NCDRC

NCDRC

FA/2128/2017

SANTOSH DEVI - Complainant(s)

Versus

HDFC STANDARD LIFE INSURANCE COMPANY LIMITED & ANR. - Opp.Party(s)

MR. VANSHDEEP DALMIA

19 Aug 2024

ORDER

NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION
NEW DELHI
 
FIRST APPEAL NO. 2128 OF 2017
(Against the Order dated 24/04/2017 in Complaint No. 192/2015 of the State Commission Haryana)
1. SANTOSH DEVI
W/O. LATE SH. HAWA SINGH. R/O. VPO CHODHARIWALI TEHSIL ADAMPUR.
HISAR
HARYANA
...........Appellant(s)
Versus 
1. HDFC STANDARD LIFE INSURANCE COMPANY LIMITED & ANR.
THROUGH ITS BANK MANAGER. BRANCH OFFICE, 1ST FLOOR, KAMLA PALACE, 57-60, KAMLA NAGAR, NEAR RED SQUARE MARKET.
HISAR
HARYANA.
2. MANAGING DIRECTOR, HDFC STANDARD LIFE INSURANCE COMPANY LIMITED.
12TH AND 13TH LODHA EXCELUS, APOLLO MILLS COMPOUND, N.M. JOSHI TODA MAHALAXMI.
MUMBAI-400011
MAHARASHTRA
...........Respondent(s)

BEFORE: 
 HON'BLE MR. SUBHASH CHANDRA,PRESIDING MEMBER
 HON'BLE DR. SADHNA SHANKER,MEMBER

FOR THE APPELLANT :
MS. NATASA DALMIA, ADVOCATE
FOR THE RESPONDENT :
MR. JOYDIP BHATTACHARYA, ADVOCATE WITH
MS. ANJALIKA SHARMA, ADVOCATE
MS. LIVYA P. LALU, ADVOCATE

Dated : 19 August 2024
ORDER

 

DR. SADHNA SHANKER, MEMBER

1.       This appeal has been filed under section 19 of the Consumer Protection Act, 1986 (hereinafter referred to as the ‘Act’) in challenge to the Order dated 24.04.2017 of the State Commission in complaint no. 192 of 2015, whereby the complaint was dismissed.

2.       We have heard the learned counsel for the appellant (hereinafter referred to as the ‘complainant’) and learned counsel for the respondents (hereinafter referred to as the ‘insurance company’) and perused the record.

3.       There is a delay of 75 days in filing the present appeal.  

In the interest of justice and considering the reasons mentioned in the application for condonation of delay, the delay in filing the appeal is condoned.

4.       The facts, in brief, are that Mr. Hawa Singh, husband of the complainant (hereinafter referred to as the ‘insured’) obtained life insurance policy from the insurance company. The premium amount of Rs.4477/- was paid and the policy commenced from 25.09.2013 for a term of 15 years and all the relevant documents were handed over to the agent at the time of signing of the proposal form. The insured expired on 30.09.2013 and the original policy and other documents were submitted by the complainant with the insurance company for obtaining the claim amount. It is alleged that as per the policy terms and conditions, as the insured died natural death, his nominee was entitled to get all the benefits of the policy including sum insured of Rs. 25 lakhs. The insurance company repudiated the claim of the complainant on the ground that the income of the life assured was less than what was disclosed in the application dated 24.09.2013 and the payment of the premium for policy was made by the third person not related to the life assured/nominee without any concern for insurable interest and that too by online mode.

5.       Being aggrieved, the complainant has filed a complaint before the State Commission seeking following relief:

“i. The respondents may kindly be directed to immediately pay the claim amount i.e. Rs. 25,00,000/- (Rs. Twenty Five Lacks) along with interest @18% per annum w.e.f. the date of claim.

ii. The respondents may kindly be further directed to pay compensation of Rs. 5,00,000/- on account of mental agony and harassment.

iii. Rupees 55,000/- as litigation charges also be awarded to the complainant.

Any other relief to which this Hon’ble Forum deems just and reasonable in the circumstances of the case, may kindly be granted to the complainant persons.

6.      The insurance company contested the complaint by filing reply stating that the insured had suppressed the material facts regarding income and had incorrectly mentioned the income in the proposal form. Had this information been provided correctly to the insurance company, the insurance company would not have issued the policy. He further argued that the payment of the premium ought to be made out of the legally declared and assessed sources but in the present case, the premium was paid by a third person not related to the insured/nominee without any concern for insurable interest, therefore, the complainant is not entitled for claim. He further argued that the contract of insurance is based on trust and ubberma fides, which means utmost good faith. He further argued that the there is no deficiency in service on the part of the insurance company and the State Commission has passed a well-reasoned order.

7.       The State Commission, vide its order dated 24.04.2017, dismissed the complaint.

8.       Being aggrieved by the order dated 24.04.2017 of the State Commission, the complainant has filed this appeal seeking setting aside of the order dated 24.04.2017 of the State Commission.

9.       Before this Commission, learned counsel for the complainant has argued that the insured was an agriculturist and used to cultivate 06 kanals agricultural land owned by his father and the insured agricultural produce worth Rs. 1.90 lakhs. Apart from this, the insured had two to three buffaloes and sell their milk, therefore, his total income is much more than Rs. 2 lakh and the complainant had not concealed any fact regarding income. He further argued that the insurance company after verifying the information pertaining to his age, health, education and income, issued the policy to the insured and no dispute had been arisen while issuing the policy. He further argued that there is deliberate deficiency in service on the part of the insurance company in repudiating the claim without leading any evidence.

10.     Learned counsel for the insurance company has argued that the detailed investigation revealed that there was a discrepancy in the insured’s income as against the disclosure of Rs. 2,00,000/- in the proposal form. He further argued that the insured had violated the terms and conditions of the policy by paying the premium through third party having no insurable interest. Therefore, the insurance company has rightly repudiated the claim.

11.     The main question for our consideration is as to whether the repudiation by the insurance company was justified.

12.     During the course of the proceedings, vide order dated 21.06.2023, the insurance company was granted liberty to file additional evidence, which they did. Thereafter, vide order dated 13.09.2023, they were granted liberty to file further additional documents. On that date, the complainant sought to rebut the above additional documents and time was granted for the same. However, the complainant failed to file any rebuttal to the additional documents filed by the insurance company.

13.     It is seen from the investigation report filed in pursuance to the order dated 21.06.2013 that one Mr. Rajesh Kumar had paid the premium amount through a credit card No. 461787*****8695 on 24.09.2013. The insured belongs to BPL category. He was, therefore, financially incompetent to purchase the policy. It was also shown through the additional documents filed that the same credit card was used to pay premium for 94 other policies on several dates. It is also mentioned in the report that a police complaint has been filed against 7 persons in this regard.

14.     The complainant has not rebutted the information provided by the investigation report despite an opportunity to do so. It is not the complainant’s case that Mr. Rajesh Kumar did not pay for the policy or that he had some insurable interest in Mr. Hawa Singh. One of the grounds of repudiation of the policy as mentioned in the letter dated 20.06.2015 is that the payment of the premium was made by some other person, which is a violation of the important terms and conditions of the policy that lay down that amounts paid/payable under the policy will be out of legally declared and assessed sources. Amounts paid otherwise will be permitted only if an insurable interest can be established.

15.     In view of the above, we are of the opinion that the insurance company has rightly repudiated the claim as no evidence has been brought on record to show that Mr. Rajesh Kumar did not pay the premium amount or that he had insurable interest in the insured. We do not find any reason to interfere with the impugned order dated 24.04.2017 and the same is upheld.

16.     The appeal is dismissed. All pending applications, if any, stand disposed of.

 
......................................
SUBHASH CHANDRA
PRESIDING MEMBER
 
 
.............................................
DR. SADHNA SHANKER
MEMBER

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