Madhya Pradesh

StateCommission

A/17/632

CEO, RELIANCE LIC LTD. - Complainant(s)

Versus

NARAYAN SINGH - Opp.Party(s)

SH.GARVESH BARJATYA

09 May 2023

ORDER

M. P. STATE  CONSUMER  DISPUTES  REDRESSAL  COMMISSION,                         

                             PLOT NO.76, ARERA HILLS, BHOPAL

 

                                      FIRST APPEAL NO. 632 OF 2017

(Arising out of order dated 21.02.2017 passed in C.C.No.68/2015 by District Commission, Mandsaur)

 

1. CHIEF EXECUTIVE OFFICER,

    RELIANCE LIFE INSURANCE CO.LTD.

    REGISTERED OFFICE- H-BLOCK, FIRST FLOOR,

    DHIRUBHAI AMBANI KNOWLEDGE CITY,

    NAVI MUMBAI (MAHARASHTRA)

 

2. BRANCH MANAGER,

    RELIANCE LIFE INSURANCE CO.LTD.

    OPPOSITE SAMRAT HOTEL, STATION ROAD,

    MANDSAUR (M.P.)                                                                                        ….           APPELLANTS.

 

                       Versus

 

NARAYAN SINGH,

S/O SHRI UDAY SINGH SOLANKI,

R/O BANIKHEDI, TEHSIL-DALODA,

DISTRICT-MANDSAUR (M.P.)                                                                         ….           RESPONDENT.                                

 

BEFORE :

            HON’BLE SHRI JUSTICE SHANTANU S. KEMKAR   :  PRESIDENT

           HON’BLE DR. (MRS) MONIKA MALIK                         :  MEMBER

                     

COUNSEL FOR PARTIES :

                Shri Jay Kumar Sahu appears on behalf of Shri R. K. Kaimaithiya, learned counsel for the appellants.

           Shri K. K. Kala appears on behalf of Shri Naresh Chourasia, learned counsel for the respondent.

          

 

                                                  O R D E R

                                       (Passed on 09.05.2023)

                   The following order of the Commission was delivered by Dr.(Mrs) Monika Malik, Member:

           

                   This appeal by the opposite parties/appellants-Reliance Life Insurance Co. Ltd. (hereinafter referred to as ‘insurance company’) is directed against the order dated 21.02.2017 passed by the District Consumer Disputes Redressal Commission, Mandsaur (for short ‘District

-2-

Commission’) in C.C.No.68/2015, whereby the complaint filed by the complainant/respondent (hereinafter referred to as ‘respondent’) was partly allowed.

2.                Briefly put, facts of the case are that Late Champabai (hereinafter referred to as ‘deceased-insured’) during her life time had obtained Reliance Life Insurance Classic Plan (Regular) no.51112798 on 20.08.2013 from the opposite party-Reliance Life Insurance Co. Ltd. (hereinafter referred to as ‘insurance company’). The complainant is the nominee of the deceased-insured.  The duration of the policy was 15 years and sum assured was Rs.2,00,000/-. Under the said policy, Rs.10,000/- as premium on half yearly basis was to be paid. During the period of insurance cover, the deceased-insured died on 12.06.2014. It is alleged that on claim being made, the insurance company repudiated it on the ground that the deceased-insured had disclosed her age incorrectly, while obtaining the insurance policy. Therefore, alleging deficiency in service against the insurance company, the respondent approached the District Commission seeking relief.

3.                The insurance company in its reply before the District Commission submitted that the deceased-insured died within 11 months from the date of obtaining the policy cover.  Upon investigation, it was found that the deceased-insured had given incorrect information regarding her

-3-

date of birth.  The deceased-insured was more than 80 years old when the insurance policy was obtained by her.  On this account, the claim is not payable.

4.                The District Commission allowed the complaint and directed the insurance company to pay sum assured i.e. Rs.2,00,000/-  with interest @ 7% p.a. from the date of repudiation of claim i.e. 08.11.2014, till payment. In addition compensation of Rs.20,000/- with additional sum of Rs.2,000/- as costs, is also awarded.

5.                Heard.  Perused the record.

6.                Learned counsel for the appellants-insurance company who has also filed written arguments in the matter stated that the age limit for obtaining the subject insurance policy is from 07 years to 65 years. The deceased-insured in the proposal form had stated her date of birth as 12.12.1952, according to which she was 61 years old at the time of filling up  of the proposal form. Upon receiving her death claim, an investigation was carried out and it was found that she was 80 years old when the subject insurance policy was issued to her.  There has been suppression of material facts with regard to her age, in order to obtain the subject insurance policy and the District Commission has therefore erred in allowing the complaint, which deserves to be dismissed.

 

-4-

7.                Learned counsel for the respondent supporting the impugned order argued that the insurance company has failed to prove by way of any cogent evidence that the deceased-insured was 80 years old when the subject insurance policy was issued to her.  Her date of birth is 12.12.1952 and she was eligible to obtain the insurance policy in question.  Therefore, the District Commission has not committed any error in passing the impugned order.

8.                On careful perusal of the record of the District Commission we observe that the insurance company has denied the death claim of the deceased-insured on the basis of an investigation report which is available in record.  The investigator has said to have carried out an investigation in the matter from where he gathered that the deceased-insured who died on 12.06.2014, was 80-90 years old. Though it is mentioned in the investigation report that the investigator had enquired from the neighbours of the deceased-insured and found out that she was an 80 years old woman, but we do not find any substantiating & determining evidence, giving mention of date of birth of the deceased-insured, when proposal form dated 25.07.2013 specifies her date of birth as 12.12.1952. The investigator in his investigation report has said to have verified the Pan Card (which is an age proof) and has found it to be genuine. Certain documents annexed with the

 

-5-

investigation report which give contradictory interpretations are not sustainable.

9.                To conclude, in the absence of any reliable confirmatory evidence, we cannot deduce that the deceased-insured had given wrong or incorrect information regarding her age in the proposal form filled by her in order to obtain the subject insurance policy. The burden of proof regarding the same lies with the insurance company only.

10.              On the above basis, the impugned award is affirmed.

11.              As a result, this appeal fails and is dismissed, with no order as to costs.

              (JUSTICE SHANTANU S. KEMKAR)          (DR. MONIKA MALIK)                     

                                 PRESIDENT                                         MEMBER