BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SIRSA.
Consumer Complaint.No.159 of 2016.
Date of Instt.: 1.07.2016.
Date of Decision: 18.4.2017.
Dinesh Kumar son of Satbir Singh son of Sultan Singh, resident of House No.11-A, Ram Dev Chowk, Bhattu Kalan, 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 U/S 12 of the Consumer Protection Act,1986
Before: Smt. Rajni Goyat, Presiding Member.
Sh. Mohinder Paul Rathee, Member.
Present: Sh. Sukhbir Dhaka, Advocate for complainant.
Sh. A.S. Kalra, Advocate for opposite parties.
ORDER
The facts of the present complaint in brief are that father of complainant namely Satbir Singh son of Sultan Singh had got himself insured with the opposite parties through op no.2 vide insurance policy no.17819061 valid from 7.8.2015 to 7.8.2030 for sum assured of Rs.5,79,531/- and made payment of premium of Rs.24,145/-. The complainant is nominee in the said insurance policy. It is further averred that father of complainant died on 17.10.2015 and after his death the complainant submitted all the requisite forms to op no.2 for settlement of the claim and he was assured that all the insurance benefits shall be released to him very soon. However, the ops have sent a letter to complainant on 6.4.2016 mentioning therein that correct age of the life assured was higher than the age declared by him in the application and that the vital information was not provided while applying for the insurance policy whereas in fact all the correct and material information were provided to the ops at the time of obtaining the insurance policy. The letter dated 6.4.2016 issued by op no.1 is wrong, against law and facts, arbitrary and has been issued without providing any opportunity of hearing to the complainant and same is liable to be set aside. Hence, this complaint.
2. On notice, opposite parties appeared and filed reply taking certain preliminary objections. It has been submitted that policy was issued to the life insured-deceased on the basis of the documents provided by him. The policy was obtained by him by understating his age on the basis of the forged documents and had the life assured given the correct age the policy would have not been issued by answering ops to the life insured or the premium with regards to the said policy would have been much higher than what was paid by the life insured at the time of taking the policy. The policy documents were issued by the answering ops to the life insured mentioning the personal details and if there was any discrepancy in the policy documents then the same could have been got corrected by the life insured after returning the said policy documents within free look-in period. The complainant had every opportunity to approach the Insurance Ombudsmen being aggrieved against the letter dated 6.4.2016. It has been further submitted that complainant is estopped by his own act and conduct by not giving any representation or legal notice against the said repudiation letter before filing the present complaint. Lastly it has been submitted that claim of complainant has been rightly rejected by the ops.
3. The complainant produced his affidavit Ex.PW1/A, repudiation letter Ex.P1, death certificate of Satbir Singh Ex.P2, copy of ration card Ex.P3, copy of Aadhar card of Satbir Singh Ex.P4 and copy of letter dated 24.8.2015 Annexure C1. On the other hand, ops produced affidavit of Sh. Amit Khanna, Executive Legal Manager Ex.OPW1/A, copy of repudiation letter dated 6.4.2016 Ex.OP1, copy of letter dated 9.7.2015 Ex.OP2, copy of first premium receipt Ex.OP3, copy of claim form Ex.OP4, copy of death certificate Ex.OP5, copies of affidavits Ex.OP6 and Ex.OP7, copy of investigation report Ex.OP8 and copies of online documents of Election office and voter list etc. as Ex.OP9 to Ex.OP12.
4. We have heard learned counsel for the parties and have perused the case file carefully.
5. It is an admitted fact that Satbir Singh life insured since deceased was insured with the opposite parties vide insurance policy No.17819061 effective from 7.8.2015 to 7.8.2030 for sum assured of Rs.5,79,531/-. It is an also admitted fact that he had paid first premium amount of Rs.24,145/- to the opposite parties on 7.8.2015 which is also evident from the documents available on record. The opposite parties sent policy documents to the life insured alongwith their letter dated 24.8.2015, copy of which is placed on file as Annexure C1. In the nomination schedule of policy documents, the name of nominee is mentioned as Dinesh Kumar. According to the complainant his father died on 17.10.2015 and after his death he submitted all the relevant documents to the ops for settlement of claim. The complainant has also placed on file death certificate of his father as Ex.P2 wherein date of death of Satbir Singh is mentioned as 17.10.2015. So the death of Satbir Singh on 17.10.2015 is not in dispute. The opposite parties have repudiated the claim of the complainant vide repudiation letter dated 6.4.2016 Ex.P1 on the ground that “the life assured had declared his date of birth as 01 January, 1965 and had produced an affidavit as proof of the same. On the basis of the aforesaid date of birth, the life assured age was 50 years. However, their investigations have established that the correct age of life assured was higher than the age declared by him in the application.” But we are of the considered view that opposite parties have wrongly and illegally repudiated the claim of complainant. In the policy documents sent by the ops to the life insured on 24.8.2015, the age of life insured being 50 years on the date of risk commencement has been admitted by the ops. In the aadhar card of Satbir Singh life insured since deceased Ex.P4, his date of birth is mentioned as 1.1.1965 and at the time of issuing insurance policy to him, the ops also obtained an affidavit from Satbir Singh wherein he declared that his date of birth is 1.1.1965. To controvert the said date of birth, the ops have relied upon documents of Election Office i.e. online document and voter list of year, 2016 in which Satbir Singh is shown to be the age of 57 years but no other authentic proof in respect of his actual date of birth has been placed on file by the ops. The insurance company works for its benefit because at the time of taking business it insured the father of the complainant and when he died then the insurance company instead of acting fairly have repudiated the claim of the complainant by mentioning that the age of insured was incorrect and the company has been misled. Perusal of policy document attached with the letter dated 24.8.2015 Annexure C1 reveals that the date of birth of the assured has been mentioned as 1.1.1965 and aadhar card is an authentic proof to prove the claim of the deceased with regard to his date of birth viz. age. Moreover, the insurance company has admitted the age of the insured vide letter dated 24.8.2015 (Annexure C1). Therefore, at this stage, there is no merit in the claim of the insurance company regarding the age of the deceased as 57 years and insurance company cannot turn around now. The aadhar card is prepared by the Government of India through authorized agency and is admitted proof of age, therefore, same cannot be challenged without any authentic proof. Moreover, in case titled as Life Insurance Corporation of India Vs. Balbir Singh & Anr. 2008 (4) CPJ 326 relied upon by learned counsel for complainant the Hon’ble Punjab State Consumer Disputes Redressal Commission, Chandigarh has held that “Life Insurance- Repudiation of claim-Contention, wrong date of birth given in proposal form, Date of birth given from ration card, with bona fide intention-Date of birth wrong not known to insured-School leaving certificate not demanded by insurer, cannot be relied upon now to justify repudiation of claim.”
6. Keeping in view the facts and circumstances of the case and in view of our above discussion, we are of the opinion that there is deficiency in service on the part of OPs as they have wrongly repudiated the claim of the complainant. Hence, we allow the present complaint and direct the OPs to pay a sum of Rs.5,79,531/- to the complainant alongwith interest @9 % per annum from the date of this order till actual realization within one month failing which the complainant will at liberty to initiate proceeding against the OPs under Section 25/27 of the CP Act. A copy of this order be supplied to both the parties free of costs. File be consigned after due compliance.
Announced in open Forum. Dated:18.4.2017
Presiding Member,
(Rajni Goyat) (Mohinder Paul Rathee) Member
Distt.Consumer Disputes Redressal Forum, Sirsa.
