BEFORE THE DISTT. CONSUMER DISPUTES REDRESSAL FORUM; FATEHABAD.
Complaint case No.128 of 2016.
Date of Instt.: 03.05.2016.
Date of Decision: 21.04.2017.
Smt.Bimla Devi widow of Nand Ram, resident of Piper Jaitsisar, Tehsil Sarsarsahar District Churu (Rajasthan).
..Complainant.
Versus
1. Reliance Life Insurance, Company Limited 9th & 10th Floor, Building No.2, R- Tech Park, Nirlon Compound, Next to Hub Mall, Behind I-Flex Bidg, Goregaon, (East) Mumbai 400063.
2. Reliance Life Insurance, Company Limited Tohana Branch, through its broker M.R.Rahul, House No.327 Ward No.6 Patel Nagar, Tohana Tehsil Tohana District Fatimabad, Haryana-125120.
..Opposite Parties.
Complaint U/S 12 of the CP Act,1986
Before: Sh.Raghbir Singh, President.
Smt. Ansuya Bishnoi, Member. Sh.R.S.Pangha, Member.
Present: Sh. Sh.P.S.Sokhal, Advocate for complainant. Sh. D.P.Jakhal, Advocate for opposite parties.
ORDER
Briefly stated the facts of the present complaint are that husband of the complainant namely Nand Ram was insured with the opposite parties (hereinafter to be referred as “Ops”) vide policy No.51657471 commencing from 10.06.2014 for a sum assured of Rs.9,00,000/- and he had made the payment of premium regularly qua the policy in question. Unfortunately said Nand Ram, husband of complainant died on 15.07.2014 during subsistence of policy. The complainant being nominee of Nand Ram (life assured) informed the OPs about the death of her husband and completed all the formalities as per their instructions and directions. However, the OPs have illegally, arbitrarily and against facts have repudiated the claim of the complainant vide letter dated 21.03.2015 on the ground that life assured had also proposed with other insurance company before proposing to them. The complainant requested many times to the opposite parties to make the payment alongwith interest @ 24% per annum but to no effect. The complainant has suffered mental agony and harassment at the hands of OPs and she is also entitled for compensation. Hence, this complaint. In evidence, the complainant has tendered her affidavit Annexure C1 besides documents Annexure C2 to Annexure C4.
2. On notice, OPs appeared and resisted the claim of the complainant by filing joint reply to the complaint wherein several preliminary objections such as maintainability, locus standi, concealment of material facts and cause of action etc. have been taken. It has been further submitted that contract of life insurance is Uberrama Fides i.e. principle of utmost good faith, therefore, it was obligatory on the part of deceased life assured to disclose all the material facts pertaining to his age, health and other history as per his/her knowledge but in the present case the life assured had not given true facts in the proposal form and had concealed the material facts with deliberate intention to commit fraud, therefore, violation on the part of life assured makes the contract void and ab-initio. It has been further submitted that on believing the information given in the proposal form to be correct, the OPs had issued policy No.51657471 dated 10.06.2014 for a sum of Rs.9,00,000/- but when the death claim of the life assured was submitted within a short span of one month and five days then the matter was investigated and it came to the notice that the life assured had concealed the material fact about taking of another policy bearing No.16660638 for a sum of Rs.4,08,897/- on 20.03.2014 from HDFC Life Insurance Company and that policy and the policy related in the present case were taken within a period of 2 months and the life assured had died within 3 months of purchasing of policies. It has been further submitted that had the life assured disclosed about the other policies then the policy in question might not have been issued to him as it was not easy to pay the premium of huge payments (having total sum assured of Rs.13,08,894/- including the present policy) because the life assured had shown his earning Rs.3,50,000/- per annum. So, the OPs have rightly repudiated the claim submitted by the complainant. There is no deficiency in service on the part of the OPs. Other pleas made in the complaint were controverted and prayer for dismissal of the complaint has been made. In evidence, the Ops have tendered affidavit of Sh.Anuj Goel as Annexure R1 and documents Annexure R2 to Annexure R4.
3. We have heard learned counsel for the parties and have perused the case file carefully. In his arguments the counsel for the complainant has reiterated the submissions made in the complaint and further argued that what harm, loss, injury and adverse impact had occurred to the Ops on account of not disclosing of previous policy by the life assured and non-disclosure of previous insurance policy is not a valid and proper ground for negativing the claim of the complainant. In support of his arguments he has placed reliance of case laws titled as IDBI Federal Life Insurance Company Limited Vs. Rameshwar Prasad Jain decided on 04.11.2016 by Hon’ble National Commission in Revision Petition No.139 of 2016, Smt.Sulochna Indurkar Vs. The Life Insurance Corporation decided on 11.09.2015 in Revision Petition No.587 of 2015 by Hon’ble National Commission, Life Insurance Corporation of India Vs. Shahida Begum 2011 (3) CPJ 373, Nazir Singh Vs. Life Insurance Company and another 2013 (1) PLR 328 (Punjab & Haryana High Court), Vijay Pal Singh Vs. Life Insurance Corporation of India and others 2014 (3) CPJ 161 (Utter Pradesh State Commission), Madan Lal Vs. Life Insurance Corporation of India 2008 (2) CPJ 67 and Tata AIG Life Insurance Company Limited Vs. Sita Devi 2012 (2) CPJ 19 (Rajasthan State Commission). On the other hand the counsel for the OPs rebutted the above said arguments of the counsel for the complainant and further in support of his contention has relied upon the judgment as incorporated in the reply of the OPs.
5. It is not disputed that the husband of the complainant had obtained an insurance policy from the OPs and also paid the premium thereof. There is also no dispute that complainant is nominee in the above said policy. The material question which this Forum has to decide is as to whether the OPs have legally repudiated the claim of the complainant or not?
6. The submissions made by the learned counsel for the complainant supported by the legal citations have weight because concealment of previous policies either accidently or inadvertently or even deliberately is not a fact to be held a material fact for repudiation of claim unless it is proved that disclosure of such facts had an adverse impact on the right of insurer. On one hand the Ops have received and accepted the huge premium from the life assured in order to increase its business but when the death claim qua the life assured was submitted then it repudiated the claim of the complainant by wriggling out and twisting the facts on account of non-disclosure of previous policy by the life assured without showing that what adverse impact had occurred for the so-called lapse on behalf of the deceased life assured. On this point reliance of judgment rendered by Hon’ble Uttar Pradesh State Commission in case titled as Vijay Pal Singh Vs. Life Insurance Corporation of India and others (supra) can be taken wherein it has been mentioned that concealment of previous policies either accidentally or inadvertently or even deliberately is not a fact to be held a material fact for repudiation of claim unless it is proved that disclosure of such facts had an adverse impact on rights of insurer. Moreover, a common man is not supposed to know all the niceties and technicalities of law, therefore, the Ops are ceased to repudiate the claim of the complainant on technicalities by leading cogent and reliable evidence to show that non-mentioning of earlier policy in present policy was with ulterior motive or with fraudulent intention or misrepresentation on part of DLA. The case law relied upon by learned counsel for the Ops titled as M/s ICICI Prudential Life Insurance Co. Limited Vs. Lilita Jain, PC Chacko and another Vs. Chairman Life Insurance Corporation of India and others 2008 (1) ALL MR 408 (SC) and Satwant Kaur Sandhu Vs. New India Assurance Company Limited 2009 (9) JT 82 (SC) are not applicable in the present case because non-mentioning of the fact of taking earlier policy in the declaration form by the DLA does not amount to suppression or concealment of material fact or misstatement in real sense, therefore, this Forum has no hitch to reach a conclusion that the Ops have violated the benevolent welfare statute of C.P.Act, 1986 meant for the protection of the consumers by repudiating the genuine claim of the complainant, therefore, present complaint deserves acceptance. Accordingly, we allow the present complaint and direct the OPs to pay claim/ insured amount of Rs.9,00,000/- to the complainant within a period of one month from the receipt of copy of this order, failing which complainant shall be entitled to interest @ 8 % per annum from the date of filing of the complaint till realization of the amount. If the opposite parties fail to comply with this order, complainant will be at liberty to initiate proceedings against the opposite parties under Section 25/27 of the Act. No order as to costs. A copy of this order be supplied to both the parties free of costs. File be consigned after due compliance.
ANNOUNCED IN OPEN FORUM Dt.21.04.2017
(Raghbir Singh)
President District Consumer
Disputes Redressal Forum, Fatehabad.
(R.S.Panghal) (Ansuya Bishnoi)
Member Member
