Haryana

StateCommission

A/58/2019

EXIDE LIFE INSURANCE COMPANY LTD. - Complainant(s)

Versus

ISHRAT AND OTHERS - Opp.Party(s)

INDERJIT SINGH

14 Oct 2019

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION, HARYANA, PANCHKULA   

 

                                                 

                                                First Appeal No.58 of 2019

                                                Date of the Institution: 17.02.2019

                                                Date of Decision: 14.10.2019

 

 

 

Exide Life Insurance Company Limited, Branch Office, 1^st Floor, Appu Ghar Complex, Opposite ADC Office, Rohtak (HR) through its authorized signatory Vaishali Urs General Manager (Legal) available at Registered Office, Exide Life Insurance Company, 3^rd Floor, JP Techno Park, 3/1, Millar Road, Bangaluru-560001 (Karnatka).

 

 

….. Appellant

 

VERSUS

 

1.      Ishrat w/o late Mumtaj Ahmed, aged 42 years son of Rashid Ahmed.

 

2.      Azima d/o late Mumtaj Ahmed, aged about 23 years.

 

3.      Tabshum d/o late Mumtaj Ahmed, aged about 18 years.

 

4.      Saniya (Minor) d/o late Mumtaj Ahmed, aged about 16 years.

 

5.      Kalu s/o late Mumtaj Ahmed, aged about 19 years.

 

6.      Shoyab s/o late Mumtaj Ahmed, aged about 18 years.

 

7.      Talib s/o late Mumtaj Ahmed, aged about 15 years.

 

8.      Masum (minor) s/o late Mumtaj Ahmed, aged about 11 years.

 

          All residents of House No.899/11, Balak Nath Colony, Jind Road, Rohtak, District Rohtak.

 

….. Respondents

 

 

 

CORAM:    Hon’ble Mr. Justice T.P.S. Mann, President.

                  

 

                  

                                     

Present:-    Shri Yugansh Siwach, counsel for the appellant.

                   Shri Kartar Singh Malik, counsel for the respondents.

                    

                  

 

                                                O R D E R

 

 

T.P.S. MANN, J.  

 

          Complaint preferred by the respondents (hereinafter referred to as “the complainants”) was allowed by learned District Forum, Rohtak and the appellant (hereinafter referred to as the opposite party) was directed to pay the amount of insurance policy of `5,06,341/- to the complainants along with interest @ 9% per annum from the date of filing of the complaint i.e. 01.09.2017 till its actual realization. Out of the said amount, complainant No.1, wife of Mumtaj Ahmed-deceased, was held entitled to receive an amount of `1,56,341/- while remaining amount of `3,50,000/- to be paid to complainants No.2 to 8, sons and daughters of the deceased, in equal shares along with interest. The opposite party was also directed to pay an amount of `5,000/- as compensation on account of mental agony and harassment and `2,000/- as litigation expenses to complainant No.1 within one month from the date of passing of the order.

2.      Aggrieved of the impugned order, the opposite party has preferred the instant appeal. Along with the same, an application has also been filed to summon the concerned official/clerk/doctor from Shri Kamalnath Aashram, Gehankar, Tehsil Tijara, District Alwar (Rajasthan) along with complete medical record and registration record of Shri Mumtaj Ahmed s/o Shri Rashid Ahmed vide registration No.1889 dated 26.3.2014, as additional evidence.

3.      According to the complainants, Mumtaj Ahmed, husband of complainant No.1 got himself insured with the opposite party for a sum of `5,06,341/- vide policy dated 31.3.2015. Before taking the policy, he was medically examined by the doctors on the panel of the insurance company, who had given clearance certificate of fitness. However, he died on 30.5.2015. After his death, complainant No.1 applied for death claim and submitted all the relevant documents but the opposite party repudiated the claim vide letter dated 21.3.2016 on the ground of non-disclosure in the proposal form that he was diagnosed to have cancer prior to proposal date. The act of the opposite party was illegal and amounted to deficiency in service. As such, prayer was made for directing the opposite party to pay the sum assured along with interest, compensation and litigation expenses to the compainants.

4.      Upon notice, the opposite party filed written version submitting therein that the life assured had concealed the prior existence of illness in the proposal form from the opposite party by providing wrong declarations. Had the life assured revealed the critical material information of his past health history, the opposite party would not have accepted the health declaration and issue the insurance policy. The registration card of Shri Kamalnath Aashram dated 26.3.2014 confirmed that the life assured had   pre-existing illness of cancer prior to submission of proposal form for obtaining insurance policy.  Therefore, the claim was rightly repudiated on account of concealment of material fact. Prayer was accordingly made for dismissing the complaint.

5.      In their evidence, the complainants tendered affidavits (Exhibits CW1/A & CW1/B) besides documents (Exhibits C-1 to C-11) whereas the opposite party tendered affidavit (Exhibit RW1/A) and documents (Exhibits R-1 to R-10).

6.      After hearing learned counsel for the parties and on going through the record, learned District Forum allowed the complaint and granted necessary reliefs to the complainants.

7.      The State Commission has heard learned counsel for the parties and perused the impugned order passed by learned District Forum.

8.      According to the appellant, the life assured was suffering from cancer at the commencement of the insurance policy and taking treatment from Shri Kamalnath Aashram, Gehankar. In this regard, the opposite party has relied upon the certificate, purportedly to have been issued by Shri Kamalnath Aashram, Gehankar, Tehsil Tijara, Alwar (Rajasthan) on dated 26.3.2014 wherein it was mentioned that Mumtaj Ahmed was suffering from throat cancer was under treatment, vide registration No.1889. However, no mention has been made in the said certificate as to who had issued the same. From a cursory look at the contents of the alleged certificate one can easily conclude that the same is a fabricated document. It does not bear the signature of the person, who had issued the same.  It is also not mentioned whether the institution, which has been referred to as an Aashram is a medical institution and qualified to treat the patients suffering from serious ailments like cancer. The entire certificate is recorded in Hindi whereas while mentioning the disease for which the deceased was allegedly suffering from, the word ‘cancer’ has been written in English. The way in which it has been recorded indicates that some quack has fabricated the same and, that too, at the instance of one who might need to use it before some adjudicating authority in support of its stand that the deceased had been suffering from cancer of throat as on 26.3.2014.

9.      At the stage of adjudication before the learned District Forum, the opposite party did not take any steps to establish the authenticity of certificate dated 26.3.2014 as no doctor or any expert had been examined to show that the life assured had been suffering from cancer of throat earlier to the taking of insurance policy. Even no affidavit was filed by the concerned person, who issued it. Now at the time of filing the appeal, an application has been filed for permitting the opposite party to lead additional evidence by summoning witness in support of the certificate dated 26.3.2014. In the said application, no mention has been made as to from where the life assured had been getting treatment for the ailment of cancer of throat which the life assured was allegedly suffering from. In case, any such material had been available earlier to establish the authenticity of the certificate dated 26.3.2014, the opposite party could have summoned such official/clerk/doctor while the proceedings were on before the learned District Forum. Apparently, an attempt is being made to beat about the bush without their being any material available as is alleged by the opposite party. As such, the application filed by the opposite party for additional evidence is devoid of any merit and, therefore, dismissed.

10.    After hearing learned counsel for the parties, this Commission is of the view that no case is made for any interference in the impugned order passed by learned District Forum. The appeal is devoid of any merit and accordingly dismissed.

11.    The statutory amount of `25,000/- deposited by opposite party-appellant while filing the appeal be disbursed in favour of the complainants, as mentioned above, against proper receipt and identification subject to filing of any appeal/revision.

 

 

Announced 14.10.2019

(T.P.S. Mann) President

D.R.