Final Order / Judgement | DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION CAMP COURT AT LUDHIANA Received by way of transfer Consumer Complaint No.207 of 2018 Date of institution: 27.03.2018 Date of Decision:03.10.2022 Udik son of Nawab Singh, aged about 50 years, resident of House No.627, Gali Gujran, Ferozepur …….Complainant Versus - PNB Met Life India Insurance Company Limited, 4th Floor, Kunal Towers, No.88, The Mall Road, Ludhiana through its Branch Manager
- Managing Director of PNB Met Life India Insurance Company Limited No.25, 1st Floor, Thunga Complex, 32nd A cross Road, Jayanagar7th Block, Opposite Bangalore, International Academy, Beside City College, Bengaluru, Karnataka 560082
……..Opposite Parties QUORUM: HON’BLE MR. RANJIT SINGH, PRESIDENT. HON’BLE MRS. RANVIR KAUR, MEMBER PRESENT: Sh. Ranvik Mehta, Adv. counsel for complainant Sh. Ritesh Mohindra, Adv. For OPs ORDER RANJIT SINGH, PRESIDENT - The present order of ours will dispose of the above complaint filed under Consumer Protection Act, by the complainant against the Opposite Parties on the ground that in the year 2015, agent of opposite party approached wife of the complainant and allured her to purchase their insurance policy and being allured by agent of the opposite party, wife of the complainant namely Bachno purchased one Life Insurance Policy from opposite party and she deposited the requisite premium being first insurance premium for sum assured of Rs.8,70,000/- for the aforesaid life insurance policy, and accordingly, the opposite party issued a policy and the premium was payable annually but no terms and conditions ever issued to the complainant or the nominee. I the above said insurance policy, the complainant was appointed as nominee by his wife. Unfortunately, wife of the complainant was died and thereafter, intimation regarding the death of the insured was given to the opposite party and thereafter the complainant being nominee in the aforesaid insurance policy declared by his wife, lodged insurance claim and submitted all the documents to the OP for settlement the claim. The complainant has again requested the officials of the complainant and pleaded them to kindly settle his claim as it was last hope, at the first the officials gave no response to the continues pleadings of the complainant then later on told the complainant to wait for few months. The complainant was made to wait for one reason or another but neither the claim was settled nor any response was received by the complainant on his request. Hence, this complaint. It is, therefore prayed that the Ops be directed to pay the claim amount to the complainant with compensation and litigation expenses.
- In reply, the OPS No.1 & 2 has filed written reply taking preliminary objections; that the Ops No.1 & 2 being offices of same insurance company are represented by duly authorized officer of the company who is having requisite authority and permission to file the reply for and on behalf of both the Ops; that the allegations of the complainant, which are contrary to or inconsistent with what is averred herein are denied in totality and that nothing in the complaint is or should be deemed to be admitted by or on behalf of Ops for want of specific traverse or otherwise. On merits, it is stated that the contract of insurance is contract based on utmost good faith. Under the provision of Section 45 of the Insurance Act, 1938 a life insurance policy can be called in question on the ground of concealment of material facts within two years of commencement of policy. The life assured died before the date of commencement of the policy and during the claim assessment, after careful examination it came to the knowledge of the Ops during its investigation that the life assured had already expired before the issuance of subject policy. The insurance company has rightfully repudiated the claim raised by the complainant on the ground of suppression of material facts and gross fraud on behalf of complainant in order to gain unlawful benefits from the Ops. The policy is obtained in breach of basis doctrine of utmost good faith. There is clear breach of contract. The complainant is guilty of concealment of true facts and has committed breach of basic condition of insurance. Rest of allegations made by the complainant against the answering Ops have been denied and prayed for dismissal of the present complaint.
- In support of the complaint, the complainant has tendered various documents. On the other hand, the OP1 also tendered certain documents in support of their version.
4. We have heard the learned counsel for the parties and have gone through the record of the file, carefully. 5. From the perusal of the documents, placed on record by both the parties, we feel, that policy in question was issued by the insurance company and after this, wife of the complainant was died. But the complainant has placed on record the death certificate, in which the date of death mentioned is 10.08.2015 but in counter the learned counsel for the OPs has placed on record the one photograph, in which the date of death of Bachno mentioned as 24.01.2015. Since the present complaint element of fraud and forgery and the complainant in order to play fraud with the opposite parties got issued the policy on 28.02.2015. Even, in his complaint, the complainant never mentioned the issuance date of the insurance policy. So, the complicated question of facts are involved in this present complaint and requires detailed and voluminous evidence. The Consumer Commission generally decide the cases on the basis of documents alone, which are not seriously disputed in nature. 7. In view of the documents placed on record by both the parties and after going through the file, we feel the complainant has failed to prove his case. Therefore, the complaint of the complainant stands dismissed. Free certified copies of this order be sent to the parties, as per rules. The file be sent back to the District Consumer Commission, Ludhiana, for consigning the same to the Record Room. October 03, 2022 (Ranjit Singh) (Ranvir Kaur) | |