ORDER

Date of order:     07 -12-2017

Upendra Jha,Member       

                   The complainant has preferred this complaint against Opposite parties with a prayer to pay her from the Opposite – parties the insurance amount of Rs. 22,75,000/- (Rupees twenty two lacs and seventy five thousand only) with 9% interest Rs. 1,50,000/- by way of compensation and Rs. 10,000/- as litigation cost.

2.           Brief facts of this case is that the husband of the complainant named Shatruhan Bantar obtained an Insurance Policy of Rs. 22,75,000/- from the Opposite- parties on 11.10.2014 on payment of premium amount Rs. 5,590/-. The Insurance Bond was effective from 13.11.2014. The life assured died on 16.01.2015 due to cold and diarrhea. The nominee- complainant filed claim with relevant documents for payment of insurance amount but it was not settled. The complainant received repudiation letter dated 21.12.2015 from the O.Ps. which was on the ground of suppression of another policy obtained by the life assured before taking this policy. Then, the complainant filed this complaint with above prayer.

3.                 The Opposite- parties filed written statement, evidence on affidavit as well as written notes of arguments. The complainant has also filed evidence on affidavit and written notes of arguments. Heard and perused the District Forum order.

4.                        The only objection raised by the Opposite-parties in this case is that the suppression of previous Insurance Policy obtained from Birla Sun Life for 13,00,000/- on 13.11.2014 which was obtained by the life assured but he did not mention this fact in the proposal form of the policy. Citing several decisions of the Hon’ble Court, the Insurance Company has justified the repudiation of the claimed amount and has submitted to dismiss the complaint on this ground alone.

5.               On the other hand, the counsel for the complainant submits that there is no concealment of facts regarding the previous Insurance Policy obtained by the Proposer. The life assured purchased another policy from Birla Sun Life Insurance Company on 13.11.2014 vide Policy No.- 006629130 for Rs. 13,00,000/- where as he purchased this Insurance Policy No.- 21427072 from the O.Ps.- PNB Met Life Insurance Company, one month before on 11.10.2014 for Rs. 22,75,000/-. Thus, there is no concealment of previous Policy by the Proposer/life assured. Secondly, the entire policy from of this policy is in English, which was filled up by the Agent of the Insurance Company and the Proposer signed in Hindi where it was required, So, there is no concealment of previous Insurance Policy. There is no other dispute. The counsel further submits that the complainant is entitled to get the Insurance amount with interest, compensation and litigation cost.

6.                              Having considered the complaint, evidence on affidavit and written arguments filed by the parties, it is admitted fact that the Proposal form to obtain the Insurance Policy from the O.P.-PNB Met Life was filled up on 11.10.2014 by the Agent of Insurance Company. The entire form is in English and the Proposer signed in the form in Hindi where it was required. The life assured did not know well the English language. He could not conceal the previous policy if any obtained by him. The Hon’ble Apex Court in the case of Sahara India Life Insurance Company Vs. Rayani Ramanjaneyulu decided on 01.08.2014 reported in laws (NCI) 2014-8.53 has held that omissions and commissions committed by an Agent, the insured or her heirs should not suffer. Repudiation on this ground cannot be sustained in law.

          The fact is that the life assured obtained Insurance Policy for Rs. 22,75,000/- from the Opposite – parties on 11.10.2014, the policy form was filled up on 11.10.2014 and the Bond was issued on 13.11.2014. The life assured obtained another Insurance Policy for Rs. 13,00,000/- from the Birla Sun Life Insurance Company on 13.11.2014 after one month from purchasing the instant Insurance Policy. So, he could not suppress the materials facts of the previous Insurance Policy. The objection raised by the opposite – parties-Insurance Company is not tenable. It cannot be sustained in law. The repudiation is wrong and unjustified. The complainant is entitled to get the insurance amount with other benefits. Hence, the Opposite-parties-PNB Met Life Insurance Company is directed to pay the complainant a sum insured Rs. 22,75,000/- with 6% interest from the date of filing complaint i.e 28.12.2016 and further directed to pay compensation of Rs. 20,000/- with litigation cost Rs. 10,000/- within a period of two months from the receipt of this order, failing which 10% interest will be payable. As the previous account No of the complainant has become in operative, hence the entire amount be paid to the complainant in existing Saving Account No.- 3404929960, as stated in Para-18 of the Complaint petition.

The complaint is allowed.

Renu Sinha                                                        Upendra Jha

Member (F)                                                        Member (M)

       Anita