DISTRICT CONSUMER DISPUTES REDRESSAL FORUM,<br /> BATHINDA (PUNJAB)<br /> <br /> CC. No. 320 of 08-11-2007<br /> Decided on :17-04-2008 <br /> <br /> Smt. Karamjit Kaur W/d of Ranjit Singh R/o Village Raipur Tehsil Sardulgarh, District Mansa. <br /> .... Complainant<br /> Versus<br /> <br /> 1.Life Insurance Corporation of India through its Branch Manager, Life Insurance Corporation of India, Bathinda (Bibiwala Road)<br /> 2.Sukhminder Singh, Agent, Life Insurance Corporation of India, Village Chahalanwala Tehsil Sardulgarh, District Mansa.<br /> <br /> ... Opposite parties <br /> <br /> Complaint under Section 12 of the Consumer Protection<br /> Act, 1986.<br /> <br /> QUORUM <br /> <br /> Sh. Lakhbir singh, President<br /> Dr. Phulinder Preet, Member<br /> <br /> For the Complainant : Sh. Lalit Mohan Sharma, Advocate.<br /> For the Opposite parties : Sh. Inderjit Singh,Advocate, counsel for opposite party No. 1.<br /> Sh. Bikramjit Gupta, Advocate, counsel for opposite party No. 2.<br /> <br /> O R D E R<br /> <br /> LAKHBHIR SINGH, PRESIDENT<br /> <br /> 1. Ranjit Singh was the husband of the complainant. He was an illiterate person. Life Insurance Policy No. 300341090 dated 31.8.05 of Rs. 1.00 Lac ( for payment of Rs. 2.00 Lacs in accidental death) was purchased by him. Complainant was his nominee under policy. He is paying the premium under the policy to opposite party No. 2 who was an agent of opposite party No. 1. He has since died on 8.11.05 as he was bitten by a snake while he was irrigating his field in the area of village Raipur, Tehsil Sardulgarh, District Bathinda. Information of his accidental death was given to the opposite parties. On the day when his last rites were performed, opposite party No. 2 had received all the relevant documents as per requirements of opposite party No. 1. Those were got signed from the complainant in the presence of Village Panchyat. Assurance was given that the payment of the amount would be made within a few days. Whenever the matter was discussed with opposite parties No. 1 & 2, they continued putting of the matter on one pretext or the other. Neither claim amount has been paid nor claim has been repudiated. In these circumstances, she alleges deficiency in service and unfair trade practice on the part of the opposite parties. Accordingly, this complaint under Section 12 of the Consumer Protection Act, 1986 (Here-in-after referred to as 'Act') has been preferred seeking direction from this Forum to the opposite parties to pay her Rs. 2.00 Lacs as claim amount alongwith interest @ 18% P.A. from the date of death of her husband till payment; Rs. 15,000/- as compensation for mental and physical harassment and Rs. 10,000/- as litigation expenses.<br /> 2. Opposite party No. 1 filed its reply taking legal objections that complaint is not maintainable in the present form; complainant is estopped from filing it by her act and conduct; claim has been rightly repudiated vide letter dated 31.3.06/7.4.06; she has no locus standi and cause of action to file the complaint; complaint has been filed on the basis of false and forged documents; intricated question of law and facts are involved which require voluminous evidence and as such, complaint cannot be decided by this Forum in a summary way and complainant is not consumer. It admits that policy was purchased by the husband of the complainant. While filing the proposal form and obtaining the policy, life assured had not disclosed the true and material facts about his exact age. He under-stated his age by about 15 years knowing fully well that his age was un-insurable at the time of submitting proposal form. Claim has been repudiated after thorough inspection. It denies the remaining averments in the complaint.<br /> 3. Opposite party No. 2 filed separate reply of the complaint stating that complaint is not maintainable; he is not a necessary party to it; there is no deficiency in service and unfair trade practice on his part and complainant has no locus standi and cause of action to file the complaint. There is no specific denial about the payment of premiums of the policy to him by the complainant and for further deposit of them with opposite party No. 1 and about the death of Ranjit Singh due to snake bite on 18.11.06. He admits that complainant had arranged the claim papers. They were handed over to him and were submitted by him to opposite party No. 1 for settlement of the claim. It is for opposite party No. 1 to award or repudiate the claim. As per information gathered from opposite party No. 1, claim has already been repudiated vide letter dated 31.3.06/7.4.06. Repudiation was conveyed to the complainant.<br /> 4. In support of her averments contained in the complaint, complainant has produced in evidence her two affidavits (Ex. C-1 & Ex. C-2), photocopy of premium receipt (Ex. C-3), photocopy of Death certificate of Sh. Ranjit Singh (Ex. C-4), photocopy of Ration Card (Ex. C-5) and photocopy of letter dated 30.10.07 (Ex. C-6).<br /> 5. In rebuttal, on behalf of opposite party No.2 affidavit of Sh. Sukhminder Singh (Ex. R-1) and on behalf of opposite party No. 1 photocopy of Ration Card (Ex. R-2), photocopy of Form No. 5096, 3260 (A), Form No. 3179 and Form No. 3179 (A), photocopy of Policy (Ex. R-4), photocopy of Claimant's Statement (Ex. R-5), photocopy of letter dated 7.4.06 (Ex. R-6), photocopy of Despatch Register (Ex. R-7), photocopy of Ration Card (Ex. R-8), photocopy of Proposal Form (Ex. R-9) and affidavit of Sh. J P Arya, Manager (Legal) have been tendered in evidence.<br /> 6. We have heard learned counsel for the parties. Besides this, we have gone through the record.<br /> 7. Some facts do not remain in dispute in this case. They are that Deceased Life Assured (Here-in-after referred to as DLA) had purchased Insurance policy from opposite party No. 1, copy of which is Ex. R-4 after submitting proposal form, copy of which is Ex. R-9. Nominee of DLA is the complainant. He has expired and copy of his death certificate is Ex. C-4.<br /> 8. As per plea of the opposite parties claim has been repudiated vide letter dated 31.3.06/7.4.06, copy of which is Ex. R-6. Complainant alleges that her claim has neither been allowed nor repudiated. Question is as to whether repudiation of the claim made by opposite party No. 1 has been intimated to her. Reply to our minds is in the negative. Opposite party No. 1 is relying upon copy of one page of Despatch Register dated 22.4.06 according to which something has been shown to have been sent to Karamjit Kaur at Mansa regarding policy No. 300341090. This is not sufficient to hold that repudiation of the claim was conveyed to her. Complainant is resident of Village Raipur, Tehsil Sardulgarh District Bathinda. In Ex. R-7 at Sl. No. 2523 dated 24.2.06 name of the addressee is Karamjit Kaur. Something which was despatched to her was sent to Mansa concerning this policy. There is no acknowledgement receipt of letter etc., No copy of the alleged letter according to which repudiation was communicated has been placed on record. Affidavit of Sh. J P Arya to the effect that repudiation letter was sent to the complainant through registered post has no basis. No postal receipt regarding this registered letter has been proved. In these circumstances, version of the opposite parties regarding communication of the repudiation letter is unfounded and baseless.<br /> 9. Opposite parties have repudiated the claim on the ground that in the proposal for Insurance signed by her husband on 31.8.05, he has given his age as 45 ears. Similarly he has given his age in the proposal statement. Answers to question No. 2 regarding his age were false as he has grossly understated his age by about 15 years at the time of proposal for Insurance. He was not less than 60 years of age. He was, therefore, of an Un-insurable age at the time of Insurance. Had he disclosed his correct age, they would not have accepted his proposal.<br /> 10. Onus to prove that repudiation of the claim made is valid is upon the Insurer. Opposite parties are relying upon photocopy of Ration Card Ex. R-2, photocopy of Declaration of age submitted by the Life Assured Ex. R-3, photocopy of the Claimant's Statement Ex. R-5, photocopy of Ration Card Ex. R-8 and photocopy of proposal for Insurance Ex. R-9. In the proposal for Insurance age given by the Life Assured is 45 years and date of birth as 16.8.60. In the Ration Card, copy of which is Ex. R-2 signed by Food & Supply Inspector on 11.8.04 age of Ranjit Singh has been recorded as 29. In the Declaration of age date of birth is 16.8.60 and in an another copy of the Ration card dated 15.5.06, copy of which is Ex. R-8 age of Ranjit Singh has been recorded as 40. Age of deceased assured has been given in the Ration cards by way of taking the base year as 1995-96.<br /> 11. To support the repudiation through letter copy of which is Ex. R-6, learned counsel for opposite party No. 1 placed reliance on copies of the Ration Cards Ex. R-2, Ex. R-8, copy of the Declaration of Age Ex. R-3 and copy of the proposal form Ex. R-9.<br /> 12. Learned counsel for the complainant argued that repudiation has been made on flimsy grounds. It has no solid basis and is liable to be set aside.<br /> 13. We have considered the respective arguments and we feel ourselves inclined to agree with the learned counsel for the complainant. In the reply of the complaint, stance of opposite party No. 1 is that DLA grossly and wrongly understated his age by about 15 years. In the affidavit Ex. R-10 of Sh. J P Arya, Manager (Legal and HPF), opposite party No. 1 has changed its stance by stating that DLA understated his age by more than 5 years knowing fully well that his age was more than 50 years at the time of filling the proposal form. In the repudiation letter, their plea is that deceased understated his age by about 15 years and he was not less than 60 years. Opposite party No. 1 is relying upon the copies of the Ration cards which are Ex. R-2 & Ex. R-8. For determining the question of age of DLA, these copies of the Ration cards are of no help to opposite party No. 1. In this view of the matter, we are fortified by the observations of the Hon'ble State Commission Maharashtra in the case of LIC of India & Another Vs. Kamala @Shakuntalabai & Another II(2006) CPJ 248. Proposal for Declaration was got thumb marked from the DLA. He was illiterate. Opposite party No. 2 is the agent of opposite party No. 1. DLA got himself Insured with opposite party No. 1 through opposite party No. 2. In this case, declaration form copy of which is Ex. R-3 has been filled by Doctor. In the declaration form, date of birth of DLA is 16.8.60. It was accepted by opposite party No. 1 while Insuring the DLA . As mentioned above, proposal form has not been filled by DLA. He has put his thumb impression on the proposal form as well as on the declaration form. In such a situation, there can be said to be no intentional and deliberate attempt on the part of the DLA to commit any fraud with opposite party No. 1. For this reference can be made to the authority Life Insurance Corporation of India & Another Vs. Shaukeen & Another II(2002) CPJ 319. Similar view has been held in the case of Life Insurance Corporation of India & Others Vs. Shiv Singh IV (2006) CPJ 270. Apart from this, Ex. R-2 is the copy of the Ration Card. It has been signed by Food and Supply Inspector, Jhunir on 11.8.04. Base year of the ages of the persons mentioned in it including DLA has been taken as 1995-96. Firstly it is evident to the naked eye that there are interpolations in the ages of the persons given it it. Since opposite party No. 1 is relying upon them, it was for it to explain them which it has failed to explain. In Ex. R-2 the age of DLA has been recorded as 29. If the base year is considered 1995-96 for issuing the Ration Card and date of issuance of the policy is 31.8.05, DLA was less than 40 years. In Ex. R-8 age of DLA has been recorded as 40 years. It is not known as to which month of 1995-96 can be considered for considering the age of DLA. Even if the age given in Ex. R-8 is considered, no value can be attached to it in view of the authority LIC of India & Another Vs. Kamala @Shakuntalabai & Another (supra).<br /> 14. Apart from the above, it is also worth mentioning that DLA has died due to snake bite as is evident from Ex. C-1 & Ex. C-2. It was an accidental death. It had no nexus with the age of the deceased. <br /> 15. From the aforesaid discussion, we have no hesitation in concluding that opposite parties have failed to establish intentional and deliberate mis-statement regarding the age by the DLA . Accordingly claim submitted by the complainant concerning accidental death of her husband has been illegally and arbitrarily repudiated by opposite party No. 1. Hence, repudiation is set aside leading to deficiency in service on its part.<br /> 16. Now question arises as to which relief should be accorded to the complainant who is the nominee of her deceased husband. Sum assured as per Ex. R-4 is Rs. 1.00 Lac. As per term and condition No. 10(2) (b) , opposite party No. 1 is liable to pay an additional sum equal to the Sum Assured under this Policy if the Life Assured sustains any bodily injury resulting solely and directly from the accident caused by outward, violent and visible means and as such injury shall within 180 days of its occurrence solely, directly and independently of all other causes results in his death. In these circumstances, direction deserves to be given to opposite party No. 1 to pay Rs. 2.00 Lacs as claim amount alongwith interest @ 9% P.A. from 9.2.06 (the date calculated on expiry of three months period from the date of death, a period required for processing the claim in an effective manner in normal course) till realisation. Complainant is craving for compensation of Rs. 50,000/-. There is no case to allow it in view of the relief which is going to be accorded as above and on account of the fact that out of interest and compensation, one can be allowed.<br /> 17. No other point was urged before us at the time of arguments.<br /> 18. In the result, complaint is accepted against opposite party No. 1 with cost of Rs. 1500/-. It stands dismissed against opposite party No. 2. Opposite party No. 1 is directed to do as under :-<br /> i ) Pay Rs. 2.00 Lacs to the complainant alongwith interest @ 9% P.A. w.e.f. 9.2.06 till realisation. <br /> Compliance of this order be made within 30 days from the date of its receipt. Copy of this order be sent to the parties concerned free of cost and file be consigned.<br /> Pronounced :<br /> 17-04-2008 (Lakhbir Singh )<br /> President<br /> <br /> <br /> (Dr.Phulinder Preet)<br /> Member<br />