(Per Shri Dhanraj Khamatkar, Hon’ble Member)
(1) This appeal takes an exception to an order dated 20/09/2004 passed by District Forum, Nashik in Consumer Complaint No.95/2002.
(2) The facts leading to this appeal can be summarized as under:-
The husband of the complainant late Aba Madhav Mogal had taken insurance from the opponent insurance company for a sum of `50,000/- on 31/08/1994. The name of the policy is Bimakiran. The husband of the complainant died on 25/07/1997. The complainant filed a claim of the policy with the opponent. The opponent repudiated the claim on the ground that the deceased had taken a policy showing his age less and hence they have repudiated the claim on 10/12/2003. The complainant approached to the ombudsman. However, the ombudsman has also confirmed the repudiation. Hence, the complainant filed consumer complaint praying that denying the claim of the complainant is a deficiency in service on the part of the opponent and hence the opponent be directed to sanction the claim of the complainant.
(3) The opponents contested the complaint contending that the policy taken is Bimakiran policy and the age limit for the policy is 35 years. However, at the time of taking policy, the deceased policy holder has shown his date of birth as 14/06/1959. As per school record, the date of birth is 01/06/1957 and at the time of taking policy, he was more than 35 years and hence the deceased policy holder had taken a policy suppressing his real age and hence the opponent has repudiated the claim. The opponent further requested that the complaint may please be dismissed.
(4) The district forum after going though the pleadings of both the parties and evidence adduced by both the parties has allowed the complaint directing the opponent to allow the claim of the complainant within 1 month from the order, failing which there will be an interest @9% p.a. The district forum further ordered that under policy table 75-20 if there is any difference in the payment of installment, it may be deducted from the claim of the complainant. Aggrieved by this order, the insurance company filed this appeal.
(4) We have heard Adv.Komal Vora, proxy for Adv.Bhave & Co. for the appellant and Adv.K.S.Shelake for the respondent. Admittedly, the deceased husband of the complainant had taken Bimakiran policy on 31/08/1994. Perusal of the proposal form shows that the agent of the appellant has signed the certificate. The certificate reads as under:-
We certify that we have verified the above information as correct from the original age proof submitted by the life assured. We further certify that the life assured affixed his signature in our presence after we have explained the contents of this form and after having fully understood the contents thereof.
(5) From perusal of the signature of the deceased, it is seen that he was a layman. The appellant insurance company has accepted the proposal and issued the policy. After the death of the deceased, when the respondent submitted the claim form, the appellants have repudiated the claim on the ground that as per the school leaving certificate, the date of birth of the deceased is 01/06/1957 while in proposal from he has shown his date of birth as 04/06/1959. In the proposal form, there is an overwriting, however, the overwriting is not attested. Section 45 of the Insurance Act, 1938 says;
No policy of life insurance effected before the commencement of this Act shall after the expiry of two years from the date of commencement of this Act and no policy of life insurance effected after the coming into force of this Act shall, after the expiry of two years from the date on which it was effected, be called in question by an insurer on the ground that a statement made in the proposal for insurance or in any report of a medical officer, or referee, or friend of the insured, or in any other document leading to the issue of the policy, was inaccurate or false, unless the insurer shows that such statement 2[ was on a material matter or suppressed facts which it was material to disclose and that it was fraudulently made] by the policy- holder and that the policy- holder knew at the time of making it that the statement was false 3[ or that it suppressed facts which it was material to disclose]:
Provided that nothing in this section shall prevent the insurer from calling for proof of age at any time if he is entitled to do so, and no policy shall be deemed to be called in question merely because the terms of the policy are adjusted on subsequent proof that the age of the life insured was incorrectly stated in the proposal.
(6) Looking into the background of the deceased husband of the complainant, it cannot be said that he has stated his age fraudulently and he was aware of the fact that his age was false.
(7) The district forum after considering this material fact and circumstances of the case has passed the order. We find that the order passed by the district forum is just and proper and there is no substance in the appeal filed by the appellant insurance company. We hold accordingly and pass the following order.
ORDER
(1) Appeal is dismissed. The order of the District Forum, Nashik dated 20/09/2004 is hereby confirmed.
(2) No order as to costs.
(3) Inform the parties accordingly.
Pronounced on 16th November, 2011.
