STATE CONSUMER DISPUTE REDRESSAL COMMISSION
BIHAR, PATNA
Appeal No. 402 of 2018
1. The Branch Manager, H.D.F.C Life Insurance Co. Ltd., Amgola Road, 2nd Floor, Vikash Bhawan Near Orient Club, Muzaffarpur- 842002.
2. The managing Directors, H.d.F.C. standard Life Insurance Company Limited Lodha Excelus 13th Floor, Appolo mills compound, N.M. Joshi Marg Maha Lakshmi, Mumbai-400011.
….. Opposite parties-Appellants
Versus
Sheela Devi, W/O- Late Bunilal Ram, resident of Vill- Bhopati, P.S- Bhojoati, P.s- Sarai, District- Vaishali, at present Mohalla- Krishna Chowk, Majhauliya road, P.S- Kazimohammadpur, District- Muzaffarpur. …… Complainant-Respondent
Before,
Hon’ble Mr. Justice Sanjay Kumar, President
Md. Ram Prawesh Das, Member
Dated 08.06.2023
O r d e r
Sanjay Kumar,J: President
Present appeal has been filed on behalf of appellant-opposite parties HDFC Life Insurance Company Ltd. for setting aside the judgment and order dated 29.06.2018 passed by learned District Consumer Disputes Redressal Forum, Muzaffarpur in Consumer Complaint Case No. 233 of 2016 whereby and whereunder the learned District Forum, Muzaffarpur has allowed the complaint case and directed appellant insurance company to pay the sum assured amount of Rs. 15,00,000/- with interest @ 8% p.a from the date of filing of case and Rs. 10,000/- as compensation for physical and mental harassment as well as cost of litigation within 30 days.
Briefly stated the facts of the case is that husband of the appellant Bunilal Ram had obtained a life insurance policy from appellant/Insurance company bearing policy no. 16621790 with sum assured amount of Rs. 15,00,000/-. The proposal form was filled by the agent of L.I.C in presence of company officials as life insured was not knowing English. Premium of Rs. 8630/- was paid and after undergoing all the formalities premium receipt as well as policy bond was issued in the name of life insured person Bunilal Ram and risk coverage period was from 13.02.2014 to 13.02.2024 Complainant being the wife of the life insured was made nominee in the insurance policy.
Life insured Bunilal Ram suddenly developed abdominal pain and dehydration on 29.07.2014 and was rushed to the clinic of Dr. Y.K. Thakur for treatment but as there was no improvement he was referred to P.M.C.H, Patna but unfortunately on 13.07.2014 at about 04.30 A.M he died while on his way to PMCH.
Complainant being the nominee and widow of life insured Bunilal Ram filed death claim for payment of sum assured amount before the insurance company along with all relevant documents but the insurance company repudiated the death claim on the ground that upon investigation conducted by the insurance company it was found that deceased life insured had concealed previous insurance policy obtained by him while filling the proposal form with respect to present insurance policy.
Complainant thereafter filed a consumer complaint case before the District Consumer Forum, Muzaffarpur for setting aside the letter of repudiation as well as for payment of sum assured amount of Rs. 15,00,000/- with interest as well as grant of compensation for mental and physical harassment and cost of litigation.
In support of her complaint case complainant placed on record premium receipt of Rs. 8630/- dated 13.02.2014, death certificate, income tax return for assessment year 2012-13 and 2013-14, death claim application dated 29.10.2015 as well as decision of N.C.D.R.C, passed in F.A 1696/2016.
On notice opposite party insurance company appeared and filed their written statement dated 26.07.2017 in which they have admitted the insurance policy issued in the name of husband of complainant as well as his death during the risk coverage period. It was further stated that during investigation it was found that deceased life insured had previously obtained insurance policy prior to obtaining present policy and same was not disclosed in the proposal form and as such there was suppression and concealment of material fact accordingly the death claim of complainant was repudiated.
The District Consumer Forum after considering submissions of both parties and considering materials and evidences available on record held that although in repudiation letter the insurance company has taken a plea that deceased life insured had also obtained insurance policy prior to present policy but same was not disclosed in the proposal form of the deceased life insured however the insurance company has neither brought on record any such insurance policy nor has given any details of such previous insurance policy in their written statement nor any such document has been filed by the insurance company in support of their repudiation of claim of complainant and accordingly allowed the complaint case filed by complainant.
Aggrieved by the judgment and order dated 29.06.2018 passed in complaint case no. 233/2016 present appeal has been filed by the opposite party HDFC Insurance Company.
Onus lies on the insurance company to established that there has been suppression and conciliation of material fact or information by the insured in the proposal form by leading cogent evidence. However, nothing was placed on record to establish that deceased insured had obtained insurance policy prior to obtaining present insurance policy which was not disclosed in the proposal form.
District Consumer Commission has specifically held that insurance company could not produce any insurance policy obtained by deceased prior to obtaining present policy yet appellant HDFC insurance company has audacity to file this appeal and even in this appeal no such document of previous insurance policy has been enclosed by the appellants.
The present appeal is frivolous and misconceived and is accordingly dismissed with a cost of Rs. 10,000/- to be deposited by The Branch Manager, H.D.F.C Life Insurance Co. Ltd, Muzaffarpur in the account number 40851298384 of “Legal Aid to the Litigants“ maintained by State Commission in Patna High Court, within 60 days from the date of receipt production of a copy of order passed by this court.
(Ram Prawesh Das) (Sanjay Kumar,J)
Member President
Agam
