for procuring other insurance policies would have been revealed by the DLA to the opposite parties, the opposite parties would not have issued the policy. The life insured had committed fraud with the Ops and the Ops have rightly repudiated the claim of the complainant. The insured had got the insurance of Rs.50 lacs with a total premium of Rs.2.50 lacs clearly indicate that DLA has acted fraudulently. He has further deposed that due to non-disclosure of the previous insurance cover and about the past medical history from the Ops in the proposal form, the policy was cancelled vide letter dated 31.05.2017.
7. During the course of arguments learned counsel for the complainant has strongly contended that it was not the legal obligation of the deceased insured to disclose the previous policies which was obtained by him from different insurance companies and furthermore, the Ops cannot repudiate the claim of the complainant on this score only. He has relied upon the judgments reported in Baleshwar Singh Vs. Life Insurance Company decided on 16.03.2017 by Hon’ble National Commission in RP No.1053 of 2008, Bajaj Allianz Insurance Company Limited Vs. Santosh and another decided on 02.11.2017 by Hon’ble Punjab and Haryana High Court in CWP No.24862 of 2017, Life Insurance Corporation of India Vs. Shahida Begum III (2011) CPJ 373 (NC) and IDBI Federal Life Insurance Company Limited Vs. Rameshwar Prasad Jain decided on 04.11.2016 by the Hon’ble National Commission in RP No.139 of 2016.
8 On the other hand, learned counsel for the Ops has strongly contended that it is proved fact that the deceased insured was holding 7 different policies obtained from different insurance companies with insured value of Rs.50 lakhs on payment of premium of Rs.2,50,000/- per year. As per financial health of the deceased insured, he was not in a position to pay this amount of high premium. He has further contended that this fact was fraudulently concealed by the deceased insured in order to commit fraud with the Ops. The movement, this fact came in the knowledge of the Ops, the Ops cancelled the said policy on 31.05.2017 and as such the Ops have rightly repudiated the claim of the complainant. Learned counsel for the Ops has relied upon the recent judgment of Hon’ble Supreme Court reported as Reliance Life Insurance Company Ltd. & Anr. Vs Rekhaben Nareshbhai Rathod decided on April, 24, 2019in Civil Appeal No.4261 of 2019.
9. The perusal of the written statement of the Ops reveals that the Ops have specifically taken the plea that the deceased insured had taken 7 different policies from the different insurance companies prior to inception of this policy and committed fraud with the Ops and the movement this fact came in their knowledge, they cancelled the policy on 31.05.2017. The perusal of the affidavit of the complaint reveals that the complainant has not uttered a single word in his affidavit that deceased insured had not taken the policies from different insurance companies prior to inception of this policy. He has further not uttered a single word in his deposition that deceased insured had not disclosed about the different policies purchased by him from the different insurance companies prior to purchasing of this policy. The complainant has further not deposed that the policy in question was not cancelled by the Ops on 31.05.2017 prior to the death of deceased on 12.06.2017. So, non-deposition of the complainant, in his affidavit, qua this facts, clearly indicates that the deceased insured had concealed these facts while making declaration qua the previous policies purchased from the different insurance companies before taking the policy in question from the Ops. The judgments relied upon by learned counsel for the complainant appears to be not helpful to the case of the complainant as facts of the reported judgments are somewhat different from the facts of the present case rather we find force from the recent judgment of the Hon’ble Supreme Court passed in SLP No.4261 of 2019 arising out of SLP (C) No.14312 of 2015 decided on 24.04.2019 in case titled as Reliance Life Insurance Company Ltd. & Anr. Vs Rekhaben Nareshbhai Rathod (supra), in which it was observed by the Hon’ble supreme Court that Failure of the insured to disclose the policy of insurance obtained earlier in the proposal form entitled the insurer to repudiate the claim under the policy. In the present case, the Ops have already cancelled the policy on 31.05.2017, prior to inception of the policy by the life assured who died on 12.06.2017. So, it appears that the Ops have rightly repudiated the claim of the complainant.
10. In view of the above discussion, we hereby dismiss the complaint of the complainant being devoid of any merits, 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. President,
Dated:30.04.2019. District Consumer Disputes
Redressal Forum, Sirsa.
Member Member
DCDRF, Sirsa DCDRF, Sirsa
