NCDRC

NCDRC

FA/222/2022

AEGON LIFE INSURANCE COMPANY LTD. - Complainant(s)

Versus

MURTI DEVI - Opp.Party(s)

M/S. LEGAL KNIGHTS LAW FIRM

31 Oct 2023

ORDER

NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION
NEW DELHI
 
FIRST APPEAL NO. 222 OF 2022
(Against the Order dated 08/11/2021 in Complaint No. 460/2013 of the State Commission Delhi)
1. AEGON LIFE INSURANCE COMPANY LTD.
Current Registered Office : A - 201, 2nd Floor, Leela Business Park, Andheri-Kurla Road, Andheri (East), MUMBAI
MAHARASHTRA -400059
...........Appellant(s)
Versus 
1. MURTI DEVI
WIFE OF LT SHRI SURESH KUMAR R/O. E-13/404, E-BLOCK EAST GOKALPUR,
DELHI-110094
...........Respondent(s)

BEFORE: 
 HON'BLE MR. JUSTICE RAM SURAT RAM MAURYA,PRESIDING MEMBER

FOR THE APPELLANT :
MR. JAIDEEP SETHI, ADVOCATE
MR. GAURAV GUPTA, ADVOCATE
FOR THE RESPONDENT :
MR. HIMANSHU MATTA, ADVOCATE
MR. ROHIT KUMAR, ADVOCATE WITH SPA

Dated : 31 October 2023
ORDER

1.      Heard Mr. Jaideep Sethi, Advocate, for the appellant and Mr. Himanshu Matta, Advocate for the respondent

2.      Above appeal has been filed against order of State Consumer Disputes Redressal Commission, Delhi, dated 08.11.2021, passed in Consumer Complaint No.460 of 2013, allowing the complaint and directing the appellant to pay Rs.5500000/- with interest @ 6% from the date of repudiation (18.06.2023) till the date of judgment. The amount was payable on or before 07.01.2022 failing which 9% interest was to be paid. The State Commission also awarded compensation of Rs.300000/- for mental agony and harassment and Rs.50000/- as litigation cost.

3.      As per office report, the appeal has been filed with a delay of 32 days. The appellant has not filed application for condonation of delay. Subject to objection by the respondent, delay in filing the appeal is condoned.

4.      Husband of the complainant (Late Suresh Kumar) obtained life insurance policy No.512093264072 from the appellant/opposite party. Sum insured in the policy was Rs.5500000/- and the policy was valid from 28.09.2012 to 27.09.2013. Unfortunately, on 09.02.2013 the life assured died due to sudden cardiac arrest. The complainant, being the nominee in the policy, filed the insurance claim with the opposite party. The opposite party, vide letter dated 18.06.2013 repudiated the claim on the ground that the life assured misrepresented his age and income in the proposal form. Aggrieved by repudiation of the insurance claim, the complainant filed Complaint No.460 of 2013 with the State Commission.

5.      The opposite party contested the complaint by filing the written version stating that the life assured had concealed the material fact relating to his age and income. As per voter list, his age was 64 years and in the proposal form he has disclosed his age as 40 years. In the proposal form it was disclosed that the life assured was a salaried person working in Visakha Enterprises. However, in the investigation report it was found that he was not a salaried person. On the aforesaid grounds, the opposite party repudiated the insurance claim on 18.06.2013.

6.      The State Commission, impugned order dated 08.11.2021 allowed the complaint and directed the opposite party as indicated above. Aggrieved by the impugned order dated 08.11.2021, the opposite party has filed the instant appeal.

7.      Counsel for the appellant submitted that the appellant appointed an investigator and in the investigation report it was found that the age of the life assured at the time of obtaining the insurance policy was 64 years and not 40 years as disclosed by him. The investigator also found that the life assured was not a salaried person and not working with Visakha Enterprises and he wrongly mentioned this fact in the proposal form. The investigator found that the life assured was suffering from liver problem and had a history of alcoholic intake. The impugned order is not based on appreciation of correct facts and deserves to be set aside. Counsel for the appellant relied on the judgment of Supreme Court in P.C. Chako & Anr. Vs. Chairman Life Insurance Corporation of India (2008) 1 SCC 321 and Satwant Kaur Sandhu vs. New India Assurance Co. Ltd. (2009) 8 SCC 316.  

8.      The facts relating to issuance of policy and that the life assured died during subsistence of the policy are admitted. The insurance claim was repudiated on two grounds that (1) in the proposal form the life assured has wrongly mentioned his age as 40 years and (2) he was a salaried person working with Visakha Enterprises. As far as date of birth is concerned, in the proposal form the date of birth of the life assured as mentioned as 01.01.1973. Alongwith the investigation report, the appellant has also filed copies of the passport as well as PAN card of the life assured. In both the documents his date of birth is mentioned as 01.01.1973. The investigator as well as the opposite party have ignored the date of birth of the life assured as given in the passport and the PAN card and relied on the date of birth given in the voters list, which shows the arbitrariness on their part. Supreme Court in Sushil Kumar vs. Rakesh Kumar (2003) 8 SCC 673 held that the entry made in voters list is not a conclusive proof. Regarding the question of income of the life assured, counsel for the respondent submitted that alongwith the proposal form, the life assured had filed the Income tax return for the relevant period. This fact is not disputed by the appellant rather the appellant has also filed the income tax return of the life assured for the assessment year 2012-2013, alongwith the investigation report. When the life assured had filed the copy of the ITR, the appellant cannot take the ground that life assured had supressed the fact relating to his income. When the life assured had filed copies of the passport, PAN, income tax return form alongwith the proposal form, repudiation of claim on the ground that the life assured had supressed the material facts relating to his age and income was not justified. The judgments relied by the appellant in P.C. Chako and Satwant Kaur Sandhu (supra) are not applicable to the facts of this case as the appellant has failed to establish that the life assured supressed any material fact relating to his age and income. As far as submission of the appellant that at the time of obtaining the insurance policy, the life assured was suffering from liver disease and taking treatment for the same is concerned, this Commission in Galada Power & Telecommunication Ltd. v. United India Insurance Co. Ltd. (2016) 14 SCC that the insurance company cannot take any new ground other than taken in the repudiation letter.  The appellant has filed reports of certain medical test conducted by Chandan Health Cente before issuance of the policy. In the said reports it is nowhere mentioned that the life assured was suffering from liver disease. Moreover, the appellant has not filed any concrete evidence to show as to what disease the life assured was suffering from. In absence of anything contrary to the evidence filed by the complainant, the State Commission was justified in allowing the complaint. The State Commission has taken into consideration copies of the passport, PAN, income tax return, driving license and date of birth certificate issued by the Municipal Corporation and appreciated the facts in correct perspective. The appellant failed to point out any illegality in the impugned order so as to interfere in the appellate jurisdiction. Therefore, the appeal has no merit and deserves to be dismissed.

                                                    O R D E R

In view of the aforesaid discussions, the appeal stands dismissed with no order as to costs.

 
..................................................J
RAM SURAT RAM MAURYA
PRESIDING MEMBER

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