Punjab

Nawanshahr

CC/21/2016

Jasvir Kaur - Complainant(s)

Versus

PNB Metlife Insurance Company Ltd - Opp.Party(s)

Amit Pathak

23 Sep 2016

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM SHAHEED BHAGAT SINGH NAGAR

 

Consumer Complaint No.      : 21/2016        

Date of decision                     :  23.09.2016

 

Jasvir Kaur W/o Jiwan Singh S/o Naranjan Singh R/o Village Urpar, Tehsil SBS Nagar, Punjab at present at DUCCIO GALIMBERTI N.20 SUZZARA (MANTOVA) ITALY through her attorney Narinder Singh S/o Karam Chand R/o H. No. B-13/377, Near Panj Mnadri, Mehli Gate Phagwara, District Kapurthala, Punjab 144401.                                                                                 ….Complainant

Versus

1. PNB Metlife Insurance Company Limited, Registered Office, Brigade Seshamahal’ Vani Vilas Road, Basavangudi, Banglore – 560004.
2. PNB Bank, Village Urapar, District SBS Nagar, Punjab.
3. PNB Metlife Bank Near Guru Nanak Mission Hospital, Jalandhar, Punjab.
4. Poonam, ARM, PNB Urapar, SBS Nagar.
5. Baldev Singh, PNB Bank Urapar, SBS Nagar, Agent of Policy, code 30003494.

                                                                    ….Opposite Parties

 

Complaint under Section 12 of the Consumer Protection Act, 1986

ARGUED BY:

For complainant            :         Sh.Amit Pathak, Advocate

For OP No. 1 & 3          :         Sh.Jatin Sharma,   Advocate

For OP No.2                            :         Sh.A.K. Sareen, Advocate

 

QUORUM:

S.BHUPINDER SINGH, PRESIDENT

S.KANWALJEET SINGH, MEMBER

 

 ORDER

 

S.BHUPINDER SINGH, PRESIDENT

 

1.       The complainant is widow of Lt.Jivan Singh having two children i.e. girl 9 years & boy 6 years old and is consumer as per provisions of the Consumer Protection Act, 1986 (hereinafter referred as Act).  The complainant’s husband – Jivan Singh has procured life insurance plan from OP bearing policy No.21367960.  In the said policy Naranjan Singh was policy holder & Jivan Singh was insured.  On 24.10.2014, Naranjan Singh (policyholder) passed away due to heart attack and on 09.08.2015 Jivan Singh (insured) also passed due to heart attack.  After the death of Jivan Singh, complainant approached the OPs for getting the amount released as per terms and conditions of the insurance policy.  On asking of Ops, the complainant had furnished requisite documents.  But till date complainant has not got policy amount.  By not paying the insurance amount to the complainant by OPs, the OPs are deficient in providing services.  On 01.02.2016, the complainant has issued legal notice to Ops, but the OPs have failed to admit the claim of the complainant.  It is prayed that Ops be directed to pay Rs.10,50,000/- as insurance claim amount alongwith interest till date.  It is further claimed that Ops be directed to pay Rs.1,00,000/- for mental harassment alongwith Rs.22,000/- towards litigation expenses.   

2.       On notice, OPs No.1 & 3 have filed written statement stating therein that the policy was fraudulently obtained, as the insured person was not present in India at the time of signing of the proposal form which is the basis of an insurance contract.  It was submitted by someone else with the malafide intention of making wrongful gain.  The present complaint is false, malicious and incorrect and is nothing but an abuse of the process of law.  The Ops was in receipt of proposal form bearing No.205019166 dated 07.08.2014 wherein the life insured name’s was mentioned as Jiwan Singh.  In the proposal form, it was mentioned that annual premium of Rs.99,997/- was payable against a sum assured of Rs.10,50,000/-.  On the basis of information furnished by deceased life assured (hereinafter referred as DLI) the policy bearing No.21367960 was issued with effective date of risk coverage from 08.08.2014.  It is also submitted that on 11.09.2015, the OP received a Death Claim intimation from the complainant that DLI had expired on 09.08.2015 due to heart attack at Italy and the same was duly acknowledged by the OP vide condolence letter dated 12.09.2015.  As the claim being an early claim, since the DLI died in a short span of about one year from the date of issuance of policy, the OP carried out an investigation to settle the claim of the complainant.  During the investigation, some contradictory facts were revealed.  The OP after evaluating the passport of the DLI, came to know that the DLI did not use to live in India and he had visited India on dated 13.08.2014.  On 07.08.2014, the proposer has submitted proposal form duly signed by the insured.  On the date of signing the proposal form the DLI insured was not present in India.  On the basis of proposal form the said policy was issued, despite the fact that complainant was not even present in India at that time.  As such some fraud was played with OP in connivance with the financial advisor,  Mrs. Poonam in order to make wrongful gain and to cause wrongful loss to the OP.  It is submitted that the OP is initiating legal action against all the person, who were involved in this act.  A copy of the passport document showing that the DLI had visited India on 13.08.2014.  The OP repudiated the claim and intimated the same to the complainant vide letter dated 19.05.2016, however inadvertently the date of repudiation was mentioned as 22.12.2015 in the said repudiation letter.  The claim was repudiated on the ground that the said policy was obtained by fraudulent means only to make unlawful gain.  The DLI late Mr.Jivan Singh was not present in India on the date when the proposal form was filled up in his name by unknown fraudsters with the aid of the financial advisor Mrs.Poonam to intentionally deceive and to cause wrongful loss to the OP and to make unlawful gain.  The deposit balance amount of Rs.1302.45 was transferred to the account of the complainant.  Each and other averments of the complaint were empathically denied and prayed for dismissal of the complaint with costs.

3.       The OP No.2 has also filed separate written version by stating therein that there is no reciprocal agreement/arrangement between the insurer and the answering OP for any liability to be fulfilled, it is the insurance company who is liable for all the consequences after the death of Jiwan Singh. Present complaint is not maintainable against OP No.2.  Complainant is barred by her act and conduct.  On merits, it is submitted that from the perusal of the file it reveals that Naranjan Singh & Jiwan Singh have expired.  Baldev Singh & Poonam have no concern with the bank dealing but if any agent of the insurance company got any person insured, it is the insurance company who is liable for all the acts.  The answering OP is not aware, if the complainant has got any amount from the insurance company.  The insurance policy does not reveal any liability of the OP No.2.  If any amount is found to be payable, it is only Metlife Insurance Company who is liable for the same.  The complainant is not entitled to claim any amount from answering OP.  The complainant has got no cause of action against answering OP.  No notice was ever served upon the OPs.  The complaint is not within time.  This Forum has got no jurisdiction to try and decide the present complaint and prayed for dismissal of the complaint with costs.

4.       In support complaint, counsel for complainant has tendered affidavit of complainant Ex.CW1/A alongwith photocopies of documents i.e. Ex.C-1 to Ex.C-14 and closed the evidence.

5.       Learned Counsel for OP No.1 &3 has tendered affidavit of V.Prashanth Ex.OP1/A alongwith photocopies of documents i.e. Ex.OP1/1 to Ex.OP1/3 and closed the evidence.

6.       Learned counsel for OP-2 has tendered affidavit of Joginder Pal (Manager) Ex.OP2/1 and closed the evidence.

7.       We have heard the learned counsel for the contesting parties, minutely gone through the record and have appreciated the evidence produced on record by the parties with the valuable assistance of learned counsels for the contesting parties.

8.       From the averments of the parties on record i.e. pleading of the parties and evidence produced on record by both the parties.  It stands fully proved on record that Niranjan Singh father of insured Jivan Singh as proposer submitted proposal form Ex.OP1/1 with OPs.  Op No.3 issued the policy for insured Jivan Singh.  The said proposal form dated 07.08.2014 is duly signed by Niranajan Singh – proposer and Jivan Singh- insured on 07.08.2014 at Village Urapar, District SBS Nagar.  Even the declaration in the proposal form was also duly singed by Jivan Singh and Niranjan Singh on 07.08.2014 at Village Urapar, District SBS Nagar on 07.08.2014.  Ex.OP1/1 proves that this proposal form bears signatures of Jivan Singh insured as well as declaration, authorization and other relevant documents dated 07.08.2014 were also duly signed by Jivan Singh who is not in India on 07.08.2014.  On the basis of this proposal form the OP issued  PNB Met Life Insurance policy bearing No.21367960 Ex.C-4.  However, Niranjan Singh – proposer expired on 24.10.2014 and thereafter Jivan Singh insured also expired on 09.08.2015 as it was case of early death of insured – Jivan Singh i.e. within a period of about one year i.e. from the date of issuance of policy.  The OP carried out investigation to settle the claim of the complainant and the opposite party concluded that policy was obtained by proposer in-connivance with Ms.Poonam agent by playing fraud with the Insurance Company.  Perusal of passport proves that the DLI did not reside in India, he was not present in India on 07.08.2014, rather, he visited India on 13.08.2014 and this fact was not denied by the complainant.  So it stands fully proved on record that the signatures of insured Jivan Singh were forged by proposer or someone else on the directions of the proposer on the proposal form, declaration, authorization and other relevant documents and it stands fully proved on record that the proposal form, declaration, authorization and other relevant documents attached with the proposal form were not signed by insured Jivan Singh in India on 07.08.2014.  Rather, his signatures were forged on these documents by someone else and the policy in question was obtained by proposer Niranjan Singh father of insured Jivan Singh by misrepresentation and by forging documents in connivance with Ms.Poonam agent.  If any policy is obtained by concealment of facts, fraud, based on forged documents or misrepresentation, the OPs i.e. Insurance Company is justified in repudiating the claim on the basis of said policy obtained by fraud, misrepresentation, concealment of facts, etc.  Here in the present case as the policy was obtained by the proposal Niranjan Singh for insured/his son Jivan Singh on the basis of forged and fabricated documents and by way of concealment of facts, the Ops – PNB Met Life Insurance Company were justified in repudiating the claim of the complainant regarding the death claim of the insured Jivan Singh vide letter dated 19.05.2016.

9.       Consequently, we hold that the present complaint is without merit and the same is hereby dismissed with no order as to costs.

10.       Certified copies of this order be supplied to the parties, as per rules. File be indexed and consigned to the Record Room.

Dated:  23.09.2016

                                                          (BHUPINDER SINGH)

                                                          President

         

 

                                                          (KANWALJEET SINGH)

                                                          Member