THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, AMRITSAR
Consumer Complaint No. 443 of 2014
Date of Institution : 14.08.2014
Date of Decision : 25.08.2015
Savinder Singh S/o Piara Singh
Roshan Singh
Harpreet Singh @ Pritam Singh
Rashpal Singh @ Tikka
Kuldeep Singh @ Bitta All Ss/o Savinder Singh R/o VPO Attari, Tehsil & District Amritsar
Manjit Kaur D/o Savinder Singh W/o Daljit Singh R/o Majitha Road, Amritsar
...Complainants
Vs.
Punjab National Bank, Branch : VPO Attari, Tehsil and District Amritsar through its Manager
Met Life India Insurance Co.Ltd., 2680 Sq.Ft Carpet, SCO 35, Third Floor, Ranjit Avenue,Amritsar through its Manager
Met Life India Insurance Co.Ltd., Brigade Seshamahal, 5, Vani Vilas Road,
Basavanagudi, Banglore 560004 through its Manager
-2-
....Opp.parties
Complaint under section 12/13 of the Consumer Protection Act, 1986
Present : For the complainants : Sh.G.S. SandhuAdvocate
For the opposite party No.1 : Sh. A.K.Sharma,Advocate
For opposite parties No. 2 & 3: Sh. Danish Bansal,Advocate
Quorum : Sh. Bhupinder Singh, President ,Ms. Kulwant Bajwa,Member &
Sh.Anoop Sharma,Member
Order dictated by :-
Bhupinder Singh, President
1 Present complaint has been filed by S/Sh. Savinder Singh, Roshan Singh, Harpreet Singh, Rashpal Singh, Kuldeep Singh and Mrs. Manjit Kaur under the provisions of the Consumer Protection Act alleging therein that Savinder Singh husband of Kulwinder Kaur obtained Insurance policy bearing No. 20932542 in the name of his wife Kulwinder Kaur with sum assured Rs. 8,10,144/- .Kulwinder Kaur died on 6.3.2013 due to heart attack leaving behind complainants as legal heirs. Thereafter complainants approached the opposite parties and informed about the death of Kulwinder Kaur. Opposite party No.1 supplied a letter dated 24.5.2013 issued by PNB Metlife for compliance of some formalities which the complainants complied with. Thereafter complainants approached the opposite parties numbers of times for release of claim amount but to no avail. Complainants again approached the opposite party No.1 and requested them to release the death claim of Kulwinder Kaur, but opposite party No.1 vide letter dated 19.7.2013 treated the claim of the complainants as void abinitio due to wrong disclosure of age of Kulwinderr Kaur. Savinder Singh has alleged that his wife Kulwinder Kaur disclosed her age as 52 years to the agent of opposite party No.2, but due to mistake of opposite parties No.1 & 2 , the age of Kulwinder Singh has been mentioned as 42 years in the proposal form . Complainants have alleged that they should not be suffered due to the mistake of opposite parties No.1 & 2 by mentioning the wrong age of Kulwinder Kaur as 43 years in the proposal form . Alleging the same to be deficiency in service complaint was filed seeking directions to the opposite parties to release the death claim of Rs. 8,10,144/- alongwith interest @ 18% p.a . Compensation of Rs. 30000/- alongwith litigation expenses were also demanded.
2. On notice,opposite party No.1 appeared and filed written version in which it was submitted that opposite party has no privity of contract of Insurance policy between Kulwinder Kaur and opposite parties No.2 to 4 as they have not issued any Insurance policy nor in any way concerned with the said Insurance policy. While denying and controverting other allegations, dismissal of complaint was prayed.
3. Opposite parties No. 2&3 in its written version have submitted that Smt.Kulwinder Kaur deceased life assured after completely understanding the terms and conditions of the policy namely Met Monthly Income Plan had submitted the proposal form bearing No. 200951130 on 3.10.2012 and offered to pay Rs. 99,999/- towards the annual premium against sum assured Rs. 8,10,144/-. The complainant No.1 was nominated as the beneficiary under the said proposal form. The contents of the proposal form were explained to the complainant , wherein the complainant has also given a declaration stating that the contents of the application were read over and explained to her and she has furnished the information after fully understanding the contents thereof. It was submitted that on the basis of information furnished by DLA Kulwinder Kaur policy bearing No. 20932542 was issued to DLA Kulwinder Kaur. It was further submitted that DLA has just paid one premium. Thereafter opposite party received the death claim intimation on 23.5.2013 alongwith death claim statement that the person insured died on 6.3.2013 due to heart attack. Therefore, being an early claim, the claim was investigated and assessed by the opposite party. During the course of investigation, it was revealed that DLA has not declared correct information in the application form dated 3.10.2012. It was observed that as per Voter ID card issued in the year 2006 person insured was 47 years old , however in the application form the age mentioned was 42 years and 45 years. On the ration card the DLA & nominee mentioned their age 61 & 66 years old respectively. As such the claim lodged by the complainants was repudiated on 19.7.2013 for reason of mis-representation while applying for the policy and the complainants were informed about the repudiation of the claim vide letter dated 19.7.2013. While denying and controverting other allegations, dismissal of complaint was prayed.
4. Complainant No.1 tendered into evidence his affidavit Ex.C-1 alongwith documents Ex.C-2 to Ex.C-7.
5. Opposite party No.1 tendered affidavit of Sh. Sanjiv Kumar,Sr.Manager Ex.OP1/1.
6. Opposite parties No.2 & 3 tendered affidavit of Sh.M.Udaiyakumar Jain, Manager Legal Ex.OP2,3/1 alongwith documents Ex.OP2,3/2 to Ex.OP2,3/24.
7. We have carefully gone through the pleadings of the parties, arguments advanced by the ld.counsel for the parties and have appreciated the evidence produced on record by both the parties with the valuable assistance of the ld.counsel for the parties.
8. From the record i.e. pleadings of the parties and the evidence produced on record by both the parties , it is clear that Savinder Singh husband of Kulwinder Singh obtained Insurance policy bearing No. 20932542 Ex.C-2 in the name of his wife Kulwinder Kaur with sum assured Rs. 8,10,144/- for the period from 4.10.2012 to 4.10.2027. Kulwinder Kaur died on 6.3.2013 due to heart attack as per certificate of Sukhbir Hospital and Nursing Home Ex.C-5. Her death certificate is Ex.C-4. Claim was lodged with the opposite parties No.2 & 3 , who demanded certain documents from the complainant vide letter dated 24.5.2013 Ex.C-3 and the complainant complied with the formalities of this letter. However, opposite party No.1 repudiated the claim of the complainant vide letter dated 19.7.2013 Ex. C-6 rather they stated that due to non disclosure of material facts, opposite parties have treated the said policy as void abinitio. Ld.counsel for the complainant submitted that as per this letter Ex.C-6, opposite party has stated that deceased life assured (hereinafter to be called DLA) has understated her age as 43 years in the proposal/application form Ex.OP2,3/2. Whereas opposite parties observed that late Kulwinder Kaur was 61 years old, as is evident from her copy of ration card Ex.OP2,3/22. Counsel for the complainant submitted that the complainant is totally an illiterate . Late Kulwinder Kaur was also illiterate and the date of birth has been written by the agent of the opposite parties on the application/proposal form . As per the terms and conditions of the policy Ex.C-7 clause 6.7.1, if the actual age proves to be higher than what is stated in the application, the basic sum assured would be adjusted to that which would have been purchased by the amount of premium paid had the age been correctly stated . So opposite party was not justified in totally repudiating the claim of the complainant and treating the policy of the complainant as void . Rather they could adjust the basic sum assured to that which would have been purchased by the amount of premium paid, had the age been correctly stated as per clause 6.7.1 of the policy Ex.C-7. He submitted that all this amounts to deficiency of service on the part of the opposite parties qua the complainant.
9. Whereas the case of opposite party No.1 is that opposite party has no privity of contract of Insurance policy between Kulwinder Kaur and opposite parties No.2 & 3. Opposite party No.1 has not issued any Insurance policy nor in any way concerned with the said Insurance policy. As such ld. Counsel for the opposite party No.1 submitted that there is no deficiency of service on the part of opposite party No.1 qua the complainant.
10. Whereas case of opposite parties No.2 & 3 is that DLA Kulwinder Kaur has obtained Met Monthly Income Plan and for that purpose ,she filled in and signed the proposal form Ex. OP2,3/2 and paid premium of Rs. 99,999/- on 3.10.2012 against sum assured Rs. 8,10,144/-. Complainant Savinder Singh husband of DLA Kulwinder Kaur nominated as beneficiary/nominee in the said proposal form. On the basis of the proposal form, opposite party issued policy bearing No. 20932542 to DLA Kulwinder Kaur. DLA has just paid one premium. Opposite parties No.2 & 3 received death claim intimation on 23.5.2013 alongwith death claim settlement stating that the person insured died on 6.3.2013 due to heart attack. Claim was investigated and assessed by the opposite parties as the claim was an early claim. During the course of investigation, it was revealed that DLA has not declared correct information in the application form dated 3.10.2012 Ex.OP2,3/2. It was observed that as per voter ID card issued in the year 2006, the person insured was stated to be 47 years old, whereas in the application form the age mentioned was 42 years and 45 years. On the ration card Ex.OP2,3/22 , the age of person insured is mentioned as 61 years. The age of DLA was understated at the time of taking the policy. Therefore, claim made by the complainant was repudiated on 19.7.2013 by the opposite party Ex.OP2,3/24 for reasons of mis-representation while applying for the policy and the opposite parties treated the said policy as void. Ld. Counsel for the opposite parties No.2 &3 submitted that there is no deficiency of service on the part of opposite parties qua the complainant.
11. From the entire above discussion, we have come to the conclusion that complainant Savinder Singh, husband of DLA Kulwinder Kaur , being proposer has obtained Insurance policy bearing No. 20932542 in the name of his wife Kulwinder Kaur, on payment of premium of Rs. 99,999/- with sum assured Rs. 8,10,144/- and filled in the proposal form Ex.OP2,3/2 dated 3.10.2012. On this proposal form, proposer Savinder Singh has thumb marked wherever the column of signatures of the proposer appears. All this shows that proposer Savinder Singh was totally illiterate. Kulwinder Kaur insured has also signed this document at different places but her signatures in Punjabi are totally of illiterate or poorly literate lady. So it stands fully proved on record that proposal form Ex.OP2,3/2 was filled in English by the agent of opposite parties No.2 & 3 and not by the proposer or the insured. Rather the signatures of Kulwinder Kaur appearing at different places i.e. on pages 2,6,7,8 and 9 of proposal form Ex.OP2,3/2 are all different not matching with each other. All this also proves that Kulwinder Kaur was also either totally illiterate or very poorly literate lady. The agent of the opposite parties has mentioned her qualification in the proposal form as +2 pass, then why the agent of the opposite parties at the time of filling in the proposal form Ex.OP2,3/2 did not ask for exact birth proof of the insured i.e. either the birth certificate or school certificate in the form of matriculate certificate, middle class certificate, primary class certificate or school leaving certificate. The proof of age of DLA Kulwinder Kaur taken by opposite parties No.2 & 3 from the insured/proposer at the time of filling in this proposal form Ex.OP2,3/2 is mentioned as Annexure B. But no such Annexure B has been produced by the opposite parties in this Forum. So all this shows that the age of insured was written by the agent of the Insurance company i.e. opposite parties No.2 & 3 from Annexure B which has been intentionally with-held by the opposite parties No.2 & 3. Insured DLA Kulwinder Kaur expired on 6.3.2013 and complainant No.1 Savinder Singh being nominee under the policy and husband of Kulwinder Kaur DLA, lodged claim with opposite parties No.2 & 3 regarding the death of Kulwinder Kaur, DLA. But opposite parties No.2 & 3 repudiated the claim vide letter dated 19.7.2013 Ex.C-6 on the ground that during the course of assessing the claim, they have observed that late Mrs. Kulwinder Kaur was 61 years as per ration card, copy of which is Ex.OP2,3/22. We have gone through the ration card. The ration card is not the conclusive proof of the age of the person. Generally this is written by the person, who filled in the application form for ration card. Moreover, no specific certificate is required for determining the age of the member while issuing ration card. It is generally written to determine the approximate age of the member for the distribution of the ration. Ration card is generally meant for distribution of ration and not meant for the exact proof of age of the member. Not only this the opposite party has also produced on record the copy of the voter card of DLA Kulwinder kaur Ex.OP2,3/4 which states that the age of Kulwinder Kaur on 1.1.2006 was 47 years and the policy in question Ex.C-2 is dated 4.10.2012 which means the age of DLA Kulwinder Kaur at the time of taking the policy on 4.10.2012 was about 53 years and not 61 years as mentioned by the opposite party on the basis of ration card. So from the document produced on record by the opposite parties No.2 & 3 itself i.e.voter card, it is clear that the age of DLA Kulwinder Kaur at the time of taking the policy was 53 years and not the age mentioned by the agent of opposite parties No.2 & 3 in the proposal form Ex.OP2,3/2. In such eventuality , opposite parties No.2 & 3 were not justified in repudiating the claim of the complainant regarding death of DLA Kulwinder Kaur. It has been held by the Hon'ble National Commission in case Anand Kumar Kejariwal Vs. LIC of India & Anrs. 2011(2) CPJ 249 (NC) that where wrong age has been claimed by the insured, opposite party was not justified in repudiating the claim of the complainant. The matter can be resolved by taking a higher premium as penalty from the insuree as there was no willful suppression of information by the insuree and insurance form had infact been filled up by the agent. Apart from this as per the terms and conditions of the policy in question Ex.C-2 clause 6.7.1 if the actual age proves to be higher than what is stated in the application, the basic sum assured would be adjusted to that which would have been purchased by the amount of premium paid, had the age been correctly stated. In the present case the actual age of the DLA is determined as 53 years as per document produced by opposite parties No.2 & 3 itself i.e. voter card of DLA Kulwinder Kaur Ex.OP2,3/4. So opposite parties No.2 & 3 were not justified in repudiating the claim of the complainant. However, they are liable to decide the claim case of the complainants as per clause 6.7.1 of the terms and conditions of the policy Ex.C-2.
12. Resultantly this complaint is partly allowed with costs and opposite parties No.2 & 3 are directed to settle and pay the claim to the complainant regarding the death of DLA Kulwinder Kaur as per clause 6.7.1 of the terms and conditions of the policy by taking the age of DLA Kulwinder Kaur as 53 years , within one month from the date of receipt of copy of this order. Opposite parties No.2 & 3 are also directed to pay litigation expenses Rs. 2000/- to the complainant. Copies of the order be furnished to the parties free of costs. File is ordered to be consigned to the record room. Case could not be disposed of within the stipulated period due to heavy pendency of the cases in this Forum.
25.08.2015 ( Bhupinder Singh )
President
( Kulwant Kaur Bajwa) (Anoop Sharma)
/R/ Member Member
