This appeal has been filed by the appellant Dharmapal Puri against the order dated 28.12.2015 of the State Consumer Disputes Redressal Commission, Chhattisgarh, (in short ‘the State Commission’) passed in Complaint No.CC/15/15.

2.      Deceased life assured (DLA) Chander Goswami, purchased life insurance policy on 07.02.2013 from opposite parties.  The sum assured of the policy was Rs.30,00,000/-.  He paid premium of Rs.23,498/-. The said policy commenced on 26.3.2013. The  complainant was the nominee of the insured.  The insured died on 08.11.2013. Reason of death was sudden cardiac arrest.  The opposite parties repudiated the claim on 8.12.2014 on the ground of suppression of real fact about the insured’s age.  Aggrieved with the repudiation of the insurance claim, the complainant filed a consumer complaint bearing No.CC/15/15 before the State Commission.  The complaint was resisted by the opposite parties by filing the written statement. The State Commission passed the following order on 28.12.2015:-

“17.  It appears that the Deceased Life Assured gave incorrect information regarding his age and suppressed his actual age and after suppressing his actual age, he obtained insurance policy from the OPs, therefore, the OPs have rightly repudiated the claim of the complainant and the complainant is not entitled to get any compensation from the OPs.  The facts of the judgments cited by the complainant are quite distinguishable from the facts of the instant case and that will not help the complainant.

18.  Therefore, the complaint of the complainant is liable to be and is hereby dismissed.  Nor order as to the cost of this complaint.”

3.      Hence the present appeal.

4.      Heard the learned counsel for the parties and perused the record.  Learned counsel for the appellant/complainant stated that the claim of the complaint filed by the complainant was repudiated vide letter dated 20.6.2014 of the respondent/Insurance Company on the ground that there was a misstatement in respect of the age in the proposal form.  The complainant also filed a representation before the Insurance Ombudsman, however, the same was also dismissed on 08.12.2014 and the repudiation letter was upheld.  At the time of filing of the proposal form, the copy of the Pan Card was also provided along with proposal form and the date of birth mentioned in the proposal form is 10.12.1963.  The Pan Card of complainant also bears the same date.  Thus, the proof of age provided in the proposal form was the Pan Card, which is one of the authorised documents to be given for age proof.  The opposite parties have not mentioned any specific objection in the repudiation letter.  It has only been mentioned that there is misrepresentation in respect of the age mentioned in the proposal form.  In the written statement, the opposite parties have mentioned that the age mentioned in the Voter list issued in December, 2013 is 63 years and thus at the time of filing of the proposal from in February 2013, the insured was more than 60 years.  Hence, the claim was repudiated as the entry age for the policy was upto 60 years only.  It is also mentioned in the written statement that the hospital record shows that the age of the insured was 70 years.  It was argued by the learned counsel that neither the hospital record nor the Voter list are the authorised documents for the age proof mentioned in the proposal form.  The State Commission has wrongly relied upon the Voter list and the hospital record.

5.      On the other hand, learned counsel for the respondent/Insurance Company stated that the proposal form was filled on 4.4.2013 and the date of birth filled in the proposal form is 10.12.1963.  The T.C. was filed along with proposal form wherein date of birth is mentioned as 10.12.1963. After investigation, it was found that this T.C. was totally fake.  It was further found that the age mentioned in the Voter list issued in December, 2013 is 63 years and this means that at the time of filling the proposal form, the Deceased Life Assured (DLA) was more than 60 years and therefore, was not eligible for the policy in question, as the maximum age of entry was only 60 years. Even the hospital record mentioned the age of the DLA as 70 years.  Hence from all the records, it is seen that the DLA was more than 60 years at the time of taking the policy.  Moreover, he tried to get the insurance policy based on the forged document of T.C.  On these grounds, the repudiation has been found to be justified by the State Commission.  It seems that on the basis of the forged TC, the DLA got his Pan Card prepared.  Thus, there is no error in the order dated 28.12.2015 passed by the State Commission.

6.      I have carefully considered the arguments advanced by both the sides and examined record.  A perusal of the proposal form shows that the Pan Card has been mentioned against the proof of age and against the address proof. Against the column of education, it is mentioned as VII Class.  It is, thus, likely that T.C. was enclosed as proof of education of the life assured.  Definitely the T.C. was not given as proof of age.  It is only an apprehension of the opposite parties that the Pan Card would have also been prepared on the basis of date of birth written in the T.C., however no evidence has been adduced in this regard.  There is a list of documents, which can be produced for proof of age and Pan Card is one of them.  The items mentioned as documents for age proof are required to be given importance.  So far as the proposal form is concerned, the date of birth mentioned is 10.12.1963 and the Pan Card has been filed as the age proof.  This statement has been contradicted by the Voter list and hospital record.  Clearly, these two documents are not part of the documents mentioned as items of age proof. However, they can only be considered as secondary evidence whereas the Pan Card is an item against the age proof and needs to be considered as primary evidence.  Thus, the statement given in the proposal form in respect of age is not found to be a misstatement as the Pan Card given as proof of age has not been alleged to be either wrong or fake.  In villages due to illiteracy most of the villagers do not remember their correct date of birth and approximations are very common.  One important thing in the present case is that the T.C. submitted by the life assured has been found to be fake and the learned counsel for the complainant has not stated a word in this regard during the agreement.  The letter written by the Principal, Krishak Inter College, Mawana (Meerut) to Assistant Manager (claims,), SBI Life Insurance Company Ltd, Navi Mumbai has not been challenged even during the arguments.  Prima-facie it is unclear why T.C. was filed when it was not required to be filed as the proof of age because the Pan Card was already filed. It seems that it was filed as proof of education.  From this aspect also, the information given in the proposal form was not correct though it will not have any bearing on the age of the life assured.

7.      From the above examination two main things are brought out.  The first is that the T.C. is mentioned against the column of education and against the address proof and against the age proof the Pan Card has been mentioned in the proposal form T.C. is not a valid and authorised document for proof of age as per the list given in the proposal form for proof of age.  Thus, there is no misrepresentation so far as proof of age is concerned.  The second aspect is the fake T.C. submitted by the complainant.  In this regard, the intention of the complainant for submitting this T.C. is not clear.  The only conclusion can be drawn that the complainant submitted his T.C. as proof of his education as he has mentioned against the column of education as class VII. Whatever may be the reason for submitting T.C. by the complainant, the fact remains that this T.C. has been found to be fake.  Neither the complainant or the learned counsel for the complainant have explained this aspect nor they have denied the same.  Hon’ble Supreme Court in Tata Motors Ltd. & anr. Vs. Hazoor Maharaj Baba Des Rajji Chela Baba Dewa Singhji (Radha Swami), 2013 SCC ONLine NCDRC 883 has observed that a person coming with unclean hands before a court cannot expect relief.  The judgment reads as under:-

8.      In the present case, the situation is that the complainant is entitled to insurance claim if the matter is considered only from the point of view of the repudiation letter as the assertion of the Insurance Company made in the repudiation letter has not been found true because there is no misstatement in the proposal form in respect of the age.  The date of birth given in the proposal form is same as given in the PAN Card which was enclosed as proof of age along with the proposal form.  The documents on which the Insurance Company is relying i.e. the voter list and the hospital treatment papers are really not in the list of documents which are required for the proof of age as per the proposal forum.  On the other hand, in the light of the judgment of Hon’ble Supreme Court in Tata Motors Ltd. & anr. Vs. Hazoor Maharaj Baba Des Rajji Chela Baba Dewa Singhji (Radha Swami) (supra), it is also true that the insured  had taken the policy where he also filed T.C. which has been found to be forged and thus, he entered into the agreement of policy with unclean hands and thus is not entitled to any relief.  As date of birth given in the T.C. is same as given in the PAN Card, the possibility cannot be ruled out that the PAN Card was made on the basis of the T.C. and as the T.C. has been found to be fake, the date of birth given in the PAN Card may also not be correct.  However, as no proof has been filed in this regard by either party to prove or deny this fact, it is to be concluded that the insurance claim cannot be repudiated totally as there is no misstatement in the proposal form even if the date of birth recorded in the PAN Card may not be the actual date of birth because PAN Card is a valid document for proof of age. In my view in the facts and circumstances of the case, the claim cannot be totally accepted because the insured entered into the policy contract with unclean hands and the same can also not be totally denied because no misrepresentation was there in the proposal form in respect of the age and that it needs to be considered because the repudiation letter is based on the issue of incorrect age only.  In the facts and circumstances of the case, in my view, the ends of justice will meet if the insurance claim is settled for 50% of the insured amount.

9.      Based on the above discussion, the First Appeal No.80 of 2016 is partly allowed and the order of the State Commission is modified to the extent that the Insurance Company shall pay Rs.15,00,000/- (rupees fifteen lakhs only) instead of Rs.30,00,000/- as allowed by the State Commission.  Rest of the conditions of the order of the State Commission remain unchanged. The order of the State Commission as modified by this order be complied by the appellant Insurance Company within a period of 45 days from the date of receipt/service of this order.