Haryana

Bhiwani

CC/30/2017

Anil Kumar - Complainant(s)

Versus

Rakesh - Opp.Party(s)

Neearaj kumar

30 Jul 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, BHIWANI.

 

                                                                  Consumer Complaint No. : 30 of 2017

                                                      Date of Institution             : 08.02.2017

                                                                  Date of order                     : 30.07.2024

 

Anil Kumar son of Sh. Prithvi Singh son of Sh. Ram Dutt, R/o village Dinod, Tehsil and District Bhiwani.

  

             ……Complainant.

 

Versus

 

1.         Mr. Rakesh Kawatra, Customer Manager, TATA AIA LIC Ltd. Plot No.2325, Red Square Market, Hisar-125001.

 

2.         TATA AIA Life Insurance Company Ltd., one of its branch situated at 1^st Floor, M.K. Plaza, Near K.M. Public School, Hansi Gate, Bhiwani, Tehsil and District Bhiwani, through its authorized signatory.

…… Opposite Parties.

 

COMPLAINT U/S 12 OF CONSUMER PROECTION ACT, 1986.

 

BEFORE:          Mrs. Saroj Bala Bohra, Presiding Member.

  Ms. Shashi Kiran Panwar, Member.

 

Present:-         Sh. Neeraj Kumar, Advocate for complainant.

Sh. Rajesh Soni, Advocate for OP No.2.

OP No.1 exparte.

 

ORDER:

 

Saroj Bala Bohra, Presiding Member.

 

1.                     Brief facts of this case are that father of complainant Sh. Prithvi Singh son of Late Sh. Ram Dutt purchased two life insurance policies viz. No.C170070122 for Rs.1,00,000/- on 30.07.2007 & No.U016914672 for Rs.6,00,000/- on 21.03.2011 from OP No.1 through agent Santosh Rathi. In the said policies, complainant is nominee and date of birth of insured person was 18.06.1957.  The life assured died on 04.08.2012, so complainant being nominee lodged claim with OP No.1 who assured that benefit under the policies will be released very soon. Vide letters dated 30.11.2012 and 14.12.2012, OP No.2 sought some documents from complainant which were submitted to the OPs. However, the OPs vide letter dated 05.12.2013 repudiated the claim of complainant.  So, legal notice was served upon the OPs but of no avail. Hence, the present complaint has been preferred seeking directions to the OPs to settle both the claim case of complainant and release the amount thereof alongwith interest @18% per annum. Also to pay Rs.1.00 lacs as compensation for harassment besides Rs.11,000/- as litigation expenses.  Any other relief which this Commission deems fit has also been sought.

2.                     OP No.2 appeared through counsel and filed written statement raising preliminary objections qua maintainability, time barred, cause of action and concealment of true facts. On merits, it is admitted that the alleged policies were issued to the life assured subject to certain terms & conditions.  It has urged that even if the proposal form was filled by the agent, it was the duty of the insured to provide correct and true facts.  It is submitted that death claims under both the policies were repudiated vide separate letters dated 05.02.2013 on the grounds of concealment of true age at the time of proposal. The life assured had breached the principle of utmost good faith by supplying the forged school leaving certificate in support of his age proof and the factum of the same came into the knowledge of OP company after conducting necessary investigation into the death claim. As such, denied for any deficiency in service on their part. In the end, prayer has been made for dismissal of the complaint with heavy costs.

3.                     OP No.1 did not respond to the notice issued by the Commission, as such, it was proceeded against exparte vide order dated 08.06.2017.

4.                     In evidence of complainant, documents Annexure C-1 to Annexure C-19 have been filed and closed the evidence on 19.04.2019.

5.                     On the other hand, in evidence of OP No.2, affidavit Ex.RW1/A alongwith documents Annexure R-1 to Annexure R-11 have been filed and closed the evidence on 09.04.2021.

6.                     We have heard learned counsel for the contesting parties and perused the record minutely. Written arguments on behalf of Ops filed. In support of his case, learned counsel for OP has placed reliance on case law delivered by Hon’ble Supreme Court of India, Civil Appeal No.8983 of 2010 titled Dr. V.N. Shrikhande Vs.Mrs. Anita Sena Fernandes decided on 20.10.2010. Further, relied upon case laws delivered by Hon’ble State Consumer Disputes Redressal Commission Haryana, Panchkula in case titled Reliance Life Insurance Co. Ltd. Vs. Mukesh Kumar FA No.180 of 2018 decided on 15.03.2019 and case titled Liladhar Soni Vs. HDFC Standard Life Insurance Company Ltd. FA No.546 of 2018 decided on 13.05.2022.

7.                     From the record, it has come out that claims of two insurance policies have been denied by OP insurance company to the complainant. The first policy is having number C170070122  and ground for repudiation to this policy vide letter dated 05.02.2013 (Annexure R-10) was that the said policy was issued on the life of Prithvi Singh on the application for insurance signed by him on 30.07.2007. However, our investigation has established that the age proof document (School Certificate) submitted by life assured at the time of application stage was a fake document and made with intent to defraud the company.  Insured’s correct age was beyond insurable age for the product. Had the correct age been declared, the above policy would not have been issued.

                        The second is having number U016914872 and ground for repudiation to this policy vide letter dated 05.02.2013 (Annexure R-10 Pg.2) was that the said policy was issued on the life of Prithvi Singh on the application for insurance signed by him on 21.03.2011. However, our investigation has established that the age proof document (School Certificate) submitted by life assured at the time of application stage was a fake document and made with intent to defraud the company.  Insured’s correct age was beyond insurable age for the product. Had the correct age been declared, the above policy would not have been issued.

8.                     From proposal form Annexures C-2 & C-3), it is evident that date of birth of life assured has been mentioned as 18.06.1957. As per School Transfer Certificate (Annexure C-19), the date of birth has been mentioned as 18.06.1957. Further as per document Proof of Identity issued by a govt. authority, also depicts date of birth of life assured Prithvi Singh as 18.06.1957.  On the other hand, OP insurance company to rebut the said date of birth has placed on record the school transfer certificate (Annexure R-8, also Annexure C-19 on case file) from OP side having an endorsement of on it that the transfer certificate is not of their school since their school is recognized since1989 and is upto 8^th standard. But the said endorsement is not believable until and unless the scriber of the same does not step into witness box before the Commission nor affidavit of such person has been placed on record. As such, the document is not justifiable in the eyes of law. It is also pertinent to mention here that Prithvi Singh deceased life assured was in govt. service and as per Pension Payment Order (Annexure C-18) was taking service pension and thus on this score also it cannot be denied that there was suppression in the date of birth of life assured.  It is worthwhile to mention here that it was incumbent upon the OP insurance company to know about the date of birth of life assured prior to issuing of the policy.

9.                     In view of the above discussion, we do not see any discrepancy in the date of birth of deceased life assured Prithvi Singh.  Thus it is concluded that the OP insurance company has wrongly and illegally repudiated the claim of complainant being nominee of the life assured in the said insurance policies.  From the insurance premium receipts placed on record from complainant side, it is clear that the insurance policy were having sum assured Rs.1,00,000/- and Rs.6,00,000/- respectively. Therefore, we are of considered opinion that the complainant is entitled for the said amount and benefits thereof alongwith compensation for harassment.  As such, the complaint is allowed and OP No.2 insurance company is directed to comply with the following directions within 40 days from the date of order:-

(i)        To pay a sum of Rs.1,00,000/- (Rs. one lac) sum assured under policy No.C170070122 and Rs.6,00,000/- (Rs. six lacs) sum assured under policy No.U016914672 to the complainant being nominee in both the insurance policies alongwith simple interest @ 9% per annum from the date of filing of complaint till the actual realization.

(ii)       To pay Rs.20,000/- (Rs. Twenty thousand) as compensation for harassment. 

3. To pay Rs.11,000/- (Rs. Eleven thousand) as litigation expenses.

                        In case of default, all the awarded amounts shall attract simple interest @ 12% per annum for the period of default.  If this order is not complied with, then the complainant shall be entitled to the execution petition under section 71 of Consumer Protection Act, 2019 and in that eventuality, the opposite party no.2 may also be liable for prosecution under Section 72 of the said Act which envisages punishment of imprisonment, which may extend to three years or fine upto rupees one lac or with both.  Copies of this order be sent to the parties concerned, free of costs.  File be consigned to the record room after due compliance. 

 Announced.

Dated:30.07.2024.