Before,

State Consumer Disputes Redressal Commission, Bihar, Patna

Appeal  No. 165 of 2017

Indrajeet Kumar Mahto, S/o- Shri Bharat Prasad Mahto, R/o- Village- Belhi, Tola- Betonah, P.O- Jainagar, P.S.- Jainagar, District- Madhubani

                                                                                                 ............... Appellant

                                      Versus

1. Branch Manager, Reliance Life Insurance Co. Ltd., Bela Road, Laheriasarai, District- Darbhanga
2. Manager, Reliance Life Insurance Co. Ltd, Artek Park, Nirlone Compound, Gorgoan (East) Mumbai
3. Manager, Registration office, Dhirubhai Ambani Gyani Sahar, Navi Mumbai, Maharashtra

                                                                    ........... Respondents/ Opposite Parties

Counsel for the appellant:  Mr. Chandan Kumar Singh, Advocate

Counsel for Respondent: Mr. Anil Kumar, Advocate

Before:

Miss Gita Verma (Judicial Member)

Mr. Subodh Kumar Srivastava (Judicial Member)

Mr. Raj Kumar Pandey (Member)

Dated: 26.08.2022

Order

Per- Raj Kumar Pandey (Member)

1. The present appeal is directed against the order dated 24.04.2017 passed by the Learned District Consumer Disputes Redressal Forum, Madhubani (herein after to be referred to as District Forum) in consumer Complaint No. 71 of 2014, wherein the Learned District Forum has rejected the claim of the complainant/appellant, stating that the complainant is not entitled to the relief sought for by him.
2. The relevant brief facts for disposal of this appeal are that the cousin brother of the complainant namely Sant Saran (since deceased “ the life insured”) took insurance policy from O.P. No. 1 under  Reliance Endowment Plan (Regular) vide client I.D. No. 84802807 under policy No. 50549364 for the sum assured Rs. 10,00,000/- (Ten lac) and the premium amount of the policy was Rs. 23,801=40 for the period 30.12.2012 to 30.11.2032. The complainant/appellant was nominee in that policy. Unfortunately, the “life insured” Sant Saran (deceased) died on 31.12.2012. Thereafter, the complainant/appellant filed a death claim with the O.P.- insurance company, but it was repudiated, hence, the complainant filed a consumer complaint before the Ld. District Forum.
3. On notices the opposite parties/respondents appeared before the Ld. District Forum and contested the complaint by filing written statement before the Ld. Forum. In written statement it has been said that the complainant has no cause of action to file the complaint. It is said that under the contract of insurance, the life assured (L.A) under solemn obligation to disclose all material facts correctly, failing which the policy is rendered viod ab-initio illegal and inoperative. It is said that the L.A. answered “No” to question no. 20 of proposal form, which reads “Are you currently insured or applying for insurance cover, critical illness, Accidental benefit cover, not covered above? However in course of investigation, it was found that L.A. had already taken simultaneous insurance policies for a total sum of Rs. 27,00,000/- but this fact was concealed by L.A. in his proposal form. It is said that L.A. had given his income Rs. 3,00,000/- p.a. It has been further stated that in course of investigation it was also revealed that the L.A. was suffering from “ heptic encephalopathy with ascites” prior to taking the policy in question, which is evident from the treatment certificate issued by A.S. Memorial Hospital, Darbhanga. It has been asserted that, had the L.A. disclosed the true and correct fact regarding his medical condition and other policies amounting Rs. 27,00,000/- (Twenty seven lacs) with annual income of Rs. 3,00,000/- only at the time of filling the proposal form, the O.Ps would have ought to rightly rejected the insurance policy. Thus, according to the opposite parties/respondents there was no deficiency in service on their part and the claim of the complainant/appellant was rightly repudiated and same has been communicated to the complainant, vide its letter dated 18.11.2013.
4. The complainant/appellant in support of his claim/complaint filed his evidence on affidavit dated 15.07.2016 along with photocopies of documents marked as annexure 1 to 6 respectively. On the other hand, the O.Ps respondent filed seven documents marked as annexure A to g respectively, before the Ld. District Forum.
5. After appraising the pleadings and evidence, the Ld. District Forum rejected the complaint of the complainant/appellant.
6. Being dissatisfied with and aggrieved by the order dated 24.04.2017 passed by the Ld. District Forum the complainant/appellant has preferred this appeal on the following grounds:-

1. For that the impugned order is bad in the eye of law as well as in the eye of fact.
2. For that the impugned order is based on only surmises and conjectures which is not tenable in the eye of law.
3. For that the learned court below has passed contradictory order on the same facts as mentioned in annexure-4.

It has been further prayed that the appeal may be allowed.

7. The appellant and respondent both have filed written notes of argument in support of their respective cases.
8. We have heard the learned counsel for both the parties and perused the record. In its written statement the Ld. Counsel for the appellant has submitted that the appellant had filed an another consumer Case No. 103 of 2014 before the same District Forum, Madhubani against the L.I.C. of India in which the facts of the case was same to the present case and in which on the same fact the learned court below has allowed the claim of this appellant vide order dated 08.03.2017. He further submitted that in said claim the amount was paid by the L.I.C. to the appellant, which was same in nature. The order of the complaint case no. 103 of 2014 has been annexed by the appellant in his memo of appeal.
9. The Ld. Counsel for the appellant has referred so many decisions in his written notes of argument, As  (1). Civil Appeal No. 7969 of 2010 (Balwindar Kaur (D) & Others, V/s Life Insurance Corporation of India & Others. (ii) case No. Bajaj/2422/Pune/Gurgaon/24/13-Sri Robin Rana 2422 V/s Bajaj Allianz Insurance Co. Ltd. order dated 08.11.2013 (iii) CHENNAI AWARD NO. 10(CHN) L-007/2013-14 dated 18.06.2013 Complaint No. 10(CHN) 21.009.2315/2012-13 Smt. P. Pushpavalli V/s Bajaj Allianz Life Insurance Company Limited,

        On other hand the Ld. Counsel for the respondent in its written notes of arguments contended that the present appeal is not maintainable and reiterated his stands taken before the Ld. District Forum. The further contention of the Ld. Counsel for the respondent is that the insurance company has rightly repudiated the claim as per the provisions laid down in section 45 of the Insurance Act. 1938. He made emphasis upon the concealment of previous policy for a total sum of approx. 25 lacs. The learned counsel for the respondent referred the decision of Hon’ble Apex Court- (i) P.C. Chako and Anr. Vs. Chairman, Life Insurance Corporation of India and others, 2008 C.P.J, 78 SC,

(ii) Mitholal Nayak V/s Life Insurance Corporation of India, The Ld. Counsel for the respondent has also referred the provision of Sec. 19 of the Contract Act. Besides above Ld. Counsel for the respondent also referred some other case laws As: Sita Holiday Resorts Limited v/s M/s Mohan Lal Harbans Lal Bhayana and company (1999-3) (123 PLDR-28); Dineshbhai Chandrana V/s LIC & Anr. First Appeal No. 242 of 2006 decided on Dt. 27.07.2006; Satwant Kaur Sandhu V/s New Assurance Co. Ltd. (2009) (9) scale-488- The Ld. Counsel for the respondent also referred the provisions of section 2 (d) of the Protection of Policy holders’ interest Regulation, 2002. Apart from above noted materials the Ld. Counsel for the respondent also attached photo copies of some relevant documents for perusal of this State Commission.

10. It is not in dispute the matter between the complainant/appellant and the O.Ps/respondent was of contractual on the terms and conditions stipulated in the insurance policy’s proposal form and both the contracting parties are bound by the terms of the contract. In present case the life assured deliberately concealed the previous policy, which was discovered by the insurance company within two years, which is basis for the repudiation under the provisions of section-45 of the Insurance Act, 1938. The Hon’ble Supreme Court in Manmohan Nanda V/s United India Insurance Co. Ltd & Anr. I (2022) CPJ 20 (SC) held that “contractual duty so imposed is that any suppression or falsity in statements in proposal form would result in breach of duty of good faith and would render policy voidable and consequently repudiate it at instance of insurer”

We have gone through all the decisions referred by the appellants, as well as decisions and provisions of law referred by the respondent. As far as the decisions referred by the appellants is concerned, we have of the considered view is that, the every case has its own merit and is decided as per the relevant provisions of law. In the case of P.C. Chako and Anr. Vs. Chairman, Life Insurance Corporation of India and Others, 2008 C.P.J, 78 SC. in which the Hon’ble Apex Court laid down the principles as under:-

“The insured furthermore was aware of the consequence of making a mis-statement of fact. If a person makes a wrong statement with knowledge of consequence thereof, he would ordinarily be stopped from pleading that even if such a fact had been disclosed; it would not have made any material changes. The purpose for taking policy insurance is not, in our opinion very material. It may serve the purpose of social security but then the same should not be obtained with a fraudulent act by the insured. Proposal can repudiated if a fraudulent act is discovered. The purpose must show that his intention was bonafide. It must appear from the face of the record.  In a case of this nature it was not necessary from the insurer to establish that the suppression was fraudulently made by the life assured or that he must have been aware at the time of making the statement that the same was false or that the fact was suppressed which was material to disclose. A deliberate wrong answer which has a great bearing on the contract of insurance, if discovered may lead to the policy being vitiated in law”.

11.           In such circumstances this Commission arrives at the conclusion that, the finding recorded by the Ld. District Forum is just and proper and does not suffer from any infirmity, irregularity and illegality, hence does not call for any interference by this Commission.
12.           Hence, the appeal filed by the appellant/complainant being devoid of any merits, deserves to be and is hereby dismissed. No order as to the cost of this appeal.

                                                                                              Gita Verma

(Judicial Member)

Subodh Kumar Srivastava

(Judicial Member)

Raj Kumar Pandey

Md. Fariduzzama