Reserved
State Consumer Disputes Redressal Commission
U.P. Lucknow.
Appeal No.1197 of 2018
Bajaj Allianz Life Insurance Company Ltd.,
4th Floor, Habibullah Estate, Hazratganj, Lucknow
through Zonal Manager, Legal. …Appellant.
Rajesh Kumar s/o Late Lekhram,
R/o Bangarh, Post, Bartal Korauna,
Tehsil, Misharik, District, Sitapur. …Respondent.
Present:-
1- Hon’ble Sri Rajendra Singh, Presiding Member.
2- Hon’ble Sri Sushil Kumar, Member.
Sri Vijay Kumar, Advocate for appellants.
Ms. Rubi Singh, Advocate for respondent.
Date 6.6.2023
JUDGMENT
Per Mr. Rajendra Singh, Member: This appeal has been preferred against judgment and order dated 3.5.2018 passed by the District Forum, Sitpur in complaint case no.27 of 2016.
The brief facts of the appeal are that, that the respondent’s father Sri Lekhram has initially given and submitted the appellant Bajaj Allianz Life Insurance Company Ltd. an insurance proposal form dated 10.3.2014 duly filled up and duly signed by him and made a declaration therein that he has read the proposal form or the same was explained to him and the answers entered in such proposal form are his answers which are fully true and complete and had authorized the appellant insurance company to act on the said entries and for issuance of the policy of the insurance. Insurance policy was issued to the policy holder. It shall be presumed that the policy holder filled the proposal form with current information.
The policy holder late Lekhram paid only one premium of Rs.18,460.00. The insured died on 15.6.2014 by heart attack. After receiving the claim the appellant started investigation due to early claim as per norms of IRDA. The claim was repudiated as various investigations confirmed that the deceased life assured has submitted fake age proof at issuance stage resulting into fraud. The investigator found that life assured was 90 years old the time of death and the policy was procured on manipulated documents. As per received ration card verified by Gram Panchayat Adhikari, life assured was 90 years old and his wife was 80 years old. The year of birth of life assured in Pariwar Register has been manipulated to 1960 whereas the date of birth of the wife of the life assured as 1926.
After repudiation of the claim, the complainant filed a complaint before the ld. District Forum, Sitapur who allowed the complaint in a arbitrary manner. The impugned judgment and order is against the record and is erroneous.
The ld. District Forum passed the following order:
“परिवादी राजेश कुमार का उपभोक्ता परिवाद विरूध् विपक्षीगण बीमा कम्पनी बजाज एलियान्ज लाइफ इंश्योरेन्स कम्पनी लि0 इस आशय से स्वीकार किया जाता है कि बीमित राशि रू05,65,800/- (रू0 पांच लाख पैंसठ हजार आठ सौ) दिनांक 14.2.2015 से 9 प्रतिशत वार्षिक चक्रवृधि ब्याज सहित, क्षतिपूर्ति राशि रू025,000/- (रू0 पचीस हजार) एंव वाद व्यय राशि रू05,000/- (रू0 पांच हजार) एक माह की अवधि में अदा की जाये अन्यथा क्षतिपूर्ति राशि रू025,000/- (रू0 पचीस हजार) एंव वाद व्यय राशि रू05,000/- (रू0 पांच हजार) पर आदेश की तिथि से 9 प्रतिशत वार्षिक ब्याज देया होगा।
विपक्षीगण द्वारा समय सीमा एक माह की अवधि में आदेश का अनुपालन न किये जाने पर परिवादी को उक्त आदेश का अनुपालन इस जिला उपभोक्ता फोरम के माध्यम से कराने का अधिकार होगा।
नियमानुसार कार्यालय द्वारा निर्णय एंव आदेश की प्रमाणित प्रति नि:शुल्क पक्षकार को अविलम्ब प्राप्त कराई जाये यदि 15 दिन की अवधि में पक्षकार द्वारा प्रमाणित प्रति प्राप्त नहीं की जाती है तो पंजीकृत डाक के माध्यम से भेजी जाये।”
On account of early death, the appellant started investigation and found that the deceased had submitted fake age proof at the issuance stage resulting into fraud. The appellant appeared before the ld. District Forum and submitted its written statement. The ld. District Forum has erred in law as well as in facts in passed the impugned order. It is submitted that the ld. District Forum has given his finding on the issue of concealment of age in its impugned judgment and order dated 3.5.2018 which is as follow:
“विपक्षी की ओर से ऐसा कोई अभिलेख दाखिल नहीं किया गया है जिसके आधार पर यह माना जा सके कि मृतक बीमित लेखराम की आयु बीमा कराते समय 90 वर्ष रही हो वैसे भी बीमा करते समय बीमा कम्पनी के प्रतिनिधि/अधिकारी/कर्मचारी द्वारा बीमित लेखराम को आवश्य देखा गया होगा, प्रपत्रों पर हस्ताक्षर कराये गये होगें 54 वर्ष 90 वर्ष की आयु का व्यक्ति देखने से स्पष्ट प्रतीत होता है कि व्यक्ति की उम्र 90 वर्ष है या 54 वर्ष 1-2 साल का अन्तर सम्भव हो सकता है। ऐसी स्थिति में विपक्षी द्वारा कहा जाना कि बीमा पालिसी लेते समय लेखराम की आयु 90 वर्ष थी किसी भी स्थिति में मानने योग्य नहीं है बल्कि परिवादी की ओर से बीमित लेखराम की आयु के सम्बन्ध में लोक अभिलेख आयकर विभाग का पेन कार्ड दाखिल किया गया है तथा परिवार रजिस्टर की प्रति विपक्षीगण द्वारा भी दाखिल की गयी है जिसमें लेखराम की उम्र पेन कार्ड में 01.01.1960 अंकित है, परिवार रजिस्टर में उम्र 1960 इसमें साफ स्पष्ट है कि लेखराम की जन्मतिथि 01.01.1960 थी। विपक्षी यह सिद्ध करने में भी पूर्ण रूपेण असफल रहा है कि बीमा पालिसी लेते समय बीमित लेखराम द्वारा किसी तथ्य को छिपाया गया हो तथा गम्भीर बीमारी से पीडित रहा हो। इस सम्बन्ध में चिकित्सा से सम्बन्धित कागजात पत्रावली पर विपक्षी द्वारा दाखिल नहीं किये गये हैं। विपक्षी पक्ष यह सिद्ध करने में असफल रहा है कि बीमित लेखराम बीमा पालिसी लेने के समय गम्भीर बीमारी दमा से पीडित रहा हो तथा उम्र-90 वर्ष रही हो बल्कि यही तथ्य मानने योग्य है बीमित लेखराम ने बीमा पालिसी लेते समय किसी तथ्य को नहीं छिपाया गया था।”
The life assured’s date of birth is 1.1.1960 and Pan Card was submitted as age proof document which was issued on 25.2.2014. The Panchayat Head’s certificate of life assured was more than 90 years and as per ration card life assured was 96 years and his wife’s age was 80 years. The year of birth of life assured in Pariwar Register has been manipulated in 1960 where as the date of birth of wife of life assured as 1926.
Dr. Naresh who was family doctor of life assured has verified the life assured’s age as 90 years. The ld. Forum, Sitapur has observed that the appellant has failed to produce Dr. Naresh as witness and on the basis of it the ld. Forum did not give emphasis on the certificate issued by Dr. Naresh. The judgment is liable to be set aside because it did not consider the documents on record.
Heard ld. counsel for the appellant Sri Vijay Kumar and ld. counsel for the respondent Ms. Rubi Singh. We have perused the pleadings, evidence and documents on record.
We have perused the impugned judgment and order. There are so many differences in the Pariwar Register, Ration Card etc. but the ld. District Forum has categorically discussed all these matters. The copy of Pariwar Register filed by the opposite party in which the date of birth of Lekhram has been mentioned as 1.1.1960. As per Pan Card the date of birth of Lekhram has been mentioned as 1.1.1960. The Pan Card is admissible in evidence as per Evidence Act. Therefore, the ld. District Forum relied upon the PAN Card regarding date of birth of the assured person. Therefore, there is no illegality in the impugned order. Hence, the appeal is liable to dismissed.
ORDER
The appeal is dismissed.
If any amount is deposited by the appellant at the time of filing of this appeal under section 15 of the Consumer Protection Act, 1986, may be remitted to the concerned District Consumer Commission for satisfying the decree as per rules alongwith accrued interest upto date.
The stenographer is requested to upload this order on the Website of this Commission today itself.
Certified copy of this judgment be provided to the parties as per rules.
(Sushil Kumar) (Rajendra Singh)
Member Presiding Member
Judgment dated/typed signed by us and pronounced in the open court.
Consign to record.
(Sushil Kumar) (Rajendra Singh)
Member Presiding Member
Dated 6.6.2023
Jafri, PA I
Court 2
