HON’BLE SUDIP NIYOGI PRESIDENT FACTS Claiming to be a bona fide consumer in accordance with the Consumer Protection Act, 2019, the Complainant filed this complaint against the OPs seeking several reliefs namely, issuing a direction upon the OPs to settle the insurance claim, a restraining order against the opposite parties from enlisting the name of the Complainant in C.I.B.I.L, compensation and cost of litigation on the ground as stated hereinbelow; During his life time Samit Sit, since deceased, who was the husband of the Complainant had purchased one flat being No. C on the 2nd floor ad measuring 746 sq. ft. super-built-up area in the building named SUBHASREE together with undivided proportionate share in land in the premises No. 4A/1, Dharmatala Road, P.S- Kasba, Kolkata- 700042 by virtue of execution and registration of a deed of conveyance in his favour. He also mutated his name with Kolkata Municipal Corporation. During his life time, said Samit Sit obtained insurance policy from OP No. 2 being policy No. IM3096030 with effect from 24/04/2019 in respect of loan No. 410YSHET261871 with basic sum assured Rs.40,00,000/- which was valid from 24/06/2019 to 24/06/2020 with an option of yearly renewal. He also had taken loans amounting to Rs.16,93,000/-, Rs.6,76,000/- and Rs.18,30,000/- being A/C No. 410TSHET261871, 410TSHEU273949 & 410HSLET046126 respectively. He obtained the life insurance policy to secure his property as well as his other loans. However, he died intestate on 08/01/2020 at Ruby General Hospital leaving behind his wife who is the Complainant and two minor children as his legal heirs and representatives. After his death, the Complainant intimated the death of her husband to the OPs and submitted insurance claim in accordance with the said policy but her claim was repudiated and a letter of repudiation dated 30/11/2020 was issued showing a ground of non-disclosure of material facts. Complainant, thereafter, requested by a letter for reconsideration of her claim dated 12/01/2021 but till date she did not get any reply from opposite parties. According to her, the repudiation of her claim is unjust as opposite parties issued the policy in favour of her husband on proper verification of his health and scrutinizing other necessary documents. All the OPs contested the case by filing written statements and adducing evidence. OP Nos. 1 & 3 filed a joint written statement claiming that Bajaj Finserv Limited is a holding company of Bajaj Finance Limited which under a mutual agreement works under the trade name of Bajaj Housing Finance Limited. Bajaj Finserv Limited does not provide any kind of housing loan etc. and both of them are different legal entities. Their further case is that following execution of a Master Assignment Agreement made between OP No. 3- Bajaj Housing Finance Limited and Asset Reconstruction Company India Limited (ARCIL) on 30/06/2021, OP No. 3 sold, assigned, conveyed and transferred to said Asset Reconstruction Company India Limited the existing loans together with all their rights, title, interest and benefits in respect of financing documents. This apart, they claimed one civil suit at the instance of the Complainant is pending in a court at Alipore on the same cause of action. They also stated that they had no role to play with respect to the claim of insurance policy which is at the sole discretion of the insurance company. They only acted as facilitator in the agreement of insurance of the husband of the Complainant. So, they prayed for dismissal of the instant complaint. OP No. 2 by filing a separate written statement claimed that there was non-disclosure of material facts as to the health and disease of the Complainant’s husband who died in Ruby General Hospital, Kolkata due to massive variable bleed and shock impatient with coagulopathy and cirrhosis of liver. They also claimed for dismissal of the complaint. Parties are found to have exchanged interrogatories and replies. All of them also filed their written notes of argument. Now, the point for consideration is whether the Complainant is entitled to the relief (s) as prayed for. FINDINGS From the materials on record, it is found admittedly by opposite party Nos. 1 and 3 that Samit Sit, since deceased, who was the husband of the Complainant during his lifetime had obtained three separate loans of Rs.16,99,000/- (not Rs.16,93,000/- as claimed by the Complainant), Rs.6,76,000/- and Rs.18,30,000/- vide loan account nos. 410TSHET261871, 410TSHEU273949 and 410HSLET046126 respectively from them. In 2020 he had bought one 746 sq. ft. flat as noted in para 3 of the petition of complaint. Thereafter in the year 2019 said Samit Sit also obtained one life insurance policy under Bajaj Allianz group term life i.e. OP No.2 vide policy no.IM3096030, Membership No. GTLN _ 303649237 having Master Policy No. 0362808827, in order to secure his loan no. 410YSHET261871. It is also found that said Samit Sit died intestate on 08.01.2020 at Ruby General Hospital, Kolkata leaving behind his wife i.e. the Complainant and two minor children as his legal heirs and representatives. Then the Complainant raised a claim with the said insurance company i.e. OP No.2, arising out of the death of her husband but her claim was repudiated for suppression of material facts / non-disclosure of material facts regarding the health status of the deceased / life assured and that was communicated to the Complainant by a letter dated 13.11.2020. Subsequently, Complainant sent another letter requesting for reconsideration of her claim but to no effect. Thereafter the Complainant filed the instant case against the OPs praying for several relief (s) as stated hereinbefore. In their written version as well as in evidence OP No.1 & 3 claimed that Bajaj Finserv Ltd. is a holding company of Bajaj Housing Finance Ltd. which under a mutual agreement works under the trade name of Bajaj Finserv Ltd. The said Bajaj Finserv Ltd. has no branches in India nor does it provide any kind of housing loan etc. and both the two companies are completely different legal entities under law. Not only that it is stated by them that following a Master Assignment Agreement between OP No.3 i.e. Bajaj Housing Finance Ltd. and Asset Reconstruction Company (India) Ltd. on 30.06.2021. ARCIL is having charge of the loan account at present and OP No.3 has nothing to do with the said loan account in the light of the said assignment deed. Apart from this, it is stated by them that the husband of the Complainant obtained insurance from OP No.2 and they acted just as a facilitator and has no role to play with respect to the claims of insurance policy which is at the sole discretion of the insurance company. They had no role in approving or rejecting the insurance claim and the authority of the same is lying with the insurance company. The copy of the insurance certificate in the name of said Samit Sit produced by the complainant which reveals that he had obtained insurance policy from OP No.2 which has already been pointed out hereinabove. The basic sum assured was Rs.40,00,000/- with annual renewal date 24.06.2020, the date of commencement of the said policy was 24.06.2019. So, it is found that the death of Samit Sit occurred during the subsistence of the said policy. After the death claim was raised by the Complainant, OP No.2 as per IRDAI norms investigated the claim and discovered that the life assured i.e. said Samit Sit was suffering from diabetes mellitus and hypertension from 2014 prior to the proposal and also had undergone liver disease treatment two years prior to the policy commencing date and that is why for non-disclosure of material facts they repudiated the claim of the Complainant. It is said by OP No. 2 that if the illness of the life assured was disclosed earlier during the policy insurance stage then the policy would not have been issued at all under the said terms and conditions. In support of their contentions, they produced an investigation report which were collected by them including the treatment-sheet of the patient at Ruby General Hospital, Kolkata Annexure – B & C revealed that the patient died at Ruby General Hospital on 08.01.2020 which is also admitted by the Complainant. The cause of death was shown as massive variable bleed and shock impatient with coagulopathy and cirrhosis of liver. The said deceased was also said to be alcoholic (severe). It is further gathered from the documents of Ruby General Hospital that he had got previous treatment of liver disease at Vellore two years back. The Complainant in fact, did not produce a single paper, barring only the death certificate issued by the KMC, as to the health status of her husband. She denied in her replies to the questionnaire filed by OP No.2 that her husband was suffering or had treated for any disease at any time or prior to making proposal form for the policy. All she claimed that the policy in favour of her husband was issued after proper verification of his health and scrutinizing other necessary documents. In her written notes of argument also she did not challenge the contention of OP No.2 as to the pre-existing deceased of the life assured and also the documents which were collected by the Investigator of OP No.2 from the said Ruby General Hospital and produced in connection with this case as annexures. So, ongoing through the materials on record including the documents produced by OP No.2 and the contentions of the Complainant we find there was suppression of material facts / non-disclosure of material facts in respect of the health of the husband of the Complainant at the time of obtaining the policy from OP No.2. In this connection be it noted here that in (2009) 3 SCC 366 SATWANT KAUR SANDHU VS. NEW INDIA ASSURANCE COMPANY LIMITED it was held that it was the obligation of the insured to disclose true and full information sought in the proposal form and non-disclosure of facts as to the illness of the insured in proposal form tantamount to suppression of materials fact enabling insurer to repudiate its liability under the policy. In another case (2008) 1 SCC 321 P.C. CHACKO AND ANOTHER Vs. CHAIRMAN, LIFE INSURANCE CORPORATION OF INDIA AND OTHERS it was held that “misstatement by itself was not material for repudiation of the policy unless the same is material in nature. But, a deliberate wrong answer which has a great bearing on the contract of insurance, if discovered may lead to the policy being vitiated in law and the policy can be repudiated if obtained with fraudulent act.” So, considering the facts and circumstances of the case and also in the light of the aforesaid discussions of the Hon’ble Apex Court, we find there was deliberate suppression of facts as to the health status of the husband of the Complainant at the time of obtaining the policy which could be discovered by OP No.2 through investigation in connection with the claim of the complainant. So, the act of OP No.2 in repudiating the claim cannot be said to be unjustified and their act does not amount to deficiency in service on their part. So, the instant complaint is liable to be dismissed. Accordingly, it is ORDERED That the instant complaint is dismissed on contest costs against all the OPs. No order as to cost. Dictated and corrected by me. President | 
