Haryana

Kaithal

227/21

Smt.Bala Devi - Complainant(s)

Versus

Life Insurance Corporation Of India - Opp.Party(s)

Sh.V.V Bhardwaj

12 Apr 2023

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KAITHAL.

                                                     Complaint Case No.227/2021.

                                                     Date of institution: 17.09.2021.

                                                     Date of decision:12.04.2023.

Smt. Bala Devi wd/o late Sh. Ved Parkash, Village and Post Office Surbrah Patti-Sibla, Tehsil Uchana, District Jind now residing at Kaithal, Tehsil and District Kaithal.

                                                                        …Complainant.

                        Versus

Life Insurance Corporation of India through its Branch Manager, Kaithal, Office at Tehsil Road, near Geeta Bhawan, Kaithal, Tehsil and District Kaithal.

….Respondent.

        Complaint under Section 35 of the Consumer Protection Act, 2019

CORAM:     SMT. NEELAM KASHYAP, PRESIDENT.

                SMT. SUMAN RANA, MEMBER.

                SH. SUNIL MOHAN TRIKHA, MEMBER.

       

Present:     Sh. V.V.Bhardwaj, Advocate, for the complainant.   

                Sh. Sudeep Malik, Advocate for the respondent.

               

ORDER

NEELAM KASHYAP, PRESIDENT

        Smt. Bala Devi-Complainant has filed this complaint under Section 35 of Consumer Protection Act, 2019 (hereinafter referred to as ‘the Act’) against the respondent.

                In nutshell, the facts of present case are that the husband of complainant purchased a life insurance policy bearing No.114298117 in the month of July, 2018 from the OP and paid a premium of Rs.1,49,999/- and he was insured for a sum assured of Rs.14,99,990/-.  It is alleged that the annual premium of above-mentioned policy was being paid regularly by his husband namely Sh. Ved Parkash (since deceased).  The husband of complainant died unfortunately on 06.08.2019.  The complainant being nominee of his wife lodged the death claim with the OP and submitted all the necessary documents but the OP repudiated the claim of complainant vide letter dt. 21.02.2020.  The said repudiation of claim is stated to be wrong and illegal.  So, it is a clear cut case of deficiency in service on the part of respondent and prayed for acceptance of complaint.     

2.            Upon notice, the respondent appeared before this Commission and contested the complaint by filing their written version raising preliminary objections with regard to locus-standi; maintainability; cause of action; that there is no deficiency in service on the part of respondent; that the answering OP has already repudiated the claim of complainant and the same stands conveyed to the complainant vide letter dt. 21.02.2020; that the policy in question was issued on the basis of proposal form dt. 03.07.2018 and life assured expired on 06.08.2019.  The duration of policy was only 1 year 19 days from the date of commencement of risk, hence, the claim was examined under Section 45 of Insurance Act, 1938.  During investigations, it was revealed that the life assured was suffering from throat cancer and paralyzed before taking policy, but this material information which was in his knowledge was not disclosed by him in the proposal form dt. 03.07.2018.  On merits, the objections raised in the preliminary objections are rebutted and so, prayed for dismissal of complaint.

3.             To prove his case, the complainant tendered into evidence affidavit Ex.CW1/A alongwith documents Annexure-C1 to Annexure-C3 and thereafter, closed the evidence.

4.             On the other hand, the respondent tendered into evidence affidavit Ex.RW1/A alongwith documents Annexure-R1 to Annexure-R12 and thereafter, closed the evidence.

5.             We have heard the learned Counsel for both the parties and perused the record carefully.

6.             Ld. counsel for the complainant argued that the husband of complainant purchased a life insurance policy bearing No.114298117 in the month of July, 2018 from the OP and paid a premium of Rs.1,49,999/- and he was insured for a sum assured of Rs.14,99,990/-.  It is argued that the annual premium of above-mentioned policy was being paid regularly by his husband namely Sh. Ved Parkash (since deceased).  The husband of complainant died unfortunately on 06.08.2019.  The complainant being nominee of his wife lodged the death claim with the OP and submitted all the necessary documents but the OP repudiated the claim of complainant vide letter dt. 21.02.2020.  The said repudiation of claim is stated to be wrong and illegal.  So, there is deficiency in service on the part of respondent.  Ld. counsel for the complainant has placed reliance upon the case law titled as Sucha Singh Vs. HDFC Life decided by Hon’ble National Commission on 21.09.2022 bearing First Appeal No.1071 of 2018. 

7.             On the other hand, ld. counsel for the OP argued that the OP has already repudiated the claim of complainant and the same stands conveyed to the complainant vide letter dt. 21.02.2020; that the policy in question was issued on the basis of proposal form dt. 03.07.2018 and life assured expired on 06.08.2019.  The duration of policy was only 1 year 19 days from the date of commencement of risk, hence, the claim was examined under Section 45 of Insurance Act, 1938.  During investigations, it was revealed that the life assured was suffering from throat cancer and paralyzed before taking policy, but this material information which was in his knowledge was not disclosed by him in the proposal form dt. 03.07.2018.  Ld. counsel for the OP has placed reliance upon the case law titled as Reliance Life Insurance Co. Ltd. & another Vs. Rekhaben Nareshbhai Rathod decided by Hon’ble Supreme Court on 24.04.2019 bearing Civil Appeal No.4261 of 2019 and Ramesh Kumar Vs. Tata AIA Life Insurance Company Ltd. & another decided by Hon’ble National Commission bearing Revision Petition No.2285 of 2018 reported as Part No.XXXVIII, October, 2019 Volume-IV. 

                The question arises before us that whether the OP has repudiated the claim of complainant vide letter dt. 21.02.2020 rightly or not? 

8.             We have considered the rival contentions of both the parties.  During the course of arguments, ld. counsel for the OP has drawn our attention towards Annexure-C1/Annexure-R1 which is proposal form dt. 03.07.2018 filled-up by husband of complainant at the time of taking the policy and false information was given as under:-

“11(a) During last five years did you consult a Medical Practitioner for any ailment requiring treatment for more than a week?

Ans.: No

11(d) Are you suffering from or have you ever suffered or undergone investigation or treatment for the following ailments:

7.     Cancer/Leukemia, lumphoma/tumor/cyst/An other growth lumps/blood disorder/enlarged glands?

Ans.: No

11(g) What has been your usual state of health

Ans.:         Good.”

It is further clear that the policy in question was obtained on 7.07.2018 by the husband of complainant and he died after depositing one installment and the duration of policy was only 1 year 19 days from the date of commencement of risk.  As per Section 45 of Insurance Act, 1938 “A Policy of life insurance may be called in question on the ground of fraud, at any time within three years from the date of issuance of policy or the date of commencement of risk or the date of revival of policy or the date of the rider to the policy, whichever is later on the ground of fraud.”  The surveyor has mentioned in his report as per Annexure-R7 that the patient was suffering from throat cancer.  The Aanganwari Worker namely Darshna has mentioned in her statement as per Annexure-R8 that Ved Parkash son of Dariya Singh died due to cancer.  The Sarpanch, Gram Panchayat, Village Surbara, Distt. Jind has also mentioned in his statement as per Annexure R9 that the death of Ved Parkash son of Dariya Singh occurred on 06.08.2019 due to cancer of one year in the Village Surbara.  Hence, we are of the considered view that the complainant has failed to prove any deficiency in service on the part of OP.  Mere allegations are not sufficient, those are necessary to be substantiated by cogent evidence.  

11.            Thus, as a sequel of aforesaid discussion, we find no merit in the present complaint and accordingly, the same is hereby dismissed.  There is no order as to costs.  A copy of this order be sent to both the parties free of cost.  File be consigned to the record room after due compliance.     

Announced in open court:

Dt.:12.04.2023.

                                                                (Neelam Kashyap)

                                                                President.

 

(Sunil Mohan Trikha),           (Suman Rana),          

Member.                            Member.

 

Typed by: Sanjay Kumar, S.G.