Haryana

StateCommission

A/172/2015

EXIDE LIFE INSURANCE CO. - Complainant(s)

Versus

PARDEEP KUMAR - Opp.Party(s)

SANJEEV GOEL

03 Nov 2015

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION HARYANA, PANCHKULA

                                                 

First Appeal No  :      172 of 2015

Date of Institution:      20.02.2015

Date of Decision :       03.11.2015

 

Excide Life Insurance Company Limited (formally ING Vysya Life Insurance Company Limited), Branch Office Ashok Plaza, 1^st Floor, Opposite Carvey, Delhi Road, Rohtak having registered office at ING Vysya House, 5^th Floor No.22, MG Road, Bangalore-560001, through their authorized signatory Chethan P. General Manager (Legal) available at Corporate Office, ING Vysa House, 5^th Floor, No.22, M.G. Road, Bangalore-56001.

                                      Appellant-Opposite Party

Versus

 

Pardeep Kumar s/o Sh. Mahender, Resident of 15-B, 2/1, JP Colony, Rohtak, Haryana.

                                      Respondent-Complainant

 

CORAM:             Hon’ble Mr. Justice Nawab Singh, President.

                             Shri B.M. Bedi, Judicial Member.

                             Shri Diwan Singh Chauhan, Member                                                                                                                                         

Present:               Shri Inderjeet Singh, Advocate for appellant.

                             Shri Virender Soni, Advocate for respondent.

 

                                                   O R D E R

 

B.M. BEDI, JUDICIAL MEMBER

 

Excide Life Insurance Company Limited formerly ING Vysya Life Insurance Company Limited (for short ‘ING Life Insurance’)-Opposite Party, is in appeal against the order dated January 2^nd, 2015, passed by District Consumer Disputes Redressal Forum, Rohtak (for short ‘the District Forum’).

2.      Mahender (since deceased)-father of Pardeep Kumar-complainant/respondent purchased a Life Insurance Policy Exhibit R-2 from ING Life Insurance on July 20^th, 2013 for Rs.1,71,400/-, vide Proposal Form Exhibit R-1.  The Life Assured died on August 8^th, 2013. Claim being filed, the Insurance Company did not pay the insured amount. Hence, the complainant filed complaint under Section 12 of the Consumer Protection Act, 1986 before the District Forum.

3.      The opposite party contested complaint by filing reply. It was stated that the life assured died within 19 days from the date of issuance of the policy. During investigation it was revealed that the life assured was suffering from cancer (tumour on neck) for the last three years and was taking treatment from Post Graduate Institute of Medical Sciences (for short ‘PGIMS’), Rohtak. Since the life assured concealed true facts regarding his health in the proposal form Exhibit R-1, therefore, nothing was payable by the ING Life Insurance as per the terms and conditions of the policy. It was prayed that the complaint be dismissed.

4.      On appraisal of the pleadings of the parties and the evidence brought on the record, the District Forum accepted complaint directing the ING Life Insurance as under:-

“…..it is observed that opposite party shall pay the sum assured of policy amounting to Rs.171400/- (Rupees one lac seventy one thousand four hundred only) alongwith interest @ 9% p.a. from the date of filing the present complaint i.e. 26.02.2014 till its actual realization, other benefits under the policy, if any and shall also pay an amount of Rs.2200/- (Rupees two thousand two hundred only) as litigation expenses to the complainant maximum within one month from the date of announcement of this order.”

5.      The plea raised on behalf of the appellant- ING Life Insurance for assailing the order of the District Forum is that the life assured was suffering from cancer prior to the date of obtaining the policy and he was taking treatment from PGIMS, Rohtak, which fact he concealed in the proposal form. To rebut the contention of ING Life Insurance, learned counsel for the respondent/complainant has urged that there is no evidence to show that the life assured was suffering from cancer.

6.      In support of his contention, learned counsel for the appellant- ING Life Insurance has placed reliance on the application (Annexure-A) which was submitted to State Public Information Officer to the Director, Unimax Surveilliance & HR Management Private Limited, Nazafgarh, New Delhi whereby information was sought regarding the treatment taken by the life assured. However, the information was not supplied stating that (Annexure-B) “The information requested is available to PGIMS on account of fiduciary relationship and to exempt U/s 8(e) of the RTI Act. This information can only be provided to the individual concerned i.e. Mahender and in the event of his/her death to the next of kin on production of evidence to that effect.”

7.      During the course of hearing, the complainant/respondent was asked to be present. The complainant who is present in person during hearing not only stated that Mahender did not take any treatment  from PGIMS, Rohtak, but even offered to give consent to the opposite party/appellant to have the record from PGIMS, Rohtak which as per opposite party alleged to have been refused. Learned counsel for the appellant/opposite party being asked to specify the period for which the information was required, learned counsel was not able to disclose any period stating that the appellant/opposite party did not know during which period treatment was taken by the life assured. All this shows that the appellant/opposite party was only trying to have fishing inquiries, as without any specific period it would be a futile exercise to search the entire record of PGIMS, Rohtak since its inception.  

8.      Except the above, there was no other plea that there was any misrepresentation on the part of the life assured while purchasing the policy.

9.      In view of the above, it is held that the appellant-opposite party was deficient while denying complainant’s claim by saying that the life assured was suffering from cancer, without any supporting evidence. Therefore, no case for interference in the impugned order is made out.

10.    Hence, the appeal is dismissed being devoid of any merits.

11.    The statutory amount of Rs.25,000/- deposited at the time of filing the appeal and Rs.1,70,577/- deposited on 29.07.2015 as per order of this Commission, be refunded to the complainant against proper receipt and identification in accordance with rules, after the expiry of period of appeal/revision, if any.

 

Announced 03.11.2015

(Diwan Singh Chauhan) Member

(B.M. Bedi) Judicial Member

(Nawab Singh) President

CL