This C.C. is coming on before us for hearing in the presence of Kankipati Girija, Advocate for complainant and of Sri. M. Srinivasa Reddy, Advocate for opposite party No.2 and the opposite parties No. 1 called absent; upon perusing the material papers on record; upon hearing and having stood over for consideration, this Forum passed the following:-

O R D E R

(Per Sri R.Kiran Kumar, Member)

          This Complaint is filed u/s.12-A of Consumer Protection Act, 1986. 

2.       The averments made in the complaint are that the complainant is the wife of the deceased Anjaneyulu, who insured his life with opposite party No.1&2 on 20-08-2010 vide ULIP policy No.LN101000102939 and he paid Rs.50,000/- as yearly installment.  The complainant submitted that after the payment the opposite party No.1 issued the policy bond in favour of Anjaneyulu for an amount of Rs.2,50,000/- as sum assured, the name of the complainant shown as nominee in the said policy.  The complainant further submitted that at the time of taking the policy, the opposite party No.1 obtained all the particulars of the deceased along with photocopies of documents and issued the policy bond in which the opposite parties No.1&2 clearly mentioned that the deceased Anjaneyulu was the retired employee.  The complainant also submitted that the said fact shows that at the time of taking the policy the deceased Anjaneyulu is completed the age of 58 years and the same is within the knowledge of opposite parties 1 & 2 and also the photocopy of PAN card also submitted along with other documents.  The complainant further submitted that the deceased Anjaneyulu expired on 12-11-2012, after his death the complainant filed the claim before the opposite parties 1 &2, the opposite parties No.1&2 sent a letter to the complainant on 23-03-2013 by stating that the PAN card submitted by the deceased Anjaneyulu was shown wrong date of birth and the same was found by them through their investigator and also informed that the said policy is not applicable to the persons who completed the age of 60 years and repudiated the same, and in the said letter   the opposite parties mentioned that the deceased Anjaneyulu is eligible for the next plan, in that he can get only an amount of Rs.1,33,389.85 only and repudiated the remaining claim of Rs.1,16,610.15.  The complainant further submitted that the deceased Anjaneyulu obtained the policy as per the directions of opposite party No.1, at the time of filling application and collecting the photocopies of documents it is the duty of opposite parties to verify and inform the fact to the customers who obtained the polices.  In this policy opposite parties No. 1& 2 collected the premium without verifying the facts and records, collected huge amount from the deceased and issued the policy, it comes under the deficiency of service on the part of opposite parties No. 1 & 2.  The complainant further submitted that the opposite parties No.1 & 2 failed to handover the photocopy of PAN card, which was submitted by the deceased Anjaneyulu, paid the less amount and avoid the payment of total policy amount by illegally repudiating the same, which is against the principles of natural justice, for that the complainant filed this complaint. 

3.       On behalf of the complainant, the following documents were filed and marked as Exs.A.1 to A.5. 

4.       On receipt of notice, opposite parties appeared through their counsel and filed counter.  In their counter, opposite parties submitted that the deceased life assured L. Anjaneyulu was supplied with proposal forms and requested to fill the correct details regarding his age, weight, health conditions, pre health conditions if any, habits, occupation, family history, etc., as per procedure of the proposal form, basing on the information furnished by the  deceased in the proposal form, the opposite party No.2 has accepted the risk on the life of the deceased and thereby issued the subject policy in good faith.  The opposite parties further submitted that the complainant intimated that the deceased/ policy holder was died on 12-11-2012, the matter was investigated by the opposite parties and the documents collected by the investigator “PAN card of the deceased / life assured and pension particulars from the Accountant General Office, Hyderabad dt. 11-01-2008 is noted that the date of birth of the deceased the life assured in the above documents were mentioned as 02-08-1949  i.e., his age as on the date of the commencement of the policy i.e. 20-08-2010 was 61 years.  The opposite parties also submitted that for taking a life insurance policy ‘Shriram Future Wealth II’ the maximum age at entry is 60 years, whereas the deceased /life assured had wrongly mentioned the date of birth as 02-08-1960 in proposal form by submitting PAN card as age proof.  The opposite parties further submitted that the details of the PAN Card submitted at the time of proposal form was verified from the official site of NSDL Income Tax PAN Service’s unit and it is verified that the PAN card on the name of deceased / life assured and with regard to the date of birth there was no record found.  After verification of the PAN card the same was accepted as KYC document as the same was attested by the deceased life assured.  The opposite parties further submitted that the copy of PAN card collected by the investigator wherein the age is 02-08-1949 and copy of pension particulars from the Accountant General Office, Hyderabad and copy of the PAN card submitted by the deceased / life assured at the time of the filling the proposal form.  The opposite parties also submitted that at the time of taking policy the deceased / life assured submitted the particulars, which are the wrong statements, when compared to PAN card and documents collected from A.G. Office, Hyderabad by their investigator.  The opposite parties also submitted that from the above it is clear that the deceased / policy holder obtained the policy with a deceitful manner by suppressing the actual age, with a fraudulent intention and to have undue advantage of the policy benefits.  The opposite parties also submitted that “Life insurance polices are contracts governed by the principle of ‘Uberrimafide’ and the proposal applied for the insurance is expected to correctly furnish all material information regarding health, habits, correct age, family history, income, height and weight etc., of the life proposed for insurance by providing correct answers to the questions in the proposal form”.  The opposite parties also submitted that the deceased / life assured had failed to provide the correct details and taken the policy, the claim under the policy is void and not enforceable in law as such the claim of the complainant got repudiated on 23-03-2013.  The opposite parties also submitted that the deceased / life assured had deliberately suppressed the material facts which were supposed to be        disclosed at the time of taking the policy and violated the terms & conditions of the policy, from the above it is clear that there is no deficiency of service on their part as such prayed to dismiss the complainant. 

5.       On behalf of the opposite parties the following documents were filed and marked as Exhibits B.1 to B.4.

Ex.B.1:- Photocopy of PAN card, wherein age is 02-08-1949.

Ex.B.2:- Photocopy of Pension particulars from the A.G. Office, Hyd.

Ex.B.3:- Photocopy of PAN card submitted by the deceased at the time of

              filling the proposal form.

Ex.B.4:- Photocopy of Proposal Form.

6.       Written arguments of complainant filed. 

7.       Upon perusing the material papers on record and upon hearing the arguments, now the point that arose for consideration is,

Whether the assured had suppressed the material facts pertaining to his Age details at the time of submitting proposal form, consequently the complainant is entitled for the claim amount under the policy?

Point:-

8.       In this case the husband of the complainant during his lifetime obtained insurance policy for a sum assured of Rs.2,50,000/- vide bearing No.LN101000102939 from opposite parties and shown the name of complainant as nominee.  That on 12-11-2012 the husband of the complainant died, after death of her husband, the complainant submitted claim form before the opposite parties No. 1 & 2.  But the opposite parties made investigation on the death of the insured, on investigation the opposite parties came to know that the deceased/ life assured had suppressed the material facts about his age and he was shown wrong date of birth in the proposal form seeks the details viz. Date of Birth, Qualification, Occupation, Annual Income and source of Income etc., which is directly effect the issuance of policy on his life, as such the opposite parties repudiated the claim of the complainant, for that the complainant approached the Forum. 

9.       It is an undisputed fact that the husband of the complainant died on 12-11-2012, while he had taken policy on 20-08-2010.  The opposite party insurance corporation made investigation.  During the course of investigation the opposite party corporation came to know that the husband of the complainant wrongly mentioned his date of birth and he obtained the policy by making the fraudulent misrepresentation intentionally and hence is void abinitio and to support their case the opposite parties filed Exs.B.1 to B.3, the record shows that the deceased had suppressed the material fact.  From the above there is no reason to doubt about the age proof furnished by the opposite party corporation. 

          And also we observed that the opposite party company repudiated the claim of the complainant as it was found that DLA had misrepresented the facts while replying to the specific questions in the proposal Form and the same has been intimated to the complainant through exhibit A2 & A3.  The opposite parties also refunded the fund value under the policy no. LN101000102939, an amount of Rs.1,33,389.85/- through cheque bearing No. 006898, dt. 28-03-2013 drawn on HDFC Bank, Lakdikaphool Branch, Hyderabad as per the terms & conditions of the policy.  The complainant failed to produce any evidence to disprove the case of opposite parties. Since the suppression is material, the repudiation of claim according to us was justified.  In these circumstances we cannot attribute any deficiency of service on the part of opposite parties as such this point is answered against the complainant.

          In the result, the complaint is dismissed.  There is no order as to costs.    

          Typed to dictation, corrected and pronounced by us in the open forum, on this the 10^th day of April, 2015.

       Member                  FAC President             

District Consumer Forum, Khammam

APPENDIX OF EVIDENCE

WITNESSES EXAMINED:-

For Complainant:-                                                     For Opposite party:-   

       -None-                                                                           -None-

DOCUMENTS MARKED:-

For Complainant:-                                                     For Opposite party:-   

                Member                  FAC President             

District Consumer Forum, Khammam