BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SIRSA.
Consumer Complaint no. 13 of 2017
Date of Institution : 18.1.2017
Date of Decision : 29.11.2017.
Inderjeet Singh son of Gurcharan Singh, resident of village Bhirdana, Tehsil & District Fatehabad.
……Complainant.
Versus.
1. 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 Chairman-cum- Managing Director/ Managing Director/ Competent and Authorized Person.
2. Branch Manager, HDFC Standard Life Insurance Company Limited, 1st 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. MOHINDER PAUL RATHEE …… MEMBER.
Present: Sh. Sukhbir Dhaka, Advocate for the complainant.
Sh. A.S. Kalra, Advocate for opposite parties.
ORDER
The case of the complainant in brief is that father of the complainant namely Gurcharan Singh had got himself insured with the opposite parties vide insurance policy No.17761826 dated 21.7.2015 for a sum assured of Rs.5,63,479/- and he made the payment of insurance premium amounting to Rs.48,200/- on 21.7.2015 and the said insurance policy was valid for a period of 15 years. The date of maturity of the policy was 21.7.2030 and the complainant is nominee in the said policy. That the father of the complainant died on 7.11.2015 and after his death the complainant informed the ops about the death of Gurcharan Singh and submitted the claim form for settlement of the claim and also completed all the requisite formalities of the ops as directed by them and the ops had assured the complainant that the claim of the complainant would be settled very soon and the complainant would be released the payment of the sum assured but the ops have not yet released the same to the complainant. The ops have also not assigned any reason for not releasing the same and two days ago the ops have verbally informed the complainant that the claim of the complainant has been repudiated and this action on the part of ops in repudiating the claim of the complainant is wrong, against law and facts and is liable to be set aside. Hence, this complaint.
2. On notice, opposite parties appeared and filed reply raising certain preliminary objections. It is submitted that the life assured had submitted to the ops a proposal/ application for the purchase of life insurance policy. The complainant also paid an initial premium of Rs.48,200/- on 21.7.2015. That based on the answers and disclosures to the questions asked in proposal form given by the complainant, said proposal for issuance of plan was accepted on standard rate by the ops and consequently a policy was issued. After the issuance of the insurance policy in question, the policy bond containing complete terms and conditions was sent to the policy holder. That the life insured deceased had concealed the fact that he had obtained various policies from different insurance companies before the issuance of the life insurance policy by the answering ops. It is further submitted that as per the proposal form of the life insured deceased vide column no.12 of the personal details of life assured, he had declared that he does not have any insurance cover. The proposal form contained specific question related to the previous insurance cover from other life insurance company wherein he intentionally concealed the previous insurance covers. It is further submitted that the LA has obtained various policies from different life insurance companies which itself shows the fraudulent intention of the life assured, the factum of which has been concealed by the life assured. It is further submitted that by concealing the vital information with regards to the previous insurance cover, the complainant has violated the basic principle of “Utmost Good Faith” and has obtained the insurance policy by keeping the ops in dark about the risks that he is transferring to the ops. It is further submitted that considering the concealment of vital information regarding previous insurance cover, while filling the proposal form the claim of complainant was repudiated vide letter dated 26.3.2016. All other contents of the complaint are denied and prayer for dismissal of the complaint has been made.
3. The complainant produced his affidavit Ex.CW1/A, copy of letter dated 24.7.2015 Ex.C1 and death certificate Ex.C2. On the other hand, ops produced affidavit of Sh. Amit Khanna, Legal Manager Ex.R1 and copies of policy documents Ex.OP1 to Ex.OP7.
4. We have heard learned counsel for the parties and have perused the case file carefully.
5. Learned counsel for the complainant has contended that it is proved on record that father of the complainant namely Gurcharan Singh had got himself insured with the opposite parties vide policy No.17761826 for a sum assured of Rs.5,63,479/- and he paid Rs.48,200/- on 21.7.2015 as premium. It is also proved on record that during the subsistence of this policy, the father of the complainant died and complainant being the nominee of the deceased life assured had lodged the claim of his father, but however, the ops arbitrarily and illegally repudiated the claim. Ld. counsel for complainant has relied upon judgments reported as RP No.1053 of 2008 titled as Baleshwar Singh vs. LIC & others (NC), III (2011) CPJ 373 (NC) titled as LIC vs. Shahida Begum, III (2014) CPJ (UP) titled as Vijay Pal Singh vs. LIC & ors., RP No.139 of 2016 titled as IDBI Federal Life Insurance Co. Ltd. & anr. Vs. Rameshwar Prasad Jain (NC), RP No.4204 of 2011 titled as Aviva Life Insurance Co. ltd. & Ors. Vs. Rekhaben Ramjibhai Parmar (NC) and also decision of the Hon’ble Punjab and Haryana High Court, Chandigarh reported as CWP No.24862 of 2017 titled as Bajaj Allianz Life Insurance Company Limited Vs. Santosh and another decided on 2.11.2017.
6. On the other hand, learned counsel for the opposite parties has strongly contended that no doubt the life insurance policy was taken by father of complainant namely Gurcharan Singh but he had concealed the material facts from the ops while filling the blanks of the proposal/ declaration form in which he had denied the fact that he had taken some other policies from other companies which were the material facts. As per provisions of Section 45 of the Insurance Act, it was legal obligation of the life insured to make sincere declaration qua his existing policies since it is a contract of good faith. He has further contended that ops have rightly repudiated the claim of the complainant on the basis of terms and conditions of the policy and has relied upon the judgments of the Hon’ble National Commission passed in case titled as LIC of India & anr. Vs. Smt. Vidya Devi & anr. decided on 16.7.2012 in which the Hon’ble National Commission has upheld the decision of the LIC and set aside the orders of the District Forum and the State Commission and also dismissed the complaint of the complainant.
7. We have considered the rival contentions of the parties and have gone through the record as well as judgments relied upon by learned counsel for the parties.
8. It is an undisputed fact between the parties that father of the complainant namely Gurcharan Singh had purchased a life insurance policy by which he got himself insured with the ops for a period 21.7.2015 to 21.7.2030 on payment of premium of Rs.48,200/-. It is further undisputed fact that said Gurcharan Singh died on 7.11.2015. The complainant being nominee of his father had lodged the claim with the ops which was registered and processed but, however, the ops repudiated the claim of the complainant on the ground that the deceased LA had suppressed the material facts from the ops qua his previous policies which he had purchased from other companies as a result of which the ops cancelled the policy vide their letter Ex.OP2 and called upon the complainant to return the original policy document by treating the policy as null and void.
9. The perusal of the proposal form Ex.OP1 which has been placed on record by the ops is a typed copy and does not bears the signatures of Gurcharan Singh life insured nor it bears the signatures of the agent who filled on the column of this proposal form, as such no reliance can be placed on this proposal form. Moreover, the form of customer acknowledgment which has been placed on record alongwith this proposal form also reveals that blanks of columns of this form are vacant and have not been filled by anyone. The evidence of the ops further reveals that ops have not led any other cogent and convincing evidence on record from which it could be presumed that the deceased LA was holding policies from other companies also and further more, the ops have not furnished the affidavit of any other official of other companies who ever issued policy to the deceased life assured Gurcharan Singh. Moreover, there is no such bar for a person who purchases the life insurance policies as per his own financial capacity and as per his own requirements after evaluating his valuable life. Moreover, we find force from the latest judgments of the Hon’ble High Court, Chandigarh in case titled as Bajaj Allianz Life Insurance Company Ltd. Vs. Santosh and another (supra) in which it was observed that “non disclosure of the policy obtained by the insured from other insurance companies is not suppression of material fact because there is no bar in obtaining/ purchasing various insurance policies.” We further find force from the judgments of the Hon’ble National Commission in cases titled as Baleshwar Singh Vs. LIC & ors (supra) and LIC of India vs. Shahida Begum (supra). So, it appears from the record that ops have arbitrarily repudiated the claim of the complainant and have passed order of cancellation of policy without making the refund of the amount of premium to the complainant rather the ops would have passed the order for payment of the claim amount to the complainant.
10. In view of the above discussion, we allow this complaint and set aside the order of cancellation of the policy and repudiation of the claim and direct the opposite parties to settle and pay the claim of the complainant to the tune of Rs.5,63,479/- to the complainant alongwith interest @4% per annum from the date of repudiation of claim within a period of 30 days from the date of receipt of copy of this order, failing which the complainant will be entitled to additional interest @9% per annum from the date of order till actual payment. We also direct the opposite parties to pay further amount of Rs.10,000/- as composite compensation and litigation expenses to the complainant. 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:29.11.2017. Member District Consumer Disputes
Redressal Forum, Sirsa.
