HON’BLE MR. JUSTICE V.K.JAIN, PRESIDING MEMBER (ORAL)        

Late Sh. Harbhajan Singh husband of the complainant obtained an insurance policy from the appellant.  In the proposal form submitted by him, he had claimed annual income of Rs.2.5 lacs.  He having died, a claim in terms of the insurance policy was lodged by the complainant she being his widow.  The claim was rejected vide letter dated 08.05.2018 which to the extent it is relevant, reads as under:

We would like to inform you that the company had covered the risk for the above said policy on the basis of the facts mentioned in the proposal form.  However, on receiving the death claim intimation for the above said policy, the various investigations done/the various medical records received reveal certain facts, which were known to the deceased life assured and were not disclosed to us.  Hence, the death claim under above mentioned policy has been declined for the following reasons:

It is a case of misrepresentation of material facts - Life assured was BPL card holder.

2.      Being aggrieved from the rejection of the claim, the complainant approached the concerned State Commission by way of a Consumer Complaint. 

3.      The complaint was resisted by the insurer primarily on the ground that the deceased did not have the income claimed in the proposal he being the holder of a BPL card and he had made a misrepresentation with respect to his annual income.  This is also the submission of the learned counsel for the appellant that had the deceased disclosed his correct income to the insurer, the policy of Rs.19.80 lacs would not have been granted to him since the extent of the insurance coverage depends upon the income of the insured. 

4.      The State Commission having allowed the Consumer Complaint, the insurer is before this Commission by way of this appeal. 

5.      The only issue involved in this appeal is as to whether the deceased had inflated his income while submitting the proposal.  No documentary evidence of the income of the deceased such as income tax return or a salary slip was produced either by the insurer or by the complainant.  The appellant placed on record what purports to be a certificate issued by the Sarpanch of Village Dassuwal Mandi certifying therein that late Sh. Harbhajan Singh was a farmer and a BPL card holder, known very well to him.  The respondent also placed on record what purported to be a certificate issued by Harpal Singh, an officer of the Food & Supplies Department stating therein that the complainant Sukhjit Kaur is a BPL card holder. 

6.      The complainant on the other hand, placed on record a certificate purporting to be issued by Block Development and Panchayat Officer informing therein that the name of Harbhajan Singh was not recorded in the BPL. 

7.      The appellant did not examine the Sarpanch of Village Dassuwal Mandi to prove the certificate purporting to have been issued by him.  No affidavit of the above referred Sarpanch was filed before the State Commission to prove the said certificate.  Similarly, neither Mr. Harpal Singh of Food & Supplies Department was examined to prove the document purporting to be issued by him nor was his affidavit filed by way of evidence, to prove the said document.  The complainant also did not file the affidavit of the Block Development and Panchayat Officer to prove the certificate purporting to be issued by him on 08.10.2018. 

8.      The onus was upon the insurer to prove that the deceased had made a misrepresentation in the proposal with respect to his income.  As noted earlier, no income tax return of the deceased was produced before the State Commission.  Though it was claimed in the certificate purporting to be issued by Sarpanch of the Village that the deceased was holding a BPL card, even the number of any such card was not given in the said document.  As far as the document purporting to be issued by the Food & Supplies Department is concerned, it is nowhere stated in the said document that late Sh. Harbhajan Singh was holding a BPL card.  This is apart from the fact that no one from the Food & Supplies Department was summoned with record to prove the issuance of the BPL card to the complainant Smt. Sukhjit Kaur.  Since a BPL ration card number was given in the document purporting to be issued by Harpal Singh of Food & Supplies Department, the appellant could easily have summoned the record of that office and in that case, it would have been possible for the State Commission to peruse the card referred in the document and verify whether the name of the deceased Harbhajan Singh was included in the said card or not.  That having not been done, the document purporting to be issued by Sh. Harpal Singh of Food & Supplies Department in my opinion, does not prove that the deceased was holding a BPL card on the date the proposal was submitted by him to the insurer.  It would be pertinent to note here that the relevant date for the purpose of finding out whether any misrepresentation as regards the income of the insured was made or not, would be the date on which the proposal was submitted.  If a person was having a particular income on the date the proposal is submitted, his income comes down subsequently and he becomes entitled to issuance of a BPL card, that would not be a case of misrepresentation with respect to the income of the insured.  Therefore, the insurer was required to prove that on the date the proposal was submitted, the deceased was holding a BPL card.  No such evidence was produced and even the document purporting to be issued by Sh. Harpal Singh of Food & Supplies Department does not give the date on which the BPL ration card was allegedly issued to the complainant Smt. Sukhjit Kaur.  Even the Sarpanch who purports to have issued the certificate dated 13.03.2018, does not disclose the date on which the BPL card was allegedly issued to Sh. Harbhajan Singh and the person who issued the document, does not even claim that on 12.12.2015, when the proposal was issued, the deceased was holding the BPL card. 

9.      A BPL card is a public document having been issued by a public servant in discharge of his official duties.  Every citizen is entitled to a certified copy of a public document.  Therefore, it was not at all difficult for the appellant to apply for and obtain a certified copy of the BPL card alleged to have been issued to the deceased.  Even the certified copy of the BPL card alleged to have been issued to the complainant was not obtained and filed though the number of the said card is given in the certificate dated 13.03.2018 purporting to be issued by Sh. Harpal Singh of Food & Supplies Department.

10.    The appellant could also have obtained requisite information under the provisions of Right to Information Act and in that manner, could have confirmed whether any BPL card had been issued to the deceased insured and if so, on which date the said card was issued.  Even an authenticated copy of the said card could have been obtained under the provisions of Right to Information Act.  That however, was not done though the deceased expired way back on 27.01.2016.   

11.    The learned counsel for the appellant submits that they have since applied for the requisite information under the provisions of Right to Information Act, but the said information is yet to be supplied.  However, this is not the stage for waiting for the information under the provisions of Right to Information Act to be received by the appellant.  I fail to appreciate why the insurer was in a hurry to reject the claim without proper verification.  The information which the appellant is now seeking under the provisions of Right to Information Act, ought to have been sought before rejection and in any case, before filing the written version to the Consumer Complaint.  Neither the certified copy of any BPL card was obtained and filed nor was the requisite information under the provisions of Right to Information Act obtained even during the pendency of the Consumer Complaint before the State Commission.  Though the appellant sought permission to examine the investigator, no permission of the State Commission was sought to summon the record of the Food & Supplies Department.

12.    For the reasons stated hereinabove, I find no good ground to interfere with the view taken by the State Commission.  The appeal as well as the accompanying application for condonation of delay in filing the appeal, are therefore, dismissed with no order as to costs.