BEFORE THE DISTRICT CONSUMER DISPUTES
REDRESSAL COMMISSION, JALANDHAR.
Complaint No.292 of 2022
Date of Instt. 22.08.2022
Date of Decision: 05.08.2024
1. Rozy wife of Deepak Kumar
2. Vansh Arora son of Deepak Kumar
Both residents of Mohall Daddal Tehsil Phagwara District Kapurthala.
..........Complainants
Versus
1. IDFC First Bank Ltd. Ladowali Road, Jalandhar through its Branch Manager.
2. HDFC Life Insurance Co. Ltd., Registered Office 11th Floor Lodha Excelus Apollo Mills Compound, NM Joshi Marg, Mahalaxmi, Mumbai through its M.D.
….….. Opposite Parties
Complaint Under the Consumer Protection Act.
Before: Dr. Harveen Bhardwaj (President)
Smt. Jyotsna (Member)
Sh. Jaswant Singh Dhillon (Member)
Present: Miss Natasha, Adv. Counsel for the Complainants.
Sh. Vikas Sood, Adv. Counsel for OP No.1.
Sh. A. K. Gandhi, Adv. Counsel for OP No.2.
Order
Dr. Harveen Bhardwaj (President)
1. The instant complaint has been filed by the complainant, wherein it is alleged that initially Deepak Kumar husband of the complainant No.1 alongwith Rozy approached the OP No.1 at Jalandhar for taking financial assistance against a property No.B-5, 23-A measuring 10 marlas situated at Mohalla Daddal Tehsil Phagwara, District Kapurthala in the year 2019. After completing all the formalities a loan agreement was duly executed between the parties and a loan of Rs.20,00,000/- was disbursed. The EMI started from 02.11.2019 till 02.10.2034. At that time, the OP No.1 got the signatures of the complainant No.1 and Deepak Kumar on blank papers. A loan was duly sanctioned @ 15.75% fixed. On the representation of the OP No.1, an insurance facility was obtained from the OP No.2. Unfortunately, Deepak Kumar expired on 29.08.2020. However, before his death, there was Covid-19 and complainant NO.1 and Deepak Kumar suffered financial loss. After the death of Deepak Kumar, complainants submitted their insurance claim before the OP No.2 and completed all the formalities. The contract of policy is based on bonafide intention. All the material information was provided to the OP No.2 that the sum assured was Rs.18,40,390/-. The insurance claim was repudiated by the OP No.2 on false grounds dated 05.03.2021. Due to this the complainant has suffered harassment and as such, necessity arose to file the present complaint with the prayer that the complaint of the complainant may be accepted and OPs be directed to settle the loan against the insurance and return the excess amount to the complainant. Further, the OP No.2 be directed to close the loan of the property lying with the OP No.1. Further, OPs be directed to issue NOC to the complainants and also to return all the title documents to the complainants. Further, OPs be directed to pay a compensation of Rs.1,00,000/- for causing mental tension and harassment to the complainant and Rs.30,000/- as litigation expenses.
2. Notice of the complaint was given to the OPs and accordingly, OP No.1 filed its written reply and contested the complaint by taking preliminary objections that the present complaint is not maintainable. There is no cause of action against the answering OP. Hence the complaint is to be dismissed. It is further averred that the present complaint is bad for mis-joinder and non-joinder of the necessary parties. It is further averred that the complainant is not come before this Commission with clean hands and has suppressed the material facts. On merits, it is admitted that the complainant and her husband approached for taking the financial assistance and the loan of Rs.20,00,000/- was sanctioned on 18.09.2019. It is also admitted that the loan was disbursed and the EMI started from 02.11.2019 till 02.10.2034, but the other allegations as made in the complaint are categorically denied and lastly submitted that the complaint of the complainant is without merits, the same may be dismissed.
3. OP No.2 filed its separate written reply and contested the complaint by taking preliminary objections that the present complaint is false, vexatious and has been filed with a malafide intention to harass the OP No.2 by misusing the process of law and to avail undue advantages. It is an attempt to waste the precious time of this Commission as no cause of action has been arose against the answering OP and in favour of the complainant, hence this complaint is liable to be dismissed. It is further averred that the complaint is not maintainable against the OPs and the same is liable to be dismissed. The OPs have rightly repudiated the claim vide letter dated 05.03.2021 as the present case is a clear cut case of concealment of material facts and misrepresentation. On merits, it is admitted that the complainant and her husband approached for taking the financial assistance against the property. It is also admitted that the deceased Deepak Kumar obtained the insurance policy and he died on 29.08.2020. It is also admitted that the insurance claim was repudiated by the OP No.2, but the other allegations as made in the complaint are categorically denied and lastly submitted that the complaint of the complainant is without merits, the same may be dismissed.
4. Rejoinder not filed by the complainant.
5. In order to prove their respective versions, both the parties have produced on the file their respective evidence.
6. We have heard the learned counsel for the respective parties and have also gone through the case file as well as written arguments submitted by counsel for the complainant and counsel for the OP No.2 very minutely.
7. It is admitted by the OP No.1 that the complainant/Rozy and her husband/Deepak Kumar approached the OP No.1 for taking the financial assistance and the loan of Rs.20,00,000/- was sanctioned on 18.09.2019. It has also been admitted that the loan was disbursed and the EMI started from 02.11.2019 till 02.10.2034. The complainant has proved the policy Ex.C-2. She has also proved on record the title deeds Ex.C-3 on the basis of which the loan was sanctioned. The document Ex.C-4 is the terms and conditions for loan against the property. Sanction letter has been proved as Ex.C-5. The complainant has alleged that the husband of the complainant died on 29.08.2000. Copy of death certificate has been proved as Ex.C-6. Death claim was lodged, which was repudiated vide repudiation letter Ex.C-1/OP No.2. The repudiation has been challenged by the complainant.
8. The OP No.2 has admitted the issuance of insurance policy. They have also admitted and proved the documents of policy alongwith terms and conditions Ex.OP-1 to Ex.OP-6. The OP No.2 has alleged that there is no illegality in repudiating the claim as the complainant has concealed the factum of disease, he was facing with. He was suffering from Diabetes, Mellitus, Hypertension and Fatty Liver at the time of execution of the insurance. The OP’s Counsel has relied upon the certificate by Arora Hospital dated 02.12.2020 as Ex.OP-4 and the investigation report Ex.OP-5. Thus, the OP has submitted the repudiation of the claim as valid.
9. Sanction of loan and disbursement of the same is not disputed. Issuance of insurance policy by OP No.2 is also not disputed. Perusal of the insurance policies show that the husband of the complainant was insured for the sum of Rs.20,00,000/- as per Ex.OP-1/C-2. Perusal of the death certificate Ex.C-6 shows that Deepak Kumar died on 29.08.2020. Now the controversy is that the OPs are alleging that he has concealed the material fact of Diabetes Mellitus, Hypertension and Fatty Liver. He was allegedly suffering from diabetes for the last 10-12 years. Perusal of the report Ex.OP-5 shows that the investigator has given the report stating that the deceased Deepak Kumar was a fit person and he had not any kind of ailing. He had sudden heart attack on 29.08.2020, but he has mentioned that he was a patient of diabetic disease since 10-11 years. There is a certificate of Counselor, relied upon by the OP, in which it has been mentioned that the deceased Mr.Deepk Kumar died on 29.08.2020 and it was a natural death. Perusal of the certificate Ex.OP-4 dated 02.12.2020 of Arora Hospital shows that when the deceased Deepak Kumar was taken to hospital on 29.08.2020, he was found to be dead. The OP has alleged that he was suffering from diabetes for the last 10-12 years, but he has not produced on record any document to show nexus between cause of death and alleged diabetes. No prescription of any doctor has been produced by the OP. No document has been proved that he was taking the medicine for hypertension. The investigator in his report has categorically mentioned that as per investigation he was never hospitalized. We are supported by the law laid down by the Hon’ble National Consumer Disputes Redressal Commission, New Delhi, in III (2021) CPJ 66 (NC), case titled as ‘PNB Metlife India Insurance Company Ltd. Vs. Godavariben Kalubhai Vaghela’ that ‘Insured had suffered a heart attack and he died - Complainant being nominee, claimed amount under the policy, which was denied by the petitioner on ground that insured had concealed material fact at the time of buying policy- Insured was not suffering from any heart ailment when he filled up proposal form- only defence taken is that insured had underwent treatment for T. B. and this fact was concealed – insured had died after about six months of buying the policy – Concealment of fact regarding treatment of T. B., if any, cannot be termed as concealment of material fact – There is no nexus between concealment of alleged fact and cause of death.’ It has been held by the Hon’ble Delhi State Commission Disputes Redressal Commission, New Delhi, in I (2022) CPJ 112 (Del.), case titled as ‘Gurpreet Kaur Vs. Bajaj Allianz Life Insurance Co. Ltd. & Ors., that ‘Death of life assured occurred due to heart attach/cardiac arrest, which is not connected with pre-existing disease and nor there is any evidence to show that death was on account of pre-existing disease of life insured- Repudiation of claim is not justified.’ It has been held by the Union Territory Consumer Disputes Redressal Commission, Chandigarh, in (2006) CPJ 270, case titled as ‘Life Insurance Corporation of India & Ors. Vs. Shiv Singh’ that ‘insured got examined from insurance doctor, found healthy – Deceased allegedly suffered from chronic obstructive pulmonary disease and chronic asthma – No nexus between cause of death and alleged ailment of deceased – Fraudulent suppression of material facts not proved- insurer liable.’
In the present case also the deceased Deepak Kumar died natural death. There is no prescription of any doctor or any other document to prove that Deepak Kumar died due to diabetes, hypertension or fatty liver. There is no nexus between these diseases with his death. These ailments are not the cause of death. So, in view of the above referred law and considering the facts of the case, the complainant is entitled for the relief.
10. In view of the above detailed discussion, the complaint of the complainant is partly allowed and OPs No.1 and 2 are directed to settle the loan and the OP No.2 is directed to pay the loan to the extent of sum insured amount. Excess amount, if any shall be paid to the complainants and if any amount becomes due after the payment of assured amount by the OP No.2, the same shall be borne by the complainants. After closing the loan the OP No.1 is directed to return the original title deeds and issue NOC. Further, OPs are directed to pay a compensation of Rs.15,000/- for causing mental tension and harassment to the complainant and Rs.8000/- as litigation expenses. The entire compliance be made within 45 days from the date of receipt of the copy of order. This complaint could not be decided within stipulated time frame due to rush of work.
11. Copies of the order be supplied to the parties free of cost, as per Rules. File be indexed and consigned to the record room.
Dated Jaswant Singh Dhillon Jyotsna Dr. Harveen Bhardwaj
05.08.2024 Member Member President
