BEFORE THE DISTT.CONSUMER DISPUTES REDRESSAL FORUM; FATEHABAD.

C.C.No.364/2017.

Date of Instt.: 20.12.2017.

Date of Decision:9.10.2018.

Smt.Mehri Bai @ Mohri wife of Mool Chand, resident of village Dhani Sanchla, Tehsil Tohana, District Fatehabad.

..Complainant.

     Versus

1.M/s. AVIVA Life Insurance Company India Limited, Head Office, AVIVA Tower, Sector Road, opposite Golf Course, DLF Phase-V, Sector-43, GURUGRAM-122003 through its Chairman-cum-Managing Director/ Director.

2.Induslnd Bank Limited, Branch Office, Daryapur Tehsil & District Fatehabad through its Branch Manager.

..Respondents/OPs.

Before:                  Sh.Raghbir Singh, President.

                                              Sh. Jasvinder Singh, Member.

Dr. Rajni Goyat, Member.

Argued by:          Sh.Sukhbir Dhaka, Adv. for the complainant.

                                              Sh.U.K.Gera, Adv. for the OP No.1.

                                              Sh.Amit Wadhera, Adv. for Op No.2.

ORDER

                                           The present complaint under Section 12 of the Consumer Protection Act, 1986 has been filed by the complainant against the Opposite Parties (hereinafter to be referred as OPs) with the averments that late Sh.Rajender Kumar, son of complainant got his life insured with OP No.1 through  OP No.2 for a sum assured of Rs.10 Lakh only vide policy No.10238246 dated 15.07.2015,  valid from 15.07.2015 to 15.07.2035. The life assured Rajender Kumar made a payment of Rs.32,012/- as premium of the above said policy to the OPs. The complainant being mother of the life assured was nominated as nominee in the above said policy. Therefore, Sh.Rajender Kumar during his life-time and after his death the complainant is consumer of OPs.

2.                             It is further submitted that Rajender Kumar died on 12.06.2017 at his village Dhani Sanchla, District Fatehabad and information regarding the same was given to the OPs. The complainant also submitted all the requisite documents to the OPs as per their instructions for settlement of the insurance claim. The complainant was assured by the OPs that the insurance benefits will be released to her at the earliest. However despite many visits made by her, the OPs avoided the matter under one pretext or the other and did not release the insurance benefits to the complainant. Thereafter, vide letter dated 08.12.2017, the insurance claim of the complainant has been repudiated by the OPs on false and flimsy ground to the effect that the life assured did not give correct information while filing the proposal form. It is further submitted that the genuine claim of the complainant has been repudiated by the OPs illegally and without any basis. The above said act on the part of OPs amounts to deficiency in rendering service to the complainant. The complainant has further prayed that the amount of insurance claim of Rs.10 lakh along-with interest may be allowed in her favour along-with compensation to the tune of Rs.1 lakh. Hence, the present complaint.

3.                             On being served the OPs appeared through their counsel and resisted the complaint by filing a joint written statement wherein various preliminary objections with regard to maintainability, jurisdiction, cause of action, estoppel, concealment of true and correct facts and jurisdiction etc.; have been raised.

4.                             In reply on merits, it is submitted that the life assured had applied for an AVIVA Dhan Samruddhi Policy from the OPs vide proposal dated 19.05.2015. On the basis of declaration made in said proposal the OPs issued policy bearing No.10238246 to the complainant. In total the life assured made payment of four half yearly installments to the tune of Rs.1,23,716/-. Thereafter, the OPs received an intimation of death of the life assured. On receipt of the death intimation, the OPs checked with other insurance and it was discovered that the life assured had already availed a number of insurance policies from other insurers and concealed existence of prior policies while availing the policy in question from the OPs. The details of other insurance policies that were availed by the life assured prior to the taking of the policy are reproduced as under:-

5.                             It is further submitted that in view of the above table the life assured had deliberately concealed the insurance of other insurance policies availed from other insurers from the OPs at the time of proposal which clearly amounts to concealment of material fact. Accordingly the claim of the complainant was repudiated by the OPs vide repudiation letter dated 08.12.2017 on the ground that in the proposal form the life assured under the insurance details had answered “No” to specific question related in respect of other life insurance policies:-

8.1             Are you holding life, health or critical illness insurance policies (in-force/paid-up) in your name or submitted any simultaneous proposed with us or any other life insurance company which is under consideration – No.

                                It is further submitted that the present complaint is without any merit and as such the same is liable to be dismissed.

6.                             The learned counsel for the complainant tendered in evidence affidavit of the complainant as Annexure CW1/A alongwith documents as Annexures C1 to C3 and closed the evidence of the complainant. On the other hand, the learned counsel for the Ops tendered  in evidence affidavit of Sh.R.K.Mishra, Authorized Representative of Life Insurance Company as Annexure R-1 alongwith documents as Annexure R-2 to Annexure R-5 and closed the evidence of the Ops.

7.                             We have duly considered the arguments advanced by learned counsel for the parties and also perused the entire material placed on record. It is not disputed that the life of late Sh.Rajender Kumar, son of complainant was insured by the Op No.1 vide insurance policy dated 15.07.2015 valid upto 15.07.2035 for an amount of Rs.10 lakh. It is also not disputed that the complainant was nominated as nominee of the life assured in the above said insurance policy. It is also not in dispute that the life assured had died on 12.06.2017 i.e. during the subsistence of the insurance policy. It is also not disputed that on the date of death of the life assured all the installments of the premium had been paid by him to the Ops. In the present case the insurance claim of the complainant has been repudiated by the Op no.1 vide repudiation letter dated 08.12.2017 on the ground that at the time of filing of proposal, the life assured did not disclose that he had obtained insurance policies of about 45 lakh Rupees from the other insurance companies. The policy holder/ proposer was duty bound to reveal all the relevant facts to the insurer so that the insurer may determine the policy holder’s eligibility for availing insurance. In view of the above, the onus was on the Op no.1 to prove that the life assured had purchased the insurance policies from the other insurance companies. However, the OP No.1 has not placed on record any evidence/ document in support of their contention. Therefore the repudiation of insurance claim of the complainant by the OPs vide repudiation letter dated 08.12.2017 is without any base and the same is liable to be quashed.  Otherwise also now it is a settled proposition of law that the life insurance claim cannot be repudiated on the ground of non disclosure of the policy obtained by the life insured from the other insurance companies as the same does not amount to be a suppression of material facts. The judgment rendered by the Hon’ble High Court of Punjab and Haryana dated 02.11.2017 in CWP 24862 of 2017 titled as “Bajaj Allianz Life Insurance Co. Ltd. Vs. Santosh and Another”. The order of Hon’ble National Commission dated 16.03.2017 in revision petition No.1053 of 2008 titled as “Baleshwar Singh Vs. Life Insurance Co. & Ors. and the judgment dated 12.04.2017 in revision petition  No.4204 of 2011 and the judgment dated 04.11.2016 in revision petition No.139 of 2016 passed by the Hon’ble National Commission  are relied upon.

8.                             In view of the aforesaid discussion the present complaint is allowed against OP No.1. From perusal of the record it is revealed that an amount of Rs.1,23,716/- has already been credited by the OPs in the account of the complainant. Therefore OP No.1 is directed for making a payment of Rs.8,76,284/- (Rs.10,00,000 – Rs.1,23,716/-)  to the complainant alongwith interest @ 7% from the date of filing of present complaint till its realization. The OP No.1 is also directed for making payment of Rs.3,100/- as compensation and litigation charges to the complainant. No deficiency has been proved against OP No.2 and as such the present complaint is dismissed against OP no.2. The present order be complied with within a period of 30 days from the date of receipt of the copy of present order otherwise the amount shall carry an interest @ 9% per annum for the default period. Copy of this order be supplied to the parties free of costs. File be consigned to record room after due compliance.

ANNOUNCED IN OPEN FORUM.                                                                                        Dt.09.10.2018                   

                                                                                                      (Raghbir Singh)

                               President

                                                                                                District Consumer Disputes                      

                                                                                Redressal Fourm,Fatehabad

( Rajni Goyat)      (Jasvinder Singh)   

      Member                   Member