BEFORE THE A.P.STATE CONSUMER DISPUTES REDRESSAL COMMISSION: HYDERABAD.

 F.A.No.518/2013 against C.C.No.23/2012 District Forum, Adilabad.

Between:

Bajaj Allianz Life Insurance Company Limited

GE Plaza, Airport Road,

Yerawada, Pune (411006)                                                    

                                                                                                                        ..Appellant/opp.party

        And

Mrs.Jonnalagadda Adilaxmi W/o.late Bhasker

Rao, H.No.12-565-1-1,

Islampur, Mancherial

Adilabad District.                                                                                                         ..Respondent/complainant

Counsel for the  Appellant: Mr.Srinivas Karra.

Counsel for the Respondent: - Notice on respondent held sufficient

QUORUM: HON’BLE SRI JUSTICE GOPALA KRISHNA TAMADA, PRESIDENT.

AND

SRI T.ASHOK KUMAR, HON’BLE MEMBER.

WEDNESDAY THE SECOND DAY OF APRIL,

TWO THOUSAND FOURTEEN

Oral Order (As per Hon’ble Sri Justice GopalaKrishna Tamada, President)

***

          The opposite party is the appellant and  filed this appeal against the order in C.C.No.23/2012 dated 16-4-2013 on the file of District Forum, Adilabad whereby the complaint filed by the respondent herein was allowed.

        The brief facts of the complaint are that the complainant’s husband, one Mr.Jonnalagadda Bhasker Rao, during his life time obtained a non participating unit link insurance policy bearing No.0174912630 for the period from 11-6-2010 to 11-6-2035 by paying a premium of Rs.12,500/- on 11-6-2010.  As per the said policy, an amount of Rs.2 lakhs is covered in the event of death of the insured.  Unfortunately the said Bhasker Rao died on 14-3-2011 i.e. during the subsistence of the policy and the complainant made a claim.  After enquiry, the opposite party/insurance company  repudiated the claim stating that the husband of the complainant has not stated his correct age while taking the policy.  Alleging that the repudiation of the policy amounts to deficiency of service, the complainant approached the District Forum  claiming the sum assured i.e. Rs. 2 lakhs with expenses of Rs.10,000/- and Rs.1 lakh towards compensation along with interest @ 18% p.a. from the date of accident till the date of realization and also costs.

        The appellant/insurance company resisted the said complaint by filing counter contending that during the course of enquiry, they have learnt that the husband of the complainant was aged 60 years as on the date of death of the policy which fact was clear from the identity card issued by the Election Commission of India, Pan card issued by the Income tax department and the ration card issued by the revenue authorities.  As the said Bhasker Rao suppressed the said fact that he was aged 60 years as on the date of the policy and mentioned his age as 51 years and the same amounts to suppression of material facts, the insurance claim of the respondent/complainant was repudiated.

        The District Forum allowed both the parties to file their chief affidavit and also marked Exs.A1 to A12 on behalf of the complainant and Exs.B1 to B4 on behalf of the opposite party-insurance company and allowed the complaint directing the appellant insurance company to pay an amount of Rs.2 lakhs with interest @ 7.5% p.a. from the date of filing of the complaint till realization together with costs of Rs.500/-.

     The said order as stated supra is challenged by the appellant/opposite party before this Commission by way of this appeal. 

The learned counsel appearing for the appellant-insurance company submitted that the husband of the complainant instead of mentioning his correct age which is 60 years mentioned his age as 51 years, which amounts to suppression of facts and in those circumstances only, the insurance company repudiated the claim.  In this context, he placed reliance on Exs.B2, B3 and B4.  He also placed strong reliance on the judgement of National Commission reported in III (2009) CPJ 38 (NC) in LIFE INSURNACE CORPORATION OF INDIA v. YOGENDRA PRASAD SINGH.

Heard.

The only point that falls for consideration is as to whether the husband of the complainant is aged 51 years or 60 years and the repudiation of the claim of the complainant by the insurance company is justified or not?

No doubt the judgement on which the learned counsel for the appellant placed reliance, if we take into consideration is squarely applicable to the case on hand.  In the said case, the insured/deceased while taking the policy mentioned that his date of birth was 18-10-1950.  On the said basis, the policy was issued by the insurance company, after his death when a claim was made, the District Forum as well as the State Commission have held against the appellant and in favour of the complainant therein, however, the National Commission reversed the said finding solely on the ground that the date of birth of the son was 01-5-1954 and when that particular date of birth of the son is taken into consideration, the date of birth of the deceased could never be 18-10-1950.  We are in agreement with the said view and there can never be any dispute.  So far as the case on hand is concerned, the husband of the complainant while taking the policy mentioned his age as 51 years as on 10-6-2010 i.e. date of the policy as against the age of 60 years.  Of course, it is mentioned that he is aged 60 years as per the documents produced by the insurance company which are marked as Exs.B2 to B4.  In our considered view, these Exs.B2 to B4 cannot be given credence for the reason that when illiterates who live in rural areas will never give the exact age while making an application for issuance of ration card or application for issuance of identity card, they mention some age approximately.  In cases of this nature, the Hon’ble Supreme Court of India in  MithooLal Mayak Vs. LIC of India (AIR 1962 SC 814 ), has laid down following three conditions for applicability of second part of Sec. 45 of the Insurance Act-

(i) the statement must be on a material matter or must suppress facts which it was material to disclose.

(ii) the suppression must be fraudulently made by the policy holder; and

(iii) the policy holder must have known at the time of making the statement that it was false or that it suppressed facts which was material to disclose.

From the said judgement, it can be definitely inferred that if the said suppression goes to the root of the case, then only the insurance company may repudiate the claim stating that it is a false declaration.  From the facts, we are of the view  that as observed earlier, in villages illiterates will never give the exact age while making an application for issuance of ration card or application for issuance of identity card and they mention some age approximately and the same in our considered view would not amount to suppression of fact.

In these circumstances, we are of the view that the order passed by the District Forum is justified and we see no merits in this appeal.  Accordingly this appeal fails and is dismissed.  There shall be no order as to costs.  Time for compliance four weeks.

                                                                                                                        Sd/-PRESIDENT.

                                                                                                                        Sd/-MEMBER.

JM                                                                                                                     Dt.02-4-2014.