Haryana

Karnal

CC/371/2021

Shimla - Complainant(s)

Versus

The Manager, TATA Capital Housing Finance Limited - Opp.Party(s)

Manoj Jani

01 Aug 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

 

                                                        Complaint No. 371 of 2021

                                                        Date of instt.03.08.2021

                                                        Date of Decision:01.08.2024

 

Shimla wife of late Shri Randhir, resident of ward no.4, Pai Gate, Pundri District Kaithal now resident of village Karsa Dod tehsil Nigdhu, District Karnal, age 56 years, Aadhar card no.9043 7665 3742.

                                               …….Complainant.

                                              Versus

 

1. The Manager, TATA Capital Housing Finance Limited, SCO 239, Ground floor, Part-I, opposite Mini Secretariat, Sector-12, Karnal.

 

2. HDFC Life Insurance Coi. Ltd. SCO 778-779 Kunjpura Road, opposite Mahavir Dal Hospital, Karnal through its Manager.

 

                                                                    …..Opposite Parties.

 

Complaint under Section 35 of Consumer Protection Act, 2019.

 

Before   Shri Jaswant Singh……President.     

      Shri Vineet Kaushik…….Member

      Ms. Sarvjeet Kaur .…..Member

 

 Argued by: Shri Manoj Jani, counsel for the complainant.

                    Shri Umesh Kumar, counsel for the OP no.1.

                    Shri Vikas Bakshi, counsel for the OP no.2.

 

                     (Jaswant Singh, President)

ORDER:   

                

                The complainant has filed the present complaint under Section 35 of the Consumer Protection Act, 2019 against the opposite parties (hereinafter referred to as ‘OPs’) on the averments that Shri Randhir husband of complainant applied for a loan of Rs.20,00,000/- and OP no.1 disbursed amount is Rs.17,04,070/-, vide loan account no.TCHHL0352000100000200, which will be repaid in 180/181 monthly installment of Rs.17,897/- each. The said loan was insured from HDFC Life Insurance Co. Ltd. vide certificate no.PP00012201KAY00 which was advise by OP no.1 and OP no.1 assured that in case of death of borrower/insured person the entire loan amount as well life insurance amount will be paid by the insurance company. The insured paid regular installment but unfortunately he died on 12.10.2019 due to Respiratory Failure and information in this regard was given to OPs. After the death of insured, complainant approached the OPs to issue NOC and also pay the life insurance cover amount i.e. Rs.17,50,166/- as per Appendix A/Table as the said loan and life of the deceased was insured and as per the version of the OPs, the insurance company will pay the entire remaining loan amount but OP no.2 did not pay the same and postpone the matter on one pretext or the other. Thereafter, complainant requested the OPs several times to issue NOC and will pay the insurance amount but OPs did not do so and sent a letter dated 08.10.2020 vide which OPs refused to pay the insurance amount. In this way there is deficiency in service and unfair trade practice on the part of the OPs. Hence this complaint.

 2.            On notice, OP no.1 appeared and filed its written version, raising preliminary objections with regard to maintainability; jurisdiction; cause of action; locus standi; limitation and concealment of true and material facts. On merits, it is pleaded that the OP is a company incorporated under the Companies Act engaged in the business of lending or financing. The OP is not doing any insurance business or deals in insurance transactions. The role of the OP towards insurance was limited to advance loan of insurance premium as per the request of the borrower. The OP has not issue any insurance policy to complainant and/to borrower. The main dispute is between the complainant and the HDFC Life Insurance Company i.e. OP no.2. OP no.1 has no role in processing of insurance claim. The OP no.1 has only given the financial assistance to purchase the home and also to pay insurance premium. OP has every right to recover the defaulted amount/ outstanding amount due towards the loan of complainant apart from availing legal remedies available as per law for recovery of outstanding amount. It is further pleaded that an amount of Rs. 20,00,000/- was sanctioned in favour of the borrower(s) namely late Shri Randhir Chhailuram and Mrs. Shimla i.e. complainant is the co-applicant. The said sanctioned amount has been disbursed in two parts. Initially an amount of Rs.17,04,070/- was disbursed and thereafter Rs.2,95,930/- was disbursed  basis on the request for the borrower against collateral/property bearing house in ward no.5, Pai Gate Khewat no.792, 994, Khatauni no.901, 1114-1117, Pundri, Kaithal. It is further pleaded that the fact of further disbursement and/or received loan amount from OP no.1 has been intentionally concealed  from this Commission. That during the covid period even complainant has enjoyed the moratorium benefit as per the directions given by RBI during pandemic. It is further pleaded that the request of complainant for issuing the NOC is declined as the NOC can only be issued after the payment of the outstanding amount and closure of loan account. There is no deficiency in service and unfair trade practice on the part of the OP. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

3.             OP no.2 filed its separate written version raising preliminary objections with regard to maintainability; cause of action; locus standi and concealment of true and material facts. On merits, it is pleaded that the present contract is between the answering OP and TATA Capital Housing Finance Ltd. i.e. OP no.1. OP no.1 has obtained “HDFC Life Group Credit Protect Plus Insurance Plan” having policy no.PP000122. Randhir “life Assured” (hereinafter referred to as LA) had taken a loan which was finance by OP no.1 and OP no.1 enrolled the life assured through enrolment form dated 07.03.2019 signed by said life assured in favour of the OP no.2. In the Group Insurance Scheme where the base sum assured was Rs.18,00,000/- on decreasing cover option and duration was 10 years. It is further pleaded that in the present case, the deceased Randhir at the time of making the said proposal dated 07.03.2019 had misrepresented about his health i.e. the deceased was suffering from and was “Hemodialysis”  prior to issuance of the policy and the suppression of this material facts at the time of making the proposal for insurance based on which the said policy was issued amounts to suppression of true and material facts. This fact is very much evident from the medical records obtained from Post Graduate Institute of Medical Education and Research, Chandigarh by the OP no.2 in which the deceased Randhir was diagnosed and was further suffering from and was “Hemodialysis.”  This fact clearly established that the deceased life assured had suppressed and concealed the very factum of the suffering from chronic pre-existing disease at the time of issuance of the policy. The death claim filed by the complainant has rightly been repudiated, vide letter dated 08.10.2020. It is further pleaded that had the correct information regarding the medical history of the life assured been mentioned in the enrolment form, the OP no.2 would not have accepted the proposal of the TATA Capital Housing Finance Ltd. regarding the insurance of the life assured. Since the material information regarding the medical history has been concealed from the OP no.2, therefore, OP no.2 were well within its right repudiate the claim of the complainant. There is no deficiency in service and unfair trade practice on the part of the OP. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

4.             Parties then led their respective evidence.

5.             Learned counsel for complainant has tendered into evidence affidavit of complainant Ex.CW1/A, copy of application regarding death claimEx.C1, copy of Member Certificate of Insurance Ex.C2, copy of death certificate of Randhir Ex.C3, copy of aadhar card of Randhir Ex.C4, copy of aadhar card of complainant Ex.C5, copy of loan detail Ex.C6, copy of loan account detail Ex.C7, copy of medical certificate of cause of death Ex.C8 and closed the evidence on 05.08.2022 by suffering separate statement.

6.             On the other hand, learned counsel for the OP no.1 has tendered into evidence affidavit of Sanjay Kumar Ex.OP1/A, copy of loan detail Ex.OP1/B and closed the evidence on 26.05.2023 by suffering separate statement.

7.             Learned counsel for the OP no.2 has tendered into evidence affidavit of Gurpreet Singh Manager Ex.RW1/A, authority letter Ex.R1, copy of Enrollment Form Ex.R2, copy of insurance policy Ex.R3, copy of death claim form Ex.R4, copy of treatment record of Randhir Ex.R5, copy of repudiation letter dated 08.10.2020 Ex.R6 and closed the evidence on 14.06.2023 by suffering separate statement.

8.             We have heard the learned counsel for the parties and perused the case file carefully and have also gone through the evidence led by the parties.

9.             Learned counsel for complainant, while reiterating the contents of the complaint, has vehemently argued that the husband of complainant applied for a loan of Rs.20,00,000/- to the OP no.1 and OP had disbursed the amount of Rs.17,04,070/-only. The monthly installment of loan was fixed as Rs.17897/-. The husband of complainant for securing the said loan had purchased a life insurance policy from the OP no.2.  The husband of complainant expired on 12.10.2019 due to Respiratory Failure and after the death of her husband, complainant contacted the OP no.1 and submitted the all documents and death certificate of her husband and requested for the adjustment of loan from the insurance company and to issue the NOC but OPs did not pay any heed to the request of complainant  and repudiated the claim of the complainant on the false and frivolous ground and lastly prayed for allowing the complaint.

10.           Per contra, learned counsel for the OP no.1, while reiterating the contents of written version, has vehemently argued that the husband of complainant availed a loan of Rs.20,00,000/- and got insured the said loan from OP no.2.  There is no role of OP no.1 except to disburse and recover the loan amount and lastly prayed for dismissal of the complaint qua OP no.1.

11.           Learned counsel for the OP no.2, while reiterating the contents of written version, has vehemently argued that at the time of securing the loan, the insured was not having a good health and was suffering from Hemodialysis and was also under treatment from various hospitals including  PGI, Chandigarh.  This fact had not been disclosed by the insured, at the time of purchasing the policy. Thus, the claim of the complainant has rightly been repudiated by the OP and lastly prayed for dismissal of the complaint.

12.           We have duly considered the rival contention of the parties.

13.           Admittedly, Randhir (since deceased) insured had availed the loan from the OP no.1 and purchased the insurance policy from the OP no.2 to secure the said loan amount. It is also admitted that during the subsistence of the insurance policy, life assured was expired on 12.10.2019. It is also admitted that complainant is the nominee in the said policy.

14.           The claim of the complainant has been repudiated the by OP no.2, vide letter Ex.R6 dated 08.10.2020 on the grounds of suppression of material information related to health of the life assured, as per the medical records of the life assured, he was suffering from Hemodialysis, which had not been disclosed by the life assured at the time of inception of the policy

15.           The claim of the complainant has been repudiated by the OP no.2 on the abovesaid ground. The onus to prove that the husband of complainant was having pre-existing disease at the time of obtaining the policy was relied upon the OP. To prove its case OP has placed on record, treatment record Ex.R5 ( page 1 to 20), wherein it has been specifically mentioned in medical record issued by New Holy Family Hospital, Ambala Road, Kaithal dated 07.06.2019  that  Randhir (insured) was suffering from Hemodialysis from six months.  DLA had also taken a treatment from another hospital namely Mittal Diagnosis and Hospital, Kaithal and PGI, Chandigarh and also got tested from the various laboratories. On perusal of the abovesaid treatment record, it has been proved on record that insured was suffering from illness mentioned in the abovementioned treatment record. The policy was purchased on 22.03.2019. Meaning thereby, insured was suffering from the abovesaid disease prior to inception of the policy.  To rebut the abovesaid evidence, complainant has not placed on record any cogent and convincing evidence that insured was not suffering from any disease prior to purchasing the insurance policy. Thus, has been proved on record that the husband of complainant was having pre-existing disease and had concealed the true and material facts regarding his health at the time of purchasing the insurance policy. In this regard, we are fortified with the observations of Hon’ble Supreme Court in case titled as Branch Manager, Bajaj Allianz Life Insurance Company Ltd. and others Vs. Dalbir Kaur in civil appeal no.3397 of 2020 decided on 09.10.2020 wherein Hon’ble Supreme Court held that a policy of insurance is governed by the principles of utmost good faith. The suppression of material facts by the insured/policyholder entitles the OP to repudiate the policy under section 45 of the Insurance Act. The said authority is fully applicable to the facts of the present case.

16.           Further, it is settled principle of insurance law that contract of insurance is a contract uberrima fides and utmost faith must be observed by the contracting parties. Every material fact must be disclosed, otherwise there is good ground for rescission of contract. If, there are misstatements or suppression of material facts, the policy can be called into question. In this regard reference may be made to the judgments of the Hon’ble Supreme Court in case titled Satwant Kaur Sandhu Versus New India Assurance Co. IV( 2009) CPJ 8 and Relinace Life Insurance Co. Ltd. Versus Rekhaben Nareshbhai Rathore decided on 24.04.2019 and judgment of Hon’ble National Commission in case Life Insurance Corporation of India and another Versus Bimla Devi Revision Petition no.3806 of 2009 decided on 12.8.2015 and Sunita Rani Versus PNB Metlife India Insurance Company Limited in appeal no.1252/2015 dcided on 21.04.2017.

17.           Keeping in view the ratio of the law laid down in the abovesaid judgments, facts and circumstances of the present complaint, we are of the considered view that there is no deficiency in service and unfair trade practice on the part of the OPs.

18.           Thus, as a sequel to abovesaid discussion, the present complaint is devoid of merits and deserves to be dismissed and same is hereby dismissed. No order as to costs. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated:01.08.2024                                                                    

                                                                President,

                                                   District Consumer Disputes

                                                   Redressal Commission, Karnal.

 

(Vineet Kaushik)                (Sarvjeet Kaur)    

                     Member                           Member