MR. KUNDAN KUMAR KUMAI
This is a complaint u/s 35 of the Consumer Protection Act, 2019.
Brief fact of the Complainant’s case is that the Complainant’s deceased wife Meherun Bibi had purchased Life Insurance Policies from Malda – II branch of the LIC, during her life time, in which she had nominated the Complainant as her nominee in the following Policies:
Policy No. & Date Amount in (Rs.)
- 406056476 dated 26/4/2019 Rs.10,00,000/-
- 406057175 dated 14/5/2019 Rs.15,00,000/-
- 406059031 dated 28/5/2019 Rs.59,00,000/-
On 16/08/2019 the Complainant’s wife died, due to heart attack. During her life time she had one cloth shop and also trade license and was also an Income-Tax payee, indicating that she was financially sound. The Complainant duly informed the matter to OP no.1, but the OP no.1 did not pay any heed. Due to such non-cooperation, the Complainant met the OP no.1 on 16/12/2019, but the OP no.1 did not provide any relief to the Complainant. Following which the Complainant submitted a Claim Letter dated 15/12/2020, but with no response from the OP no.1. The Complainant filed another Claim Letter dated 10/05/2021 by providing reference of the earlier Claim Letter dated 15/12/2020. But again, there was no response. The father of the deceased Meherun Bibi also submitted one Request Letter for disbursement of the claim.
On 07/12/2021 the OP no.2, sent one letter being Reference No. –JDO/D. Claim/REPDN. /MNGR., repudiating all the three Policies and forfeiting the money received, on the ground of suppression of material facts, with the suggestion to approach the Zonal Office, Claim Disputes Redressal Committee at Kolkata, being OP no.3. The Complainant then lodged a complaint before the OP no.3 on 30/12/2021 and one reply was received on 04/01/2022 vide Reference No.-EZO/CRM/REPD.DEATH CLAIM/2021/67. Being dissatisfied, the Complainant further sent another letter dated 22/01/2022 to the OP Members, but with no response. The Complainant further sent another letter through on-line being no.-DEID/E/2022/02663 dated 17/2/2022, but they said was disposed of by OP no.3, without any reasonable cause. The Complainant further submitted another appeal being no. -CP GRAM APPEAL no. – DEAID/E/A/22/0000327 dated 23/02/2022 and the OP no.2, in collusion with other OP Members, had repudiated the Complainant’s claim. Thereafter, the Complainant sent one Legal Notice dated 04/04/2022 being Reference No. -66 to 69/2022 to OP nos. 1, 2, 3 & 4 by Speed Post.
The OP nos. 1, 2 & 3 had violated the Rules & Regulations made by IRDA and also caused deficiency of service. The Complainant lodged a complaint with prayer of refund of Rs.85,00,000/- (Rupees eighty-five lakhs) only, along with Rs.15,00,000/- (Rupees fifteen lakhs) only for mental agony along with bank interest from 16/08/2019 and litigation cost.
The OP nos. 1, 2 & 3 have appeared to contest the case by filing written version, wherein they admitted the purchase of three Policies, involving of a total of Rs.84,00,000/- (Rupees eighty-four lakhs) only, by the deceased Meherun Bibi during her life time, within a short interval of one month (26/4/2019 to 28/5/2019). At the time of purchase of the Policies, had submitted ITR Acknowledgement for Assessment Year 2017-18, 2018-19 & 2019-20. In ITR for Assessment Year 2017-18 the Return was submitted on 12/04/2017 and which was verified on 12/04/2017, but in case of ITR Assessment Year 2018-19, the Acknowledgement showed that the Return was submitted on 13/04/2018 and verification by IT Authority was done on 12/04/2017, much before the Return was submitted.
It was further stated that in the letter dated 22/05/2022, Executive Assistant of Marnai G P, Uttar Dinajpur, the deceased Meherun Bibi had deposited Tax for Trade Registration Certificate for the period 2019-20, amounting to Rs.500/- (Rupees five hundred) only, on 03/04/2019 vide Receipt No.7096. Thereafter, she neither deposited any fees on Trade Registration Certificate nor renewed or received any Certificate of Registration, for running trade from Marnai GP, indicating that she received Trade Registration Certificate only once for 03/04/2019 to purchase the Insurance Policies with a motive for unlawful gain. For acceptance of such huge Insurance Coverage of Rs. 84,00,000/- (Rupees eighty-four lakhs) only, on female life, the husband’s Insurance was needed. The Complainant also procured two Policies on his own life, being nos. 406057152 dated 14/05/2019 for Rs.25,00,000/- (Rupees twenty-five lakhs) only and Policy No. 406058817 dated 02/06/2019 for Rs.45,00,000/- (Rupees forty-five lakhs) only. Both the Policies were in lapsed condition with first unpaid premium on 11/2019 for Policy No.406057152 and yly. FUP 062020 for Policy no. 406058817, indicating that the Complainant purposefully procured the insurance with a motive of unlawful gain, on his wife’s life.
It was further mentioned that the deceased, Meherun Bibi, had opened a S/B A/c no.50483325845 IFSC Code ALLA0211568 on 04/04/2019. As per bank’s Statement there was 65 (sixty-five) transactions from 04/04/2019 to 21/11/2020. During these 65 transactions the deceased had deposited cash only three times being Rs.1000/- (Rupees one thousand) only on 05/04/2019, Rs.5000/- (Rupees five thousand) only on 11/04/2019 and Rs.1000/- (Rupees one thousand) only on17/04/2019. Till 21/11/2020 she never deposited any amount indicating that she did not have regular income and she opened the bank a/c only to fulfil the anti-money laundering guidelines, required for acceptance of her insurance.
The deceased had also made a false declaration in the proposal for insurance and also in her letter dated 30/07/2019 that she had stock business and she had stored her harvest in her go-down and that she had cloth shop and Lichee Bagan. According to her proposal, these were main sources of her income and in connivance with the Complainant had misled the LIC, into accepting her proposal for insurance with this false declaration. The assessment list for the financial year 2019/2020, supplied by the Executive Assistant of 10, Marnai GP, revealed that there was only eight satak of bastu land, recorded in favour of the deceased, whose present market value was Rs.1,00,000/- (Rupees one lakh) only. From the Panchayet Bokeya and Hal Dabi and Aday Karan boi, supplied by the Executive Assistant, it was found that the deceased had deposited Rs.120/- (Rupees one hundred twenty) only, as Tax for the year 2019-20 on 10/04/2019 and no Tax was paid for the years 2017-18, 2018-19, & 2020-21. Documents supplied by the Executive Assistant clearly proved that the deceased had a small piece of land in her name and there was no cloth shop or any Lichee Bagan or any go-down recorded in the GP office in her name, indicating that the declaration made by the deceased, which is the basis of insurance contract was false and intentionally fabricated. Thereafter, the case of the Complainant was denied with the exception of repudiation by the different hierarchies.
The Proforma OP no.4 also filed a written version wherein it was claimed that the OP no.4 was a regulator of insurance sector and did not solicit any insurance nor offered or rendered any service and it was a Statutory Body with no specific relief had been sought against it.
In support of his case, the Complainant had examined PWs 1, 2, 3 & 4 and the Complainant was subjected to Questionnaires by the OPs. The OP nos. 1, 2 & 3 on the other hand had examined OPW 1 on their behalf. Both the sides have furnished certain documents which have been kept in the record.
The only point only needs to be decided is whether the OPs have been able to prove that the Policies have been obtained by fraud.
Decisions with Reasons
Ld. Advocate for the Complainant at the time of final hearing, had submitted that no question was raised at the time of execution of the Policies and inspite of filing the Claim Petition on time, the OPs repudiated the Policies vide letter dated 07/12/2021 more than two years after the death of the deceased on 16/08/2019. He therefore prayed for issuing an order in favour of the Complainant, as per the prayer made in the complaint. He has relied in the judgement passed by the Hon’ble Supreme Court in J.S.K. Industries Pvt. Ltd. Vs. Oriental Insurance Co. Ltd. reported in 2022 Live Law (SC) 884, Hon’ble SCDRC, Gujarat in Met Life India Ins. Co. Ltd. Vs. Bhavesh Arvind Bhai Chauhan on 03/04/2021 and the direction of the IRDA in Kunti Devi Vs. HDFC Standard Life.
Ld. Advocate for the OPs at the time of final hearing, had submitted that the Complainant’s wife had submitted forged and misleading ITR Acknowledgement for the Assessment Year 2017-18, 2018-19 & 2019-20 with ITR Acknowledgement for the Assessment Year 2018-19, showing the Return had been submitted on 13/04/2018 and verified on 12/4/2017 and contradicted by the ITO of Malda Ward vide letter dated 29/09/2022 stating that the deceased had not filed IT Return for the Assessment Year 2017-18 & 2018-19. It was further argued that the deceased, Meherun Bibi, had falsely declared in her proposal, that she had stock business and used to store seasonal crops in her godown and also a clothes shop and Lichee Bagan, which were her main sources of income. But the pre-assessment list of the Financial Year 2019-20, supplied by the Executive Assistant of Marnai GP, wherein only 8 shatak of bastu land, was recorded in the name of the deceased and the present market value was only Rs.1,00,000/- (Rupees one lakh) only. From the information recorded in the Panchayet Bokeya and Hal Dabi and Aday Karan Boi, supplied by the Executive Assistant it was found that the deceased had deposited Rs.120/- (Rupees one hundred twenty) only as Tax for the year 2019-20 on 10/04/2019 and no Tax was paid for the years 2017-18, 2018-19, 2020-21 & 2020-21. That apart it was submitted that the deceased had deposited Rs.500/- (Rupees five hundred) only as tax for trade, for the period 2019-20 on 03/04/2019, but she neither deposited any fees on Trade Registration Certificate nor renewed, nor received any Trade Registration Certificate and for running trade under Marnai GP. The deceased had only received Trade Registration Certificate for only one year to create a false impression of her financial soundness to purchase the Insurance Policy. It was also submitted that in order to accept Policy of Rs.84,00,000/- (Rupees eighty-four lakhs) only, on female life, Policies of her husband were also needed and the present Complainant had procured two Policies amounting to Rs.25,00,000/- (Rupees twenty-five lakhs) only and 45,00,000/- (Rupees forty-five lakhs) only, which assisted in the acceptance of the deceased’s Policy, but apart from the initial premium no second premium was paid, indicating the illegal motive behind the procuring of the deceased’s Policy. It was also pointed out that the deceased’s Savings Bank Account with the Indian Bank showed paltry deposits on the three occasions, indicating that the deceased did not have any regular source of income. Ld. Advocate for the OPs therefore prayed that the Complainant and the deceased had misled the OPs in accepting the Policies by indulging in false and forged documents and he had relied in the judgement passed by the Hon’ble Supreme Court in United India Insurance Company Vs. M. K. J. Corporation reported in 1996 (6) SCC 428.
The execution of the Policies dated 26/04/2019, 14/05/2019 and 14/08/2019 are not disputed. The only point of dispute is that the OPs had repudiated the said Claim on the ground of suppression of material fact at the time of taking these Policies under the provisions of section 45(2) of the Insurance Act. Therefore, the onus now shifts upon the OPs to prove their contention.
In this regard, the OPs have laid reliance on the letter issued by the ITO of Malda Ward vide letter dated 29/09/2022 which clearly shows that the IT Return of the deceased, Meherun Bibi (PAN – ELFPB5363B) had not filed any IT Return for the Assessment Year 2017-18 & 2018-19 as per E-filing Portal and CPC-2.0, indicating that the ITR Acknowledgements for the above two Assessment Years filed by the deceased, Meherun Bibi, had been either false or manufactured. In this respect, the Complainant had neither filed any evidence to contradict the above, even though there was an opportunity for him to do so. That apart it was within the knowledge of the Complainant as the deceased wife could not have possibly hidden such disclosure from him and committed such an incident without the Complainant’s active support and abetment.
With reference to income of the deceased, Meherun Bibi, had claimed vide letter dated 30/07/2019 (Annexure 12) that she used to purchase Rabi and Kharif mustard plants and stored in her godown and sold them at a premium, comprising her main source of income. That apart she had a Lichee Bagan and a Clothes business and therefore would be able to pay the premium for the LIC Policies, she intended to purchase. To counter the above, the OPs had filed the letter dated 23/05/2022, issued by the Marnai GP Executive Assistant stating that the deceased, Meherun Bibi, had obtained a Trade Registration Certificate for the period 20/9/2020 and had deposited Rs.500/- (Rupees five hundred) only on 03/04/2019 vide Receipt no.7096. Prior to that the Late Meherun Bibi had neither deposited any fees for Trade Registration Certificate nor renewed or got any Trade Registration Certificate for running a trade from the said Gram Panchayat (Annexure 7 of the OPs). To counter this document, there is no evidence forthcoming from the Complainant nor any evidence to counter the contents of the document or to prove the different sources of income, as claimed by the deceased, Meherun Bibi in her letter dated 30/07/2019 (Annexure 12). Therefore, the failure on the part of the Complainant to deflect the evidence filed by the OP clearly strengthens the veracity of the evidence filed by the OPs.
Furthermore, the SB Account No. of the deceased 50483325845 (IFSC Code: ALLA0211568) with Zalua Bathel Br. of Indian Bank showed deposits by the deceased, Meherun Bibi, only on three occasions out of a total transaction of 65 times, reflected by Annexure 11 of the OPs, with deposits shown on transaction dated 17/04/19, 11/04/19 & 05/04/19 amounting to Rs. 1,00,000/- (Rupees one lakh) only, 5000/- (Rupees five thousand) only and 1000/- (Rupees one thousand) only, respectively. This evidence also goes against the deceased wife’s credibility to pay the premiums of such huge amount i.e., 84,00,000/- (Rupees eighty-four lakhs) only. Moreover, it further emphasizes the lack of solvency on the part of the deceased wife, Meherun Bibi to afford LIC Policies, of such amount.
Therefore, from the above findings it becomes clear that the deceased wife Meherun Bibi had wrongly portrayed herself as solvent enough to the purchase of three LIC Policies, thereby misleading the Opposite Parties, belying the good faith needed to be observed by her, as laid down in the judgement passed by the Hon’ble Supreme Court in United India Insurance Company Vs. M. K. J. Corporation reported in 1996 (6) SCC 428.
The only legal point raised on behalf of the Complainant is there was inordinate delay in responding to the Claim made by the Complainant after the death of the deceased. In this regard, the explanation forthcoming from the OPs is that, during the period Pandemic prevailed all over the world and the response could not be made on time. Moreover, with the investigation to verify being impeded by the Pandemic closure, also proved a hindrance to the submission of the reply, to the Claim Application. Since the findings mentioned above clearly goes against the Complainant the delay in responding the Claim Application appears to be justified.
Hence, in view of the discussions and conclusions arrived at it becomes clear that the claim of the Complainant fails and consequently the instant Case also fails.
It is therefore,
ORDERED
The instant Case be and the same is dismissed on contest, but without cost.
Copy of the Order be sent to the parties free of cost.
