The complainant Lal Bachan Mandal has filed this complaint petition against Branch Manager,  Birla Sun Life Insurance  company Ltd., and Managing Director, of the same company for realization of Rs. 5,63,000/-(sum assured) due to death of insured person Usha Kumari D/O complainant  with 18 % p.a. interest from the date of death of  life insured person till date of  final payment , realization  of Rs. 45,000/- for compensation as mental agony, physical harassment, and Rs. 25,000/-  as litigation cost.  

The case of the complainant, in brief, is that complainant  Lal Bachan Mandal has filed this case in the capacity of nominee father of life assured person namely Usha Kumari Proposer of the said policy. The further case is that the o.p company after being satisfied with the soundness of health, age, and others formalities, gave an proposal form to the complainant  on 10-09-2014 for insurance of his child life. The further case is that the complainant paid Rs. 13,000/-as premium amount on the same day i.e on 10-09-2014 to the company and purchased a policy for sum assured of RS. 5,63,000/- along with other monitory benefits. The further case of the complainant is that entire proposer form was filled up by the company agent in the presence of company officials   because the complainant had no knowledge of English and the complainant only put the signature  whereas the agent of said office directed him to do so. The further case is that after accepting the premium amount against policy No.- 006591973 the aforesaid company issued premium receipt  and bond in the name of life assured person namely Usha Kumari (minor) and hence the said  company started risk coverage of life of  Usha Kumari from 29-09-2014 with sum assured  Rs. 5,63,000/- along with other monitory benefits . The Further case is that in the morning 11-11-2014, all of sudden life assured namely Usha Kumari  died due to chest pain.  The further case is that after incident, complainant filed death claim against policy No.-006591773 to the aforesaid insurance company with all documents, but after persistent demand and several requests by the complainant  the company repudiated the claim of the complainant on the ground that the complainant had not stated about prior policy detail pertaining to the life assured in the proposal form and therefore suppressed material information.

 The complainant  has filed the following documents with the complaint petition - photocopy of premium receipt  in the name of Usha Kumari  annexure-1-, photocopy of death certificate of  Usha Kumari  annexure-2-, photocopy  of  income tax return of Lal Banchan Mandal annexure-3-, photocopy of repudiation letter by the company to the Lal Bachan Mandal annexure-4-, photocopy  of  Pan Card of Lal Bachan Mandal annexure-5-, photocopy of  certificate in respect of income of Lal Bachan Mandal annexure-6.

O.Ps appeared on 30-03-2017 and filed his w.s. on                     05-03-2018. It has been mentioned in the w.s. that the complaint petition is false , frivolous  and vexatious, and the same  is liable to be dismissed u/s 26 of Consumer Protection Act., it has been further mentioned that no cause of action has been disclosed in the complaint petition so, complaint petition is liable to be dismissed as per section 11 (2) (C ) of the Consumer Protection Act 1986. It has been mentioned in the w.s. that the claim of the complainant has been repudiated by the company because complainant has suppressed the material fact u/s – 45 of the insurance Act 1938 vide letter dated 25-03-2016. He has also mentioned that the complainant had taken other policies in the name of diseased and he didn’t mention the same in the proposal form and as he suppressed the fact.

A list of insurance policies, purchased in the name of Usha Kumari has also been mentioned in the w.s.

The following  documents has been annexed with the w.s. on behalf of o.ps  photocopy of certificate  incorporation pursuant to change of name of the company annexure-A-, photocopy of proposal form  in the name  of Usha Kumari annexure-B-, photocopy of   death claim of claimant dated 14-12-2015 annexure-C-, photocopy of E.mails exchange annexure-D, photocopy of repudiation letter dated 25-03-2016 annexure-E.

             On behalf of complainant PW-1 Lal Bachan Mandal  (complainant himself),  has deposed on affidavit and he has  supported his complaint petition   and exhibited  the papers filed on his  behalf  as Exhibit 1to 6.

            Both parties have filed Written Arguments. The  learned lawyer for the o.ps has relied on many ruling mentioned in the written arguments as well as in w.s. whereas the learned lawyer for the complainant  relied on  ruling  of the case of Renu Devi V/s PNB Mate Life Insurance Company Ltd. Bangalore  and others granted   by State Consumer Dispute Redresal Commission, Bihar  Patna vide order dated 07-12-17  in  complaint case No.- 64/2016, Judgment of Hon’ble Supreme court in the case of Om Prakash  V/s  Reliance General Insurance  and another  (civil Appeal No. 18611/2017 arising out of SLP ( c )No. 742/2015 certified copy of order dated 16-10-2015 in complaint C. No.- 53/2014 passed by this forum and certified copy of  order dated 31-08-2017 passed by   Hon’ble  State Consumer Forum Bihar, Patna in the case of Branch Manager, Birla Sun Life Insurance Company Ltd. V/s Pramod Roy.

The main question for determination  is as to whether the o.ps company has rightly repudiated the claim of claimant due to suppression of material fact or not?  The complainant has asserted in the complaint petition itself  that the proposal form was filled by the agent in the presence of officials  of the o.ps and he only put his signature. The learned lawyer for the complainant has submitted  that the claim of the complainant cannot be repudiated on the ground that he has taken other policies before issuance of this policy. He has relied on the order dated 07-12-2017  passed by Hon’ble State Consumer Dispute Redressal Commission  Bihar, Patna passed in Renu Devi/Vs. PNB Mot life insurance company Ltd.         

On perusal of order of the Hon’ble State Commission Bihar, Patna, passed in the above case it transpires that the same type of matter had come  before the Hon’ble State Commission in which insurance company had also cited several decisions  of the Hon’ble court and the company had repudiated the claim of the claimant on the same ground. After considering all the facts, Hon’ble Commission has held that the objection raised by  the o.p and insurance company is not tenable and the same cannot be sustained in law Hon’ble State Commission has also observed that the complainant is entitled  to get insurance amount with other benefits .

So, from the above judgment it transpires that Hon’ble State Commission has scrutinized all the facts raised by the insurance company and the Hon’ble State Commission, was pleased to hold that the o.p company cannot repudiate the claim of the complainant on the ground of prior issuance  of policy.

The complainant has supported his version by examining himself on affidavit and exhibited the claims filed on his behalf,  Whereas the insurance company has not adduced any evidence in support of his version. It is admitted fact that  o.ps  company issued the policy in the name of complainant’s daughter  Usha Kumari. On perusal of the proposal form it transpires  that the same is not in the hand writing   of Lal Bachan Mandal.  Death of the Usha Kumari is not under the challenge. So, on the basis of above discussions we are of the opinion that the o.p company has wrongly repudiated the claim of the claimant  and there is deficiency in service on the part o.p

O.P No. 2 B Managing Director, Birla Sun Life company Ltd. had filed a petition on 05-03-2018 for deletion  of his post name / cause of title of complaint and after hearing both  parties on 02-11-2018 order has been passed that the o.p No. 2 B has  made party as proforma  defendant.

Accordingly the claim petition of the complainant is allowed and the o.p  2 A  Branch Manager Birla Sun Life Insurance company/ Aditya Birla Sun Life Insurance Company is directed to pay Rs. 5,63,000/- as sum assured with 8 % interest p.a.  from the date of filing of the complaint petition, Rs. 30,000/- as compensation for mental agony and physical harassment  and Rs. 10,000/- as litigation cost  to be complainant   within 2 months of the order / receipt  of order, of  failure he shall be liable to pay the sum assured with 9 % p.a. interest from the  date of  filing  till realization. Let a copy of this order be furnished to both the parties  as per rule.