Punjab

StateCommission

CC/13/32

Gurdeep Singh Sahni - Complainant(s)

Versus

SBI Life Insurance Co. Ltd. - Opp.Party(s)

P.K. Gupta & Munish Gupta

02 Dec 2016

ORDER

                                                               FIRST ADDITIONAL BENCH

 

STATE  CONSUMER  DISPUTES  REDRESSAL  COMMISSION,    PUNJAB

          SECTOR 37-A, DAKSHIN MARG, CHANDIGARH.

 

                   Consumer Complaint No.32 of 2013

 

                                                          Date of Institution: 18.03.2013  

                                                          Date of Decision : 02.12.2016

 

Gurdeep Singh Sahni son of Sh. Kuldeep Singh Sahni and Late Smt. Rajinder Kaur, resident of H.No.265/1, Sher-e-Punjab Market, Patiala 147001 (Punjab).

 

                                                                                       …..Complainant

                                                Versus

1.       SBI Life Insurance Company Limited, Banks Square, Near HDFC        Bank, Chhoti Baradari, Patiala.

2.       SBI Life Insurance Company Ltd., State Bank Bhawan, Madame          Cama Road, Nariman Point, Mumbai 400021

 

                                                                                  ….Opposite Parties

         

Consumer Complaint U/s 17(1)(a) of the Consumer Protection Act, 1986 (as amended up to date).

Quorum:-

          Shri J. S. Klar, Presiding Judicial Member.

               Shri J.S Gill, Member.

         

Present:-

          For the complainant                   :  Sh. Munish Gupta, Advocate

          For opposite parties                  :  Sh. Rajneesh Malhotra, Advocate.

          . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

J. S. KLAR, PRESIDING JUDICIAL MEMBER:-

                                     

           The complainant has filed this complaint U/s 17(1)(a) of the Consumer Protection Act 1986 (in short the "Act) against the OPs on the averments that he is nominee of his mother late Smt. Rajinder Kaur, who took a life insurance policy by paying a onetime premium of Rs. 5 lac by filling up the proposal form, as required by OPs. She was persuaded by the employees of the OPs to take a life insurance policy. The proposal form was filled in by the employees/official of OPs. The  sum assured under the policy was of Rs.25,00,000/-, which was payable by the OPs in case of any untoward incident. The premium paid by the life assured Rajinder Kaur was duly accepted by the OPs and insurance policy was continued. Unfortunately, Rajinder Kaur (mother of the complainant) expired on 29.03.2012. The OPs sent its official to the complainant's residence and got filled certain documents and also took the original policy documents. The complainant was shocked to find that the insurance claim of the complainant has been repudiated, vide letter dated 31.10.2012 along with cheque of Rs.4,44,909/-. The complainant contacted OPs at Patiala and apprised them of the entire matter for wrongful repudiation of the claim. He also sent email dated 16.11.2012 to OPs in this regard. The said email was replied by OPs on 20.11.2012 intimating that the documents submitted at the time of filing up of the proposal form were found to be false upon enquiry. The entire proposal form was got filled in by the officials of OPs and life assured Rajinder Kaur only signed it. The OPs could not have backed out from the contract of insurance. It was duty of the OPs to check the documents submitted with the proposal form by the proposer. The complainant got policy details generated from Patiala office of OPs. Despite various communications, personal requests and personal visits to the office of the OPs at Patiala, the OPs have not paid any heed to accept the request of the complainant, as per the regulations of the insurance companies within the specified period, therein and in case the said documents are found to be false, the OPs were duty bound to cancel the policy and refund the amount forthwith thereafter. The policy in hand was a life insurance policy and in case of death of the policyholder, it was the duty of the OPs to pay the assured sum to the nominee therein without any hitch. All the documents were taken by the officials of the OP/company at the time of taking up the claim form from the complainant, therefore, the complainant was not left with any document whatsoever. It was further averred that the act and conduct of the OPs is wholly unreasonable and uncalled for amounting to deficiency in service.  The complainant has, thus, filed the complaint directing OPs to pay Rs.25 lac in total by deducting Rs.4,44,909/-, which has already been received by the complainant. The complainant further prayed for interest @ 18% p.a and also paid for Rs. 5 lac as compensation for mental harassment and Rs.55,000/- as costs of litigation.

2.      Upon notice, OPs appeared and filed written reply and contested the complaint of the complainant by raising preliminary objections that the coverage is offered by the insurance company in accordance with the provision of the Insurance Act. The contract of insurance is based on the principle of UMBERRIMA FIDES (utmost good faith) and proposer is duty bound to disclose everything consisting of his health, income and other matters pertaining to life insurance policy and source of income, which are within his knowledge at the time of making the proposal form. The insurer has right to repudiate the claim in case insured gave wrong and false answers at the time of filing the proposal form. Rajinder Kaur life assured gave wrong answers to the questionnaire no.1 of the proposal form. The deceased life assured Rajinder Kaur mentioned in proposal form as her occupation as "Business Agriculturalist" with annual income of Rs.250000/- showing as source of income "Business plus Agriculturist" Rs.50,000/- from Boutique and Rs.2,00,000/- from Agriculture. She submitted extract of land records and Form J deliberately to obtain insurance cover of such a high amount. She furnished false documents to mislead the OPs. It was found during investigation that she was merely a housewife. The extract of land record and Form J submitted by her with proposal form were fabricated and forged documents. She gave deliberately gave wrong information with regard to her income, occupation and ownership of land in the proposal form. OPs justified repudiation of contract of insurance on this point. Her insurance cover would be restricted to a maximums of Rs.3.5 lac, subject to other factors. The claim was for Rs.4,95,000/- under another policy no.33032075109, which was taken firstly. She deliberately furnished fabricated documents to obtain huge insurance covers. Various judgments quoted in the pleadings regarding purpose of the pleadings is to disclose Facta Probandas only and not to quote the law. Even on merits, complaint was contested on the above-referred grounds by OPs. OPs justified the repudiation of contract of insurance and prayed for dismissal of the complaint.

3.      The complainant tendered in evidence his affidavit Ex.C-A, along with copies of documents Ex.CW-2/1 to Ex.CW-3/1 and other documents Ex.C-1 to Ex.C-7. As against it; OPs tendered in evidence affidavit of V. Srinivas authorized representative of SBI Life Insurance Company Ltd Ex. OP-A along with copies of documents Ex.OP-1 to Ex.OP-18 and closed the evidence.

4.      We have heard learned counsel for the parties at considerable length and have also examined the pleadings and material evidence on the record. The counsel for the complainant submitted that there is no sufficient evidence adduced by OPs on the record with regard to forged nature of land record and J Form with regard to sale of crops appended with the proposal form by the complainant. The counsel for the complainant mainly relied upon the affidavit of the complainant Gurdeep Singh Ex.CA on the record. He also sought corroboration from the report of one Dr. Inderjit Singh. The alleged document expert gave his report Ex.CW-2/1  on the record. Ex.CW-3/1 is the Special Moral Hazard & KYC Verification Report (UWN024) by the complainant on the record primarily relying upon the report of expert witness Dr. Inderjist Singh Ex.CW-2/. The submission of counsel for the complainant before us is that the forged nature of land record and J Form attached with the proposal form by life assured has not been substantiated by the OPs on the record. On the other hand, counsel for the OPs refuted this argument of the complainant by urging that complainant relied upon forged land record and J Form to claim higher amount of coverage. It was submitted by counsel for OPs that she was merely a housewife, earning no sufficient income of her own with no independent income of her own and hence she obtained the coverage of the higher amount of insurance on the basis of falsity by submitting forged documents. The case of both parities solely revolves around this matter. This is a pivot of the matter in this case, as to whether life assured submitted genuine documents or not to OPs. The OPs relied upon Ex.OP-11 the report of investigator to prove this fact that life assured submitted forged and fabricated extract of land record and J Form only to seek higher amount of coverage with the proposal form. Ex.OP-12 is interview of the complainant Gurdeep Singh Sahni. His statement is on the record as Ex.OP-13 by the investigator in this regard. The copy of jamabandi, which is not legible is Ex.OP-14 showing that Rajinder Kaur is owner of 139 kanal of land and is also in self cultivation thereof. This document was received in the office of OPs. There is noting on this document that this record is forged because it is not as per the land record maintained by the office submitted by counsel for OPs. J Form is Ex.OP-15 with regard to sale of 75 kg crop of Rs.142280/-, it has been issued by M/s Pargat Singh and Sons Purchase Centre Dhablan (Patiala). Ex.OP-16 is cheque of basic sum assured Rs.4,95,000/- with regard to policy no.33032075109 of Rajinder Kaur. Ex.OP-17 is the letter dated 01.11.2012 addressed to complainant Gurdeep Singh that Rajinder Kaur life assured (since deceased) submitted false record with the proposal form with regard to her annual income of Rs.250000/-. Ex.C-17-A is record prepared by the OPs. Ex.OP-18 is email dated 20.11.2012 on the record.

5.      From careful evaluation of above-referred evidence on the record and hearing respective submissions of counsel for the parties, we find that the moot point of dispute between the parties in this case pertains to, as to whether the land record and J Form submitted by the life assured with proposal form were forged documents or not. It is evident from perusal of above record that life assured showed her income of Rs.25 lac per annum, out of which she showed income of Rs.50,000/- from Boutique and Rs.2 lac from agricultural land. The contention of OPs is that she owned no land nor did any work of boutique/business and she was merely  a household lady, as appeared in the investigation report. The OPs submitted that land record Ex.OP-14 and J Form Ex.OP-15 were forged documents, as submitted by her. The counsel for complainant relied upon the report of Inderjit Singh Ex.CW-2/1 on the record.  We regret our inability on the point as to how account of rush of work, it has been permitted to be brought on record. The Consumer Forum is vested with summary jurisdiction only to decide the case on the basis of documents alone. It is not function of the Consumer Forum to look into this type of controversy, as to whether the documents are forged or not. It means we will have to start the regular trial of case, like civil court; as OPs would also be given rebuttal chance to examine their own document expert against it. It is beyond the competence of Consumer Forum to decide such complexity of the matters. The dispute between the parties centers around this point, as to whether the land record and J Form with regard to ownership of land and sale of crops by the complainant were forged documents; as it is submission of the OPs that she owned no land nor any other income from boutique and she was merely a household lady. This is a crucial and disputed point, which is not within the province of Consumer Forums to decide. When forgery is alleged and the evidence on record is to this effect, then Consumer Forum cannot delve into such type of controversy. Such type of matters need to be relegated to competent Civil Court, where the matter can be decided on the basis of detailed evidence to be led by the parties, as to the documents were genuine or forged documents. If we start entering into such controversy, then it would entail the summoning of the revenue record with the original record, involving cross-examination of the witnesses and re-examination thereof besides rebuttal evidence, as well as, counter document expert evidence on the record to decide such controversial matter. Since we are endowed with summary jurisdiction under Consumer Protection Act 1986 and hence it is beyond our competence to decide such complex matters. On this point, we are fortified by law laid by National Commission in District Transport Officer Mansa versus Amit Goyal reported in 1 (2016) CPJ 521 (NC) in which it was held that case involves issues relating to forgery, fraud and cheating, etc and dealing under CP Act may not be right approach. Matter remanded to civil court. Apex Court also held in Oriental Insurance Company Ltd versus Munimahesh Patel reported in IV (2006) CPJ I (SC) that nature of proceedings before the Commission as noted above, are essentially in summary nature. The factual position was required to be established by documents. The Commission was required to examine, whether, in view of the disputed facts, it would exercise the jurisdiction? The State Commission was right in its view that the complex factual position requires that the matter should be examined by an appropriate court of law and not by the Commission under CP Act.

6.      In addition to that, it is a mere consequent factum in this case, as to whether repudiation is justified or not, in case the finding is returned that these records appended were fabricated, then it is beyond pale of our competence. The Hon'ble Supreme Court has held in P.C Chacko and another versus Chairman Life Insurance Corporation of India and others reported in 2008(3) CPC 248 and Apex Court held in Satwant Kaur Sandhu versus New India Assurance Company Ltd reported in 2009(3) CPC Page 6 that the insurance contract is liable to be repudiated for deliberate concealment of facts. The Apex Court also approved this proposition of law in P.C Chacko and another (supra). Even otherwise, the contract is rendered voidable at the option of other in case it is initiated by the fraud, under Contract Act, 1872. We find no support from law relied by counsel for complainant in Life Insurance Corporation  versus Chanagoni Upendra and others reported in 2012(1) CPJ 409 by National Commission to the effect that if proposer declared annual income, then it should have been rejected by the insurer on that ground. This authority is distinguishable from fact situation of the case, because insurer had no yardstick at that time to decide, as to whether this land record and J Form as submitted by proposer were genuine or not. The complainant further referred to law laid down in Bajaj Allianz Life Insurance Company Ltd  versus Virender Singh reported in 2015(2) CPJ 701. This authority is again distinguishable from the facts of the case, because in the cited authority, the claim was repudiated, merely on the ground that school leaving certificate is not conclusive evidence and it depends upon circumstances of the case whether it is so or not. The ratio of this authority is again not applicable in this case. Reference was also made to law laid down in Birla Sun Life Insurance Co. Ltd versus Charakapu Chinna Rao, reported in 2012(1) CPJ 557 by National Commission. We find that this authority is again not applicable in this case due to different facts. In this case, the record produced by the proposer with the proposal form with regard to her income was a material one, which could have definitely affected the mind of the insurer, whether to accept the insurance contract or not for such a high coverage. The documents with regard to income of proposer/life assured were quite material in nature and it cannot be said that they were not germane to the matter in dispute.

7.      We are, thus, of this opinion that this matter cannot be examined by the Consumer Forum on account of complicated questions of facts involved in this case, which can be decided with the aid of detailed evidence only, including document expert evidence and countered document expert evidence, besides seeking report of Government Scientific experts, other type of detailed evidence is also required in this type of case; entailing detailed cross examination and re-examination of witnesses. The matter can be appropriately tried and decided by competent court of law only, in our opinion, on account of forgery alleged to be involved in this case in the submission of above documents by the proposer.

8.      As a result of our above discussion, we dismiss the complaint of the complainant, by giving liberty to complainant to approach the competent court to seek redressal of his grievance in this regard. The complainant could invoke the provisions of Section 14 of the Limitation Act, 1963 before the competent  court, as permitted by law.

9.      Arguments in this complaint were heard on 30.11.2016 and the order was reserved. Now the order be communicated to the parties.

10.    The complaint could not be decided within the statutory period due to heavy pendency of court cases.

 

                                                                          (J. S. KLAR)

                                                             PRESIDING JUDICIAL MEMBER

 

 

                                                                              (J.S GILL)

                                                                                MEMBER

 

 

                                     

December 2,  2016                                                                  

(ravi)