BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, AMRITSAR.
Consumer Complaint No. 31 of 2014
Date of Institution: 25.1.2014
Date of Decision: 04.07.2016
Harjeet Singh S/o Late Sh. Harnam Singh aged 30 years, resident of H.No. 102, Village Bhosrshi Rajputan, Tehsil Baba Bakala District Amritsar
Complainant
Versus
- Reliance Life Insurance Company Limited, Branch Office Rayya , Near Mattewal Collection, Amritsar through its Branch Manager
- Reliance Life Insurance Company Limited, Registered office “H” Block, Dhirubhai Ambani Knowledge City, Navi Mumbai, Maharashtra
Opposite Parties
Complaint under section 12 and 13 of the Consumer Protection Act, 1986 as amended upto date.
Present: For the Complainant: Sh.S.S.Jammu,Advocate
For Opposite PartyNo.1&2 : Sh.Vikas Mahajan ,Advocate
& Sh. Amit Bhatia,Advocate
Coram
Sh.S.S.Panesar, President
Ms.Kulwant Kaur Bajwa, Member
Mr.Anoop Sharma, Member
Order dictated by:
Sh.S.S. Panesar, President.
1. Harjeet Singh has brought the instant complaint under section 12 & 13 of the Consumer Protection Act, 1986 on the allegations that father of the complainant Sh. Harnam Singh had obtained a Life Insurance Policy from the opposite party on 21.2.2011 bearing policy No. 19605541 for a sum assured of Rs. 3 lacs. Harnam Singh died in his sleep on 13.2.2013. The complainant being nominee in the abovesaid policy approached the opposite party for the death claim and submitted all the required documents as called by the opposite party for payment of the death claim . In the month of September 2013, complainant came to know from letter dated 21.8.2013 of opposite party vide which the opposite party has repudiated the death claim in the abovestated policy on frivolous grounds. Opposite party alleged in the abovesaid letter dated 21.8.2013 that the father of the complainant had understated his age at the time of making the proposal and misled the opposite party. As per their investigation, opposite parties have irrefutable evidence that Harnam Singh was of 81 years of age at the time of making proposal, as such the contract is void abinitio and they have ceased all the claim benefits. The contention of the opposite party is false, frivolous because at the time of obtaining the insurance, father of the complainant has submitted his PAN Card No. DVVPS3428D with date of birth being 12.4.1954 , as such at the time of obtaining the insurance, Harnam Singh was of the age of 56 years 10 months and 9 days which was duly admitted by the opposite party. The opposite party illegally and unlawfully without any cause and reason , has not paid the death claim amount of Rs. 3 lacs and has been wrongly retaining the same by repudiating the genuine claim of the claimant under the Insurance policy in dispute. The complainant has sought grant of Rs. 3 lacs on account of death claim besides compensation of Rs. 50000/- alongwith interest from the date of the complaint uptil date of payment alongwith cost of the complaint. Hence, this complaint.
2. Upon notice, opposite parties appeared and contested the claim by filing written version taking certain preliminary objections therein inter alia that the complaint as framed is not maintainable. The complainant is not covered under the definition of consumer as defined in the amended provisions of the Consumer Protection Act ; that at the very outset , opposite parties denies the contentions , averments made by the complainant as the same are baseless and without any merit. The complainant may be put to strict proof of the same and submitted that the complaint deserves to be dismissed ; that complainant has not approached this Forum with clean hands and hence he is guilty of suppression of material facts from the knowledge of this Forum with ulterior and malafide object and intention to mislead and misrepresent before the District Forum. At the time of obtaining the policy , deceased Harnam Singh has concealed the true facts from the opposite party. Harnam Singh has not stated his true age at the time of making payment , which was very much material for issuance of the policy. Harnam Singh has misled the opposite party at the time of taking the policy and he has provided false and inaccurate information, hence, the contract of insurance is void and abinitio. The complaint under reply as such deserves dismissal on this ground alone ; that the complainant is estopped by his own act and conduct from filing the present complaint ; that the present complaint is false, frivolous, vexatious and malafide and hence unsustainable under the provisions of the Consumer Protection Act . Therefore, the complaint is liable to be dismissed under section 26 of the Act ; that the complaint is bad for mis-joinder and non-joinder of parties ; that opposite parties seek protection under section 45 & 64 VB of the Insurance Act and reserves its right to file any other additional facts or submissions as may be warranted in future ; that the complainant has not approached this Forum with clean hands . On merits facts narrated in the complaint have been specifically denied and a prayer for dismissal of the complaint with cost was made.
3. In his bid to prove the case Sh.S.S.Jammu,Adv.counsel for the complainant tendered into evidence affidavit of the complainant Ex.C-1, copy of policy schedule Ex.C-2, copy of driving licence Ex.C-3, copy of PAN card Ex.C-4, copy of letter dated 21.8.2013 Ex.C-5 and closed the evidence on behalf of the complainant.
4. To rebut the aforesaid evidence Sh.Amit Bhatia,Adv.counsel for the opposite parties tendered into evidence letter dated 21.8.2013 Ex.OP1, investigation report Ex.OP2, attested copy of voter list Ex.OP2/A, affidavit of Savit Chawla Ex.OP3, copy of death certificate Ex.OP4, copy of driving license of deceased Ex.OP5, copy of premium receipt Ex.OP6 and closed the evidence on behalf of the opposite parties.
5. All the parties submitted written synopsis of arguments . We have carefully gone through the evidence on record as well as written synopsis submitted by the parties to the complaint . We have also heard oral submissions made by the counsel for the parties.
6. Ld.counsel for the opposite parties have vehemently contended that the present complaint is liable to be dismissed on following grounds:-
- That the complainant has not approached this Forum with clean hands and hence , he is guilty of suppressing and concealing the real facts from this Forum.
- At the time of obtaining the policy, deceased Harnam Singh has concealed his true age which was very material for the issuance of the policy . At the time of obtaining the policy, the father of the complainant has given his driving license to the opposite party for the purpose of his age proof, but during the investigation of the claim, it was found by the investigator that the driving license of the deceased is forged one and in this regard, the opposite party has adduced his evidence by calling the clerk/Steno of DTO office namely Pawan Kumar, who has made a statement on oath to the effect that driving license of the deceased was not genuine one. During the investigation of the case, the investigator had found the age of the deceased Harnam Singh was approximately 81 years. To prove this fact the investigator has taken the voter list , copy whereof is Ex.OP2/A from which it is clearly confirmed that the age of Harnam Singh was 81 years at the time of his death.
7. On the basis of abovestated facts, ld.counsel for the opposite parties have vehemently contended that it is crystal clear that deceased has misled the opposite party by giving fake age proof at the time of getting the Insurance policy issued. The contract of insurance is based the principal of utmost good faith and deceased life assured was duty bound to correctly and diligently disclose all the facts within his knowledge in response to various queries made in the proposal form without with-holding any information. But in the present case, non- disclosure of correct age was significant material fact which would affect the decision of the respondent company in accepting a proposal for issuance of insurance policy. Hence, the claim of the complainant has rightly been repudiated by the opposite party vide repudiation letter Ex.OP1.
8. But, however, from the appreciation of the facts and circumstances of the case, it becomes evident that claim of the complainant for death claim of Harnam Singh on the basis of the insurance policy, copy whereof is Ex.C-2 has been wrongly and illegally repudiated by the opposite party vide repudiation letter dated 21.8.2013 Ex.C-5/Ex.OP1. It is not disputed that Harnam Singh, father of the complainant had obtained insurance policy, copy whereof is Ex.C-2 with sum assured Rs. 3 lacs on account of death claim. Harnam Singh had admittedly died , copy of the death certificate accounts for Ex.OP4. The complainant applied for release of the death claim on the basis of Insurance policy in dispute . But the claim was repudiated by the opposite party without any reasonable cause on 21.8.2013. In the repudiation letter, the opposite party had alleged that father of the complainant had mis-stated his age at the time of making proposal which prompted the opposite party to issue Insurance policy in dispute. As per their investigation, opposite party had irrefutable evidence that Harnam Singh was 81 years of age at the time of making of proposal, as such contract was void abinitio. However, complainant has produced PAN Card No. DVVPS3428 Ex.C-4 wherein date of birth of Harnam Singh has been stated to be 12.4.54 as such at the time of obtaining the insurance cover, Harnam Singh was of the age of 56 years 10 months and 9 days. Election Commission has also issued voter card in favour of Harnam Singh, now deceased which is Ex.OP2/A on record and the date of birth mentioned therein also correspond to his date of birth mentioned in PAN card Ex.C-4. Statement of Dr.Balwinder Singh was also recorded by the investigaor, who conducted pre-policy medical check up of Harnam Singh. He has stated that he has been practicing for the last 43 years and prior to this , he was working in Punjab Govt and after his retirement he was empanelled with the Insurance company. Dr.Balwinder Singh has stated that it is difficult to ascertain the age of any person by merely seeing the physical structure of the person. He has admitted the signatures on documents Ex.C-6 to Ex.C-12. In his cross examination, he has stated that h has written the age of insured person whatever was disclosed by him. It is unbelievable that a doctor, who had worked for 43 years as Govt.employee and conducted the medical examination of insured before issue of the policy, could not ascertain the difference of age of 59 years and 81 years from the face of the insured. The complainant has produced numerous documents regarding age of the insured. He has produced copy of policy schedule Ex.C-2, driving license Ex.C-3 PAN card Ex.C-4, copy of letter dated 21.8.2013 Ex.C-5. In the driving license and PAN Card, date of birth of Harnam Singh is given as 12.4.1954 which is authenticated proof of date of birth. Opposite parties have produced Ex.OP2 final report in which it is clearly mentioned that insured was of the age of 59 years at the time of death as per PAN Card copy, which was confirmed to be genuine and in order as per online verification from original document. PAN card is the authenticated proof of age which the complainant had produced and found to be genuine by the investigator. In the report Ex. OP 2 submitted by opposite party No.2, it has admitted at page 5 & 6 of the report “ that they made enquiry from neighbours and nearby hospital and they confirmed that insured Harnam Singh was not suffering from any kind of illness before the commencement of the policy and no negative information was captured regarding his health and habits.” Opposite party had declined the death claim only on wrong assumption that as per alternate age proof documents procured during investigation, wide age gap of 22 years has been confirmed. Opposite party had not given any weightage to the authenticated document of age proof i.e. PAN card of the insured which the opposite parties themselves verified as genuine and correct documents. The driving license also depicted same date of birth of the insured which was given in the PAN card and the clerk of DTO office has admitted and confirmed that this driving license bears stamp of DTO office Amritsar. The facts of the case of the complainant are almost the same and relevant to the case decided by the Hon’ble Punjab State Consumer Disputes Redressal Commission, Chandigarh in Pawan Kumar Vs. Bajaj Allianze Life Insurance Co. first appeal No. 1332 of 2007 decided on 28.8.2012 wherein it has been held as under:-
“The opposite party/respondent should have actually examined the authenticity of the driving license at the time when they issued the policy and accepted it as correct proof of age. It is generally the tendency of these companies to accept everything when they issue the policy and start finding faults in the same document, subsequently when, they are liable to pay compensation to the insured. The opposite party who accepted the driving license as valid proof of age at the time of issuing the policy had sufficient time at its disposal to subsequently also examine the authenticity of the said driving license.”
9. In the present case also the insurance policy was issued on 21.2.2011 while insured person died on 13.2.2013 and during this period no efforts were made to ascertain the authenticity of the driving license in dispute. In the face of over-whelming evidence on record which corroborates the date of birth of deceased Harnam Singh to be 12.4.1954, a bald entry made in the voter list will not outweigh the overwhelming evidence adduced on record by the complainant. Thus, it becomes amply clear that the opposite parties have wrongly and invalidly repudiated the rightful insurance claim of the complainant on account of death of his father Harnam Singh. Not only that complainant is the nominee under the Insurance policy. He also happen to be first class heir of deceased Harnam Singh being a son. Therefore, he is a rightful person to get the death claim to the tune of Rs. 3 lacs from the opposite parties alongwith interest @ 9% p.a. from the date of filing of the complaint uptil full and final recovery. However, he shall be under legal obligation to account for this award amount with other first class legal heirs of Harnam Singh, now deceased. Cost of litigation are assessed at Rs. 2000/-. Compliance of this order be made within 30 days from the date of receipt of copy of this order ; failing which, complainant shall be at liberty to get the order executed through the indulgence of this Forum. Case could not be disposed of within the stipulated period due to heavy pendency of the cases in this Forum.Copies of the orders be furnished to the parties free of costs. File is ordered to be consigned to the record room.
Announced in Open Forum
Dated : 04.7.2016
/R/
