Present         (1)    Nisha Nath Ojha,   

                              District & Sessions Judge (Retd.)                                                                                         President

                    (2)     Sri Sheo Shankar Prasad Singh,

                              Member

                    (3)     Smt. Karishma Mandal,

                              Member

Date of Order :23.06.2015

                    Sri Sheo Shankar Prasad Singh

1. In the instant case the Complainant has sought for following reliefs against the Opposite parties:-

1. To quash the decision taken by the authority as contained in letter dated 30.03.2013. ( Annexure – 8 of the complaint petition )
2. To pay sum assured and double accident benefit with interest @ 12% from 18.01.2011 till full and final payment.
3. To pay Rs. 1,00,000/- as compensation.
4. To pay Rs. 15,000/- as litigation cost.

2. Brief facts of the case which led to the filing of complaint are as follows:-

1. The proposal for life insurance endowment policy was properly filed by the complainant’s father namely Basant Saw without concluding any material facts and information required by the insurer and the same was submitted in the prescribed manner.
2. The opposite party no. 1 accepted the said proposal and issued the life insurance policy scheme bearing policy no. 517043260. ( Vide Annexure – 1 )
3. The complainant’s father had paid the premiums within stipulated period and duly discharged the obligation and liabilities imposed upon him under such policy.
4. Suddenly the complainant’s father developed fever, cold and cough for which he consulted with the local medical practitioner namely Dr. Avinash Chandra but unfortunately he died on 18.01.2011 on account of his cough and cold. ( Vide Annexure – 2 and 3 )
5. The complainant being nominee in the said policy informed the Branch Manager of LIC of India, Biharsharif, Distt. Nalanda that his father died on 18.01.2011 on account of cold and cough. Then he was asked to submit claim form/ application in pursuance of such direction he submitted the claim form with relevant documents in the prescribed manner. ( Vide Annexure – 4 )
6. The complainant approached the Branch Manager LIC of India, Biharsharif,  Distt. Nalanda and submitted an application before him in which after stating entire facts requested to settle the death claim without unnecessary delay and to pay amount as early as possible. ( Vide Annexure – 5 )
7. The letter dated 19.12.2012 was issued from the office of LIC of India, Patna Division by which complainant was asked to submit documents that is medical prescription and certificate relating to age of insured and his elder son. ( Vide Annexure – 6 ) and in reply to the said letter complainant submitted application before the Divisional Manager LIC of India, Division office Patna along with copy of prescription, declaration of age certificate affidavit, school leaving certificate and other relevant documents. ( Vide Annexure – 7 )
8. The complainant submitted all the documents required by the insurer in the said division office so that the death claim is settled without any delay.
9.  The letter dated 30.03.2013 was issued by Senior Divisional Manager and sent to the complainant in which it is stated that the authority has decided to repudiate the claim preferred by the complainant on account of the deceased having with held material information regarding his age at the time of affecting the assurance with us. ( Vide Annexure – 8 )
10. The authority entrusted with the discretionary power exercised its power in casual manner without due care and caution and repudiated the claim for double Accident benefit without applying its mind to the facts and circumstances of the case and without following the principals of nature justice. In this regard, Hon’ble supreme court has held in Asha Goel case 2001 ( 1) SLT 89 SC that in course of the time, the corporation (LIC of India ) has grown in size and at present it is one of the largest public sector financial under - taking. The public in general and crores of policy holders in particular, look forward to prompt and efficient service from the corporation. Therefore, the authorities in - charge of management of affairs of the corporation should bear in mind that the credibility and reputation depends on its prompt and efficient service. Therefore, the approach of corporation in the matter of repudiation of policy admittedly issued by it should be one of extreme care and caution. It should not be within a mechanical and routine manner.
11. The complainant was not satisfied with the decision, thus he filed the representation for reconsideration of his claim and same is still pending before the Zonal Manager LIC of India East Central Zonal Office, Exhibition Road, Patna.
12. It is submitted that the claim preferred by the complainant has been repudiated without appreciating the principal settled by the constitutional court and commission and without following the principal of natural justice.
13. It is submitted that the deceased / insured had not made a false statement regarding his age at the time of taking the policy. There was no suppression of real age by the insured person.
14. There is no any substantial evidence/ documents on record that the deceased had intentionally made a false statement regarding his age.
15. It is well settled by the commission in Kamal case that the Voter I Card was not considered as a proof of age. It is meant to establish identity of voter. The corporation could not dispute the age of insured on the basis of voter or list.
16. After nominee situated on similar footing of the complainant preferred the claim under their policies and the same was settled by the opposite party no. 1.
17. The decision taken by the authorities as mentioned in letter on 30.03.2013 is arbitrary malicious, illegal erroneous and is against the principal settled by the commission.

3. Following assertions have been made by the Opposite Parties in their written statement :-

1. The present complaint is wholly misconceived groundless, unsustainable in law and particularly in view of the fact that the complainant was repudiated on the ground of suppression of material fact with respect of the age of the life assured Basant Saw at the time of proposal of the relevant policy ( bearing no. 517043260 T.T. 14/10 sum assured Rs. 80,000/- ( Rupees Eighty Thousand only ) premium Rs. 9029/- ( Rupees nine Thousand twenty Nine only ) date of commencement 28.10.2009.
2. At the outset it is submitted that the name of opposite party no. 2 Zonal Manager, East Central Zone may be expunged / deleted from the present proceedings as the same is not actually and voluntarily resides or carries on business or has a Branch office or personally works for gain as required under Section 11 (2) (a) of the Consumer Protection Act.
3. At the time of proposal, the deceased life assured ( L/A ) filled the relevant column of his age to be 50 years ( D.O.B. 01.01.1960 ) intentionally to avoid rigorous medical examination as well for low premium amount meant for the policy in question.
4. Admittedly assuming the statement on the part of L/A regarding his date of birth to be true and in utmost good faith, the opposite parties no. 1 to 4 Life Insurance Corporation of India ( here in after referred as Corporation ) issued the aforesaid policy in question.
5. After the death of the L/A on 18.01.2011, the nominee son lodged a claim under the aforesaid policy which was properly scrutinised and investigated by corporation.
6. During the course of investigation it was found that at the time of proposal ( 28.10.2005 ) the deceased L/A declared his age to be 50 years ( D.O.B. 01.01.1960 ). However in the voter list ( Hilsa) of the year 2009, his actual age was shown to be 61 years ( S.M. 716 ). Thus the deceased L/A had taken the policy with mis – statement/ suppression of his actual age. ( Vide Annexure – A and A1 )
7. It is submitted that at the time of proposal the deceased L/A suppressed his actual age to avoid rigorous medical examination and to save the premium amount. Further had the deceased L/A disclosed the actual age at the time of proposal, the corporation would not have accepted the same.
8. Under the circumstances, the corporation had no option then to repudiate the liability of basis sum assured under the policy on account of deceased having withheld material information regarding his age at the time of affecting the assurance with corporation and intimated to his effect vide its letter dated 30.03.2013 ( Vide Annexure – 8 )
9. It is submitted that under the said mis – representation the company shall not be liable to take any payment under the policy in question in respect of any claim if such claim be in any manner intentionally or recklessly or otherwise misrepresented  or concealed or non disclosure of material facts or making false statement by the insured person. Such action shall render this policy null and void and all the claims hereunder shall be for feited.
10. It is submitted that policy is a matter of contract and both the parties are strictly bound by the terms and conditions of the policy. Repudiation of claim of the complainant is in consonance with the breach of said terms and conditions. Hence, there is no deficiency in service on the part of the corporation.
11. It is submitted that the complainant admitted this fact that the proposal form was duly and properly filed up by his father himself and thus he intentionally and knowingly filled all the relevant information required by the corporation including his age and date of birth.

4. The complainant in his supplementary affidavit has asserted following facts :-

1. It is submitted that the deceased insured had not made a false statement regarding his age at the time of taking policy. He submitted duly sworn/ affidavit form of Life Insurance Corporation of India regarding declaration of age. The opposite party no. 1 after making detail inquiry and verification accepted the proposal submitted by insured/proposer and accordingly policy schedule bearing policy no. 517043260 has been issued and provided to the insured. On plain reading of medical attendance’s certificate, claim form and form no. 3785 and 3786, it appears that the age of the deceased insured was 51 years. Here no documentary evidence on affidavit has been produced to show that the deceased had intentionally made a false statement regarding his age. It is well settled law that voter I card/List is not considered as a proof of age. In the prescription dated 15.01.2011 it is stated that the deceased was 51 years old.
2. It is submitted that the letter dated 30.03.2013 has been issued under signature of Senior Divisional Manager, without complying the principal of natural justice, without appreciating the mandatory provision of the Insurance Act 1938 and without considering the principal settled by the commission.

Perused the document available on the record and heard the complainant only as opposite parties were not present during hearing stage but they have filed written statement denying the version of complainant.

Having gone through the record We are of the opinion that the opposite parties Life Insurance Corporation of India has not taken a reasonable approach in the matter and only taken decision to repudiate the claim of the complainant on the basis of date of Birth recorded in the voter I Card whereas the date of Birth of the deceased policy holder in the Doctor’s prescription prior to his death somewhat different and it cannot be presumed that his age was intentionally got recorded to be 51 years in the Doctor’s prescription as if the complainant was aware of his imminent death.

Moreover the complainant citation of Hon’ble Commission Order that voter I Card cannot be treated a valid record for knowing Date of Birth but it is only a card for identification.

In view of the discussion made above we direct the opposite party no. 1, 2, 3 and 4 jointly and severally to pay to complainant Rs. 80,000/- ( Rs. Eighty Thousand only ), the sum assured with in a period of two months from the date of receipt of this order failing which the aforesaid amount will carry an interest @ 9% per annum annually till it is finally paid.

The aforesaid opposite parties are further directed to pay to the complainant Rs. 10,000/- ( Rs. Ten Thousand only ) as composite charge for compensation and litigation cost.

Thus the complaint petition stands allowed to the extent indicated above.

         Member                                               Member                                           President