Final Order / Judgement | DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION PATIALA. Consumer Complaint No. 353 of 2.9.2019 Decided on: 16.1.2023 - Shamsher Singh S/o Late Baldev Singh
- Gurdeep Kaur w/o Late Baldev Singh
Both r/o village Galoli, PO Shergarh, Tehsil Patran, District Patiala. …………...Complainants Versus - The Divisional Manager, Life Insurance Corporation of India, Railway Road, Sangrur.
- The Divisional Manager, Life Insurance Corporation of India, Chhoti Baradari, Patiala.
…………Opposite Parties Complaint under the Consumer Protection Act QUORUM Hon’ble Mr. S.K.Aggarwal, President Hon’ble Mr. G.S.Nagi, Member PRESENT: Sh.Parshotam Garg, counsel for complainants. Sh.Amit Kumar Bedi, counsel for OPs. ORDER S.K.AGGARWAL,PRESIDENT - The instant complaint is filed by Shamsher Singh and Gurdeep Kaur son and wife of Late Baldev Singh (hereinafter referred to as the complainant) against The Divisional Manager, Life Insurance Corporation of India and another (hereinafter referred to as the OP/s) under the Consumer Protection Act ( for short the Act).
- It is averred that deceased Baldev Singh had taken a life insurance policy Jeevan Saral (with profits) bearing No.165378014, from OP No.1 on 28.7.2013, with half yearly premium of Rs.24260/- having sum assured of Rs.10,00,000/-, commencing from 22.8.2013. The complainants were the nominee of the policy in question and has been reinforced by OP No.1 vide letter dated 4.4.2019.
- It is further averred that deceased had regularly deposited the installments amounting Rs.2,47,800/-approximately and had also got issued loan of Rs.1,50,000/- on the said policy.
- It is further averred that Baldev Singh expired on 28.3.2018.Thereafter, complainants lodged death claim with the OPs. It is further averred that OP No.1, in the letter dated 4.4.2019, sent to the complainant mentioned that total amount payable was Rs.1,82,605/- and after deducting the loan amount of Rs.1,51,821/- have issued cheque bearing No.054955 amounting to Rs.31,784/- dated 30.3.2019 payable at Axis Bank, Sangrur.
- It is further averred that as per the terms of policy, in case of death of the life assured, the beneficiary shall be entitled to get the amount of sum assured of Rs.10,00,000/-. It is further averred that the complainants time and again requested the OPs for the payment of the said amount but the OPs flatly refused to do so. The complainant also got issued legal notice dated 9.5.2019 in this regard but a vague reply was given. The complainant also filed an application under RTI Act to disclose the facts on which the complaint of the complainant is rejected but the OPs did not supply complete record as demanded in the RTI application. The act and conduct caused mental agony and harassment to the complainant. There is also deficiency in service on the part of the OPs in not providing the complete record. Consequently, prayer has thus, been made for acceptance of the complaint.
- Upon notice, OPs appeared through counsel and filed written reply taking various preliminary objections. It is alleged that the policy in question was taken by the life assured by concealing true and material fact about his age. The complainant intentionally mentioned wrong age and gave a KYC document i.e. driving licence to support the fact of his age at the time of filing the proposal form. It is further alleged that the date of birth mentioned in the driving licence was 10.8.1970 whereas actual date of birth of the deceased/life assured was 1.1.1955 and this fact came to light only when the complainants submitted claim documents and produced Aadhar card of the deceased/life assured-Baldev Singh. It is further alleged that as per correct date of birth, the age of the life assured as on proposal date i.e. on 28.7.2013 would have been 58 years plus, whereas with wrong date of birth his age comes to 43 years only. It is further alleged that son of life assured-Shamsher Singh has submitted copy of his PAN card, Aadhar card, where his date of birth is 12.7.1980, year of birth of younger daughter of the life assured is 1984 and date of birth of the eldest daughter of the life assured is 1979.As such the life assured had mentioned his wrong date of birth in the proposal form and if the LA had stated his correct age then the proposer had to undergo various medical tests such as ECG, FBS, RUA, Lipido, Hb% and was thus rightly repudiated.
- It is further averred that the life assured was not regular in depositing the premiums and the policy in question got lapsed for non deposit of premium from 7/2016 to 7/2017 and was revived on 25.7.2017 on the basis of DGH and deposit of arrears of premiums.
- It is further alleged that the DLA applied for loan of Rs.1,50,000/- against the policy in question which was granted on 12.2.2018.It is further alleged that the OPs procured information from the treating doctor in the shape of Form No.3784 that Baldev Singh was suffering from Live cirrhosis/HCV +ive .
- On merits, the OPs reiterated the facts as have taken in the preliminary objections which are not repeated for the sake of brevity. Ultimately, after denying all other averments of the complainant, the OPs have prayed for the dismissal of the complaint.
- In order to prove the case, ld. counsel for the complainants has tendered in evidence,Ex.CW1/A affidavit of Shamsher Singh alongwith documents Ex.C1 copy of insurance policy,Exs.C2 &C3, copies of Aadhar cards,Ex.C4 copy of ration card, Ex.C5 to Ex.C12, copies of receipts, Ex.C13 copy of death certificate,Ex.C14 copy of letter dated 4.4.2019,Ex.C15 copy of cheque dated 30.3.2019,Ex.C16 copy of legal notice, Ex.C17 & C18, copies of postal receipts, Ex.C19 copy of reply to legal notice, Ex.C20 to Ex.C23, copies of applications under RTI and their postal receipts, Ex.C24 copy of reply under RTI, Ex.C25 to Ex.C28, copies of documents supplied by the OPs alongwith reply of RTI application and closed the evidence.
- On the other hand, the ld. counsel for the OPs has tendered in evidence Ex.OPA affidavit of Jai Bhagwan Bansal, Manager L & HPF alongwith documents, Ex.OP1 copy of authority letter,Ex.OP2 copy of DL of Baldev Singh, Ex.OP3 copy of Aadhar card of Baldev Singh, Ex.OP4 copy of Aadhar card of Shamsher Singh, Ex.OP5 copy of pan card of Shamsher Singh, Ex.OP6 copy of Aadhar card of Rupinder Kaur, Ex.OP7 copy of Aadhar card of Charanjeet Kaur, Ex.OP8 copy of proposal form, Ex.OP9 copy of policy, Ex.OP10 copy of repudiation letter dated 30.3.2019,Ex.OP11 copy of form 3784, Ex.OP12 copy of loan intimation letter, Ex.OP13 copy of proof of payment of loan amount, Ex.OP14 copy of form No.680,Ex.OP15 copy of revival quotation,Ex.OP16 copy of terms and conditions of the policy, Ex.OP17 copy of legal notice,Ex.OP18 copy of reply to legal notice and closed the evidence.
- After hearing the ld.counsel for the parties and going through the record of the case, carefully, the question arises for determination as to whether repudiation of the claim vide Ex.OP10 on the basis of date of birth is justified and the answer is negative.
- From the perusal of record, it is clear that while getting the insurance policy deceased Baldev Singh/life assured disclosed his age as 43years.Now the OPs are saying that at the time of taking the policy age of deceased Baldev Singh was 55 years, on the basis of documents produced lateron by the complainants. This allegation of the OPs is not tenable, as it was for the OPs to have asked the deceased life assured to furnish better proof regarding his date of birth particularly the school leaving certificate if, they were doubtful about the correctness of the date of birth/age of deceased Baldev Singh, shown in the driving licence.It was never asked for by the OPs. If the OPs had taken the date of birth of deceased life assured as 10.8.1970 as furnished by him to be correct and accepted the proposal form, they cannot turn around now and challenge the correctness of the date of birth of Baldev Singh(now deceased).
- In this context, reference can be made to the judgment of the Hon’ble Calcutta High Court titled as Allianz Und Stuttgarter Life Insurance Bank Ltd. Vs.Hemanta Kumar Das, AIR,1938 Calcutta 641, in which it has been held that:
“It is to be borne in mind that this was an insurance by a man who admittedly was, at any rate, at the age of over forty-five years. He himself stated that he was fifty four. Therefore, the transaction came within the category of those proposals which require at the outset the furnishing by the proponents of proof of their age.Noot Behari Das was required to furnish proof of his age. He produced a horoscope. The horoscope was accepted by the company as being sufficient. Therefore, we may take that the company issued the policy upon the footing that they were insuring the life of a man whose age was fifty four. This is not a case where the proposer says that his age was fifty four and the company merely accepted the statement at its face value and proceeded to issue a policy on that footing and subsequently, either shortly afterwards or a long time afterwards, admitted the age as stated in the policy in accordance with the provisions of Clause 9(2) thereof. This was a case where the whole transaction from the very beginning proceeded upon the basis that the company had satisfied themselves that the proposer was of the age of fifty four and then issued the policy accordingly. In my view therefore, the admission contained in the endorsement at page 3 of the policy is of such a character that the defendants when the policy matured could not be heard to say that the age of the insured was anything different from what he himself had stated it to be in February 1934.It is not necessary that one should apply in terms of the principle of estoppel, because that is merely a rule of evidence. In my view, this matter goes far deeper than that. The question of age of the deceased was a definite and determining factor in the transaction from the very outset”. - Since the assured specifically mentioned in the proposal form that the date of birth of Baldev Singh was given from the driving licence, therefore, it is clearly proved that he did not know that date of birth given by him was wrong or that he had furnished the wrong information with fraudulent intention.It is therefore, held that deceased Baldev Singh had given his date of birth with bona fide intention and he had relied upon the information as shown in the driving licnece.Since the school leaving certificate was not demanded by the OPs, now the OPs cannot place reliance on it and justify the repudiation of the insurance claim. In this regard, ld. counsel for the complainant has placed reliance upon the judgment titled as Life Insurance Corporation of India Vs. Balbir Singh and Anr. First Appeal No.1213 of 2007 decided on 28.8.2008 by the Hon’ble Punjab State Consumer Disputes Redressal Commission, Chandigarh.
- Not only this, as per the pleadings of the OPs, the policy in question was lapsed for the period from 7/2016 to 7/2017 due to not payment of premium and they revived the same on 25.7.2017.At that time also it was more incumbent upon the OPs to ask for the document with regard to date of birth of life assured but they did not do so and revived the policy.
- Moreover, Section 45 of the Insurance Act,1938,reads as under:
“45.Policy not to be called in question on ground of misstatement after two years-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 calledin 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 (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 [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 life insured was incorrectly stated in the proposal.]” - Consequently, it is found that the OPs were not justified in repudiating the claim as insurance policy was commenced on 22.8.2013 and they did not raise any objection also with regard to correctness of age within two years of issuing the policy.
- As such, in view of above discussion, the complaint is partly allowed and the OPs are directed to pay the sum assured after deducting the amount already paid to the complainant. No order as to costs.
- Compliance of the order be made by the OPs within 30 days from the date of the receipt of certified copy of order.
- The instant complaint could not be disposed of within stipulated period due to heavy rush of work, Covid protocol and for want of Quorum from long time.
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G.S.Nagi S.K.AGGARWAL Member President | |