NCDRC

NCDRC

RP/1029/2020

BHARTI AXA LIFE INSURANCE CO. LTD. & ANR. - Complainant(s)

Versus

SHAIK SHAFI - Opp.Party(s)

MR. PRAVEEN MAHAJAN

20 Feb 2024

ORDER

NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION
NEW DELHI
 
REVISION PETITION NO. 1029 OF 2020
(Against the Order dated 13/02/2020 in Appeal No. 290/2017 of the State Commission Andhra Pradesh)
1. BHARTI AXA LIFE INSURANCE CO. LTD. & ANR.
...........Petitioner(s)
Versus 
1. SHAIK SHAFI
...........Respondent(s)

BEFORE: 
 HON'BLE DR. INDER JIT SINGH,PRESIDING MEMBER

FOR THE PETITIONER :
MR. PRAVEEN MAHAJAN AND MS. VRINDA, ADVOCATES
FOR THE RESPONDENT :
MR. SADINENI RAVI KUMAR AND MS. ISHA, ADVOCATES

Dated : 20 February 2024
ORDER

1.       The delay in filing the Revision Petition is covered under the period exempted under the Covid as per Hon’ble Supreme Court’s judgment, hence is deemed condoned.

2.       Heard Counsel for both sides.  Claim of the Respondent herein was repudiated by the Petitioner herein -Insurance Company vide claim rejection letter dated 31.12.2014 on the ground of wrong statement of the date of birth/age in the proposal form.  In the proposal for insurance, the life assured has stated his Date of Birth as 14.11.1945 (55 years of age on the date of proposal) and has produced PAN Card as proof of the same.  While considering the claim, the insurance company stated that they have documentary proof of the life assured that he is aged more than 55 years at the time of proposal.  Hence, taking it as a case of misleading the insurance company for non-disclosure of the material facts i.e. pertaining to the actual age in the proposal form for the insurance policy, rejected the claim. In support of their case, the Insurance Company has placed on record copy of the Adhaar Card, the Electoral Role, Voter Slip and Unified Birth and Death Registration Management System record.  A perusal of the Adhaar Card shows that it is in the name of Shaik Karimullah while the deceased’s name as per the Death Certificate is Shaik Karinunnisa.  Similarly, the name as per the Voter Slip, is Abdul Kharimunnisa.  Similarly, as per the Electoral Role, the name is Abdul Kharimunnisa.  Hence, it is clear and admitted during the hearing that these documents are not in the name of the deceased and hence much reliance cannot be placed on these documents to arrive at the correct age of the deceased.  As regard, extract of Unified Birth and Death Registration Management System record, which the Petitioner/Insurance Company claims to have downloaded from the website, claiming it to be a Public record, although most of the particulars match with the Death Certificate, the Respondent herein disputes the authenticity of these documents stating that it bears no authentication by the concerned issuing authority and hence cannot be relied upon.  As per this document age is shown as 75 years, meaning thereby that at the time of taking Insurance Policy, the approximate age would be 72 years.  On the other hand, the PAN Card clearly states the Date of Birth as 14.11.1955 and this document was accepted by the Insurance Company as a valid proof of Age/D.O.B. at the time of issuing the Policy.  We are in agreement with the contentions of the Respondent herein that the copy of the extract of Unified Birth and Death Registration Management System, being an unauthenticated document, cannot be relied upon.  In this regard, it is to be seen that Ombudsman has also looked into these aspects.  The extract of relevant observations of the Ombudsman are reproduced below:-

“During the hearing, the complainant repeated contentions of his complaint. On the other hand, the representative of the insurer who attended the hearing argued that their investigator collected irrefutable evidence showing that the deceased was aged more than 55 years at the time of proposal and hence their repudiation decision was justified.

On careful consideration of the contentions put forth by both the parties and the documentary evidence adduced, it is observed that the insurer had accepted the proposal on the basis of a standard age proof i.e., PAN Card, as per which the DLA was aged 55 years at the time of proposal.

The age of the DLA appeared to be more than 60 from the extracts of Voter Slip and Voter rolls of Guntur East Assembly Constituency. As per the extract of Unified Birth and Death Registration of A.P.Govt., also the DLA was aged 72 at the time of her death three years after commencement of the policy.

But, as all these are non-standard age proofs they cannot stand as substantial evidence to counter the age admitted at proposal stage on the basis of a standard age proof 'PAN card'.

On a detailed verification of the Adhar Card copies produced by the insurer, it is noticed that the year of birth of the son of the deceased life assured was 1965 and that of her grand son was 1988.

From the above, it is evident that the age of the complainant's father in the proposal year 2011 was 46 years and that of the complainant was 23.

Further, during the course of the hearing, the complainant who is the grandson of the deceased life assured, informed this forum that his father is the second child out of the five children of his grandmother. From this, it is very much clear that the DLA's age cannot be 55 in 2011 as the gap between her age and her second child's age could not be 9 years or less.

Not withstanding the observations in the preceding para, the fact remains that Adhar Card is still a non-standard age proof, as many a time the date of birth is recorded on mere declaration. But the ages of the children as also other proofs provide enough circumstantial evidence against the age shown as per the PAN Card.

Considering the facts and circumstances of the case, I consider it fair to direct the insurer to settle the claim on non-standard basis, taking that no reliable age proof has been produced by the DLA.”

 

 

3.       We have carefully gone through the order of the State Commission, District Forum, other relevant records and rival contentions of the parties.  In this regard, extract of relevant paras of the order of the State Commission are reproduced below:-

“15. The contention of the learned counsel for the opposite parties is that the District Forum did not consider Exs.B-4 to B-7 in right perspective. It is needless to say that the District Forum or this Commission has to consider the documents filed by both the parties in order to arrive at a just and reasonable conclusion. The Commission can place reliance on the authenticated documents produced by both the parties. The opposite parties produced the voters slip and Electoral Roll and Unified Birth and Death Register as well as Aadhar Card. All these documents are unsigned as well as photostat copies. The opposite parties did not evince any interest to produce the attested copies or the copies secured from the concerned departments to substantiate its stand. It is needless to say that this Commission cannot place reliance on unauthenticated documents. Viewed from factual or legal angle, no credence or credibility can be attached to Ex.B-1 to B-7. The District Forum rejected the above referred documents, after considering the evidentiary value of these documents.

16. The opposite parties have taken a plea in the counter that the opposite party can repudiate the claim of the complainant in view of Section 45 of the Insurance Act. As rightly pointed out by the learned counsel for the appellant, the Insurance Company can repudiate the claim on the ground of mis-representation within two years from the date of issuance of the policy in view of Section 45 of the un-amended Insurance Act. In the instant case, the policy was issued on 22.07.2011 and the life assured died on 20.06.2014. Admittedly, the life assured died two years after the policy came into force. The insurer is not entitled to challenge the validity of the policy on the ground of mis-statement in the proposal form, after lapse of two years from the date of issuance of the policy. In the light of the foregoing discussion, we are of the considered view that the opposite party is not entitled to repudiate the claim taking aid of the Section 45 of the Insurance Act.

17. If the findings recorded by the District Forum are not based on evidence or based on evidence which is not admissible under law, then such findings can be termed as perverse. In the instant case, the findings recorded by the District Forum are fully supported by the documentary evidence produced by both the parties. In such circumstances, we are not inclined to accede to the contention of the appellants that the findings recorded by the District Forum are perverse. The District Forum has assigned reasons much less cogent and valid reasons to its findings. There is no illegality or irregularity in the impugned order which warrants interference of this Commission. Viewed from any angle, the appeal is liable to be dismissed. Accordingly, the point Nos. 1 and 2 are answered in favour of the complainant and against the opposite parties.”

 

 

4.       We are in agreement with the observations/findings of the State Commission. As was held by the Hon’ble Supreme Court in Rubi Chandra Dutta Vs. United India Insurance Co. Ltd. [(2011) 11 SCC 269], the scope in a Revision Petition is limited. Such powers can be exercised only if there is some prima facie jurisdictional error appearing in the impugned order. In Sunil Kumar Maity Vs. State Bank of India & Ors. [AIR (2022) SC 577]  held that “the revisional jurisdiction of the National Commission under Section 21(b) of the said Act is extremely limited. It should be exercised only in case as contemplated within the parameters specified in the said provision, namely when it appears to the National Commission that the State Commission had exercised a jurisdiction not vested in it by law, or had failed to exercise jurisdiction so vested, or had acted in the exercise of its jurisdiction illegally or with material irregularity.”  

5.       We find no illegality or material irregularity or jurisdictional error in the order of the State Commission, hence the same is upheld.  Accordingly, the Revision Petition is dismissed.

6.       The pending IAs in the case, if any, also stand disposed off.

 
................................................
DR. INDER JIT SINGH
PRESIDING MEMBER

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