BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, MOGA.<br /> <br /> Complaint No.10 of 2008.<br /> Instituted On:01.02.2008.<br /> Date of Service: 27.02.2008.<br /> Decided On: 18.09.2008.<br /> <br /> <br /> Charanjit Kaur wife of late Sh.Harchand Singh son of Harnam Singh, resident of village: Bhinder Kalan, Patti Narain, Tehsil & Distt.Moga.<br /> Complainant.<br /> <br /> Versus<br /> <br /> 1. The Zonal Manager, Life Insurance Corporation of India, Zonal Office, Cannaught Circus, Jeevan Bharti, New Delhi-110001.<br /> 2. Divisional Manager, Life Insurance Corporation of India, Amritsar Division, Jeevan Parkash Building, Near Shopping Complex, Ranjit Avenue, Amritsar.<br /> 3. Manager, Life Insurance Corporation of India, Zira, M.R.Chopra Complex, Ferozepur Road, Zira.<br /> Opposite Parties.<br /> <br /> Complaint under section 12 of The<br /> Consumer Protection Act, 1986.<br /> <br /> Quorum: Sh.J.S.Chawla, President.<br /> Smt.Bhupinder Kaur, Member.<br /> Sh.Jit Singh Mallah, Member.<br /> <br /> Present: Sh.Sher Singh, Adv.counsel for the complainant.<br /> Sh.Vaneet Jaidka, Advocate, counsel for the OPs.<br /> <br /> (J.S.CHAWLA, PRESIDENT)<br /> Smt.Charanjit Kaur complainant has filed the present complaint under section 12 of The Consumer Protection Act, 1986 (herein-after referred to as ‘Act’) against Life Insurance Corporation of India, New Delhi through its Zonal Manager and others-opposite parties (herein-after referred to as ‘LIC’) directing them to pay the insured amount of Rs.2 lacs alongwith benefits and interest thereon @ 18% per annum till realization and Rs.50000/- as compensation for causing mental tension and harassment beside costs of litigation.<br /> 2. Briefly stated, Harchand Singh (now deceased) son of Harnam Singh and husband of the complainant purchased money back policy with profit and accidental benefit bearing no.471290544 on 15.5.2003 for a sum of Rs.2 lacs from OP3-LIC and paid premium of Rs.8002/- against receipt. That while purchasing the aforesaid policy, Harchand Singh duly nominated Charanjit Kaur complainant, his wife as nominee. That the OPs-LIC issued the policy in question to Harchand Singh after making the due enquiry and examining him from the approved and well qualified doctors appointed by them. That as ill luck would have it, Harchand Singh died on 26.7.2005 and after his demise, the complainant applied to the OPs-LIC to make the payment of policy and other benefits being widow and nominee of Harchand Singh life assured and completed all the formalities. That the OPs-LIC repudiated the claim of the complainant vide letter dated 6.10.2007 on the false, frivolous and baseless grounds. That it was the bounden duty of the OPs-LIC to make full enquiry and verification of the concerned person and it was also done in the case of Harchand Singh deceased before issuing the policy. But inspite of making the payment of the insurance premiums by Harchand Singh deceased, who died a natural death, the OPs-LIC had been making the false and vague objections and harassing the poor, innocent and illiterate complainant. That the repudiation of her claim by the OPs-LIC is totally wrong and illegal. That the aforesaid act and conduct of the OPs-LIC had caused great inconvenience, harassment and mental agony to her for which she has claimed Rs.50000/- as compensation beside costs of litigation. Hence the present complaint.<br /> 3. Notice of the complaint was given to the OPs-LIC, who appeared through Sh.Vaneet Jaidka Advocate and filed written statement contesting the same. They took up preliminary objections that this Forum has got no jurisdiction to try and decide the present complaint; that the present complaint is not maintainable before this Forum because it involves complicated questions of law and facts, for which voluminous evidence is required; that the present complaint is liable to be dismissed as the policy in question has been obtained by undergoing medical test ‘in-absentia’. The deceased life assured has played a fraud with the OPs-LIC by stooging somebody else in his place, who undergone medical test by impersonating as life assured which fact has been discovered by the OPs-LIC while investigating the claim and that there is no deficiency in service on the part of the OPs-LIC as Harchand Singh life assured purchased policy no. 471290544 for a sum of Rs.2 lacs with date of commencement 15.5.2003 and date of acceptance of risk as 31.7.2003. The life assured at the time of purchasing of present policy had another three policies i.e. i)policy no.470963831 dated 15.11.2001 for Rs.1 lac obtained from Branch Office Zira, ii) policy no.131623460 dated 15.6.2002 for Rs.2 lacs and iii) policy no. 131803052 dated 28.11.2002 for Rs.1 lac purchased by him from Divisional Office Jalandhar. As the life assured had three other running policies, special medical report was called for regarding his state of health apparently the life assured was medically examined. Finding the special medical reports as satisfactory, the life assured was issued the present policy. Further as per the claim lodged, the life assured reportedly died on 26.7.2005. The claim being an early one having run only for one year and eleven months, it was ordered to be investigated. During investigation, it revealed that life assured died due to heart attack and he was lying ill for the last 2/3 years and was getting treatment from DMC & Hospital Ludhiana but exact date of taking treatment was not found. It was further revealed that life assured also took treatment from Civil Hospital, Bhinder Kalan from 10.2.2004 to 11.2.2004 and from 12.2.2004 to 15.2.2004 but in this case also his treatment file was not available. Finding the case to be a peculiar nature, three more investigators of the rank of Branch Manager were appointed, who gave their reports suggesting that life assured was not enjoying good health before taking the policy. The fact that life assured was not enjoying good health and he took four policies for a heavy sum of Rs.6 lacs in a quick succession and that his special medical report does not indicate any disease, the competent authority opined that it may be that special medical report had been obtained ‘in-absentia’ and decided to seek hand writing expert’s opinion for tallying the signatures of life assured appearing on proposal form with the signatures appearing on special medical report vide letter dated 5.9.2007. The hand writing expert vide its report dated 17.9.2007 opined that signatures on special medical report purporting to be of life assured does not tally with the signatures on the proposal form. This fact that the signatures on the proposal form differs from the signatures on the special medical report makes it amply clear that there was impersonation while undergoing the medical test and the medical reports had been obtained ‘in-absentia’, rendering the policy null and void. Had the deceased not been suffering from any disease he would have himself appeared for the test and signatures on the proposal form and special medical reports would have tallied. The policy was taken just to defraud the OPs-LIC. The competent authority repudiated the claim on the basis of convincing and reasonable evidence and ordered the departmental action against the concerned agent, who introduced the life assured; that the present complaint is liable to be dismissed as the contract of insurance is based upon principle of ‘uberrimafide’ i.e. utmost good faith. On merits, the OPs-LIC took up the same and similar pleas as taken up by them in the preliminary objections. All other allegations contained in the complaint were specifically denied being wrong and incorrect. Hence, it was prayed that the complaint filed by the complainant has no merit and it deserves dismissal.<br /> 4. In order to prove her case, the complainant tendered in evidence her affidavits Ex.A1 and Ex.A2, copy of policy Ex.A3, copy of death certificate Ex.A4, copy of letter Ex.A5, copies of receipts Ex.A6 to Ex.A9, and closed her evidence.<br /> 5. To rebut the evidence of the complainant, the OP-LIC tendered in evidence affidavit of Sh.S.D.Balwal Manager Ex.R1, copy of report Ex.R2, copy of receipt of consultation charges Ex.R3, specimen signatures Ex.R4, copy of proposal form Ex.R5, copies of medical forms Ex.R6 to Ex.R11, copy of letter Ex.R12, copies of reports Ex.R13 to Ex.R18, copies of status report Ex.R15 to Ex.R17, copy of policy Ex.R19, affidavit of Sh.Jassy Anand Ex.R20, copy of letter dated 6.5.2008 Ex.R21 and closed their evidence.<br /> 6. Both the parties have filed their written arguments and also submitted oral arguments. We have gone through the written arguments of the parties, heard the oral arguments of Sh.Sher Singh ld. counsel for the complainant and Sh.Vaneet Jaidka ld. counsel for the OPs-LIC and carefully perused the evidence on record. <br /> 7. Sh.Vaneet Jaidka ld.counsel for the OPs-LIC has mainly argued that this Forum has got no jurisdiction to try and decide this complaint because the policy in question was purchased from branch office Zira Distt. Ferozepur under the Divisional Office, Amritsar. He has relied upon i) 1991(II) CPJ 686 (NC) titled as Indian Airlines Corporation Vs. Consumer Education & Research Society, ii) AIR 1992 SC 1514 titled as Patel Roadways Vs. Prasad Trading Company, iii) Writ Petition no.4684 of 2005 decided on 17.11.2006 by Hon’ble Delhi High Court in Satish Pathik Vs. LIC of India, iv) 1986(1) PLR 584 (Punjab & Haryana) titled as The Director Indian Road Construction Corporation Vs. Amolak Singh and v) AIR 1997 SC 2459 titled as Harshad Shah Vs. LIC of India. This contention of the ld.counsel for the OPs-LIC has no merit. Admittedly, Sh.Harchand Singh (deceased) life assured had purchased insurance policy in question for a sum of Rs.2 lacs from branch office at Zira, but paid the premium of Rs.8002/- to their agent on 15.5.2003 at Moga. It is also admitted that the repudiation letter dated 6.10.2007 Ex.A5 was sent to Charanjit Kaur complainant in her village Bhinder Kalan, Tehsil & Distt.Moga. Thus, it shows that a part cause of action also arose in the district Moga where the repudiation letter was sent to the complainant. Section 11 of the Consumer Protection Act, 1986 deals with the jurisdiction of District Foras. Sub Section 2(c) provides that a complaint shall be instituted in a District Forum within the local limits of whose the cause of action, wholly or in part arises. In the instant case, the cause of action has partly arisen to the complainant where the repudiation letter was sent to her i.e in village Bhinder Kalan, Tehsil & Distt.Moga. Hence, this District Forum has also got jurisdiction to entertain and decide the present complaint. In this regard, the supra rulings cited by ld.counsel for the OPs-LIC do not apply to the facts of the present case and we discard the same. <br /> 8. On the other hand, Sh.Sher Singh ld.counsel for the complainant has mainly argued that the OPs-LIC has wrongly and illegally repudiated the lawful claim of the complainant. This contention of the ld.counsel for the complainant has full force. Admittedly, Harchand Singh (deceased) life assured purchased money back policy with profit and accidental benefit bearing no.471290544 for a sum of Rs.2 lacs from OP3-LIC and paid premium of Rs.8002/- against receipt on 15.5.2003. It is also admitted case of the parties that said Harchand Singh died on 26.7.2005. According to the complainant case, he died a natural death whereas the OPs-LIC has alleged that he was suffering from heart ailment. Firstly, he was having heart ailment for the last 2/3 years and was getting treatment from DMC & Hospital, Ludhiana, but failed to produce any evidence to prove the same. Then they alleged that the life assured took the treatment from Civil Hospital, Bhinder Kalan from 10.2.2004 to 11.2.2004 and from 12.2.2004 to 15.2.2004, but further failed to produce any documentary evidence on record to this effect. Thus, it shows as far as the heart ailment of life assured alleged by the OPs-LIC is concerned, they failed to produce an iota of evidence to prove the same. Hence, in the absence of any evidence to this effect, it can not be said that the life assured was suffering from heart ailment or that he had suppressed any material fact from the knowledge of the OPs-LIC. <br /> 9. After failing their contention to prove that Harchand Singh (deceased) life assured was suffering from heart ailment and denying the claim of the complainant on this ground, they got the matter investigated from their Investigators/ Branch Managers. Sh.K.S.Brar, Investigator who gave his report Ex.R18 dated 27.06.2006 and held that “During investigation it was observed that L.A. was agriculturist. He was in good health before the date of proposal. L.A. died suddenly due to heart attack. Claim is recommended for admission.” Thus, the report Ex.R18 of Sh.K.S.Brar, Branch Manager shows that Harchand Singh died due to natural death and he recommended his case for payment.<br /> 10. Having not satisified with the report Ex.R18 of Sh.K.S.Brar, Investigator, the OPs-LIC appointed two more Investigators/ Branch Managers to ascertain the cause of death of Harchand Singh (deceased) life assured and they submitted their reports Ex.R13 and Ex.R14. The reports of other two Investigators/ Branch Managers i.e. Sh.A.S.Nagpal (Ex.R13) and Sh.N.K.Saini (Ex.R14) are contradictory to each other. Sh.A.S.Nagpal in his report (Ex.R13) has stated that Harchand Singh (deceased) life assured was alcoholic and was suffering from heart problem also, as per the information gathered during investigations and the statements though he was getting treatment from Ludhiana also, but it could not be ascertained from where he was getting treatment at Ludhiana. Dr.Ranjodh Singh (M.D) of Dukh Niwaran Hospital, Dharamkot knows the entire case, but he is not willing to give anything in writing to him. The aforesaid report of Sh.A.S.Nagpal, Investigator shows that he has failed to find the cogent and convincing evidence to support his opinion that Harchand Singh (deceased) life assured was alcoholic or suffering from heart ailment. <br /> 11. On the other hand, Sh.N.S.Saini, Investigator in his report Ex.R14 has stated in para no.1 that the life assured was suffering from some serious illness likewise ‘Aids’, but no person is ready to give in writing. He failed to conclude in his report and stated that he recommends to make further enquiry to Moga Branch Office in this case. Thus, the reports of Sh.A.S.Nagpal (Ex.R13) and Sh.N.K.Saini (Ex.R14) show that both of them have given contradictory reports regarding the state of health of Harchand Singh (deceased) life assured. According to Sh.A.S.Nagpal, Investitagator the deceased was alcoholic having heart ailment whereas according to Sh.N.K.Saini, Investigator, the deceased was suffering from ‘Aids’. The disease of ‘heart ailment’ is quite different than that of ‘Aids’ and both have no relevancy with each other. Thus, it shows that both reports of Sh.A.S.Nagpal (Ex.R13) and Sh.N.K.Saini (Ex.R14) contradicts each other and are prepared on the basis of surmises and conjectures. They failed to collect any documentary evidence in support of their reports and also failed to record the statement of any witness in this regard. Hence, their reports can not be accepted to be correct. On the other hand, Sh.K.S.Brar Investigator/ Branch Manager in his report Ex.R18 dated 27.06.2006 has stated that life assured was agriculturist having good health before the date of proposal. He also stated that life assured died suddenly due to heart attack and he recommended his case for admission. Thus, the report Ex.R18 of Sh.K.S.Brar Investigator/ Branch Manager is quite natural and based on the facts, but the OPs-LIC has failed to accept the same for the reasons best known to them. Rather they ordered to appoint two more Investigators/ Branch Managers only to give their reports in their favour to dislodge the claim of the complainant. In view of the aforesaid facts and circumstances, the OPs-LIC has failed to prove that Harchand Singh (deceased) life assured was suffering from any heart ailment or serious disease likewise ‘Aids’. Rather the report Ex.R18 of Sh.K.S.Brar Investigator/ Branch Manager proves that he was quite healthy and has not suppressed anything at the time of purchasing of policy in question. <br /> 12. Thus, the OPs-LIC has failed to prove that the deceased life assured suppressed his pre-existing disease of heart ailment at the time of purchasing the policy in question. On this point, the rulings i) AIR 1962 SC 814 titled as Mithu Lal Nayak Vs. LIC of India, ii)1995(1) CPJ 630 in LIC of India Vs. Vimlesh Kumari, iii) 1995(2) CLJ titled as LIC of India Vs. Niranjan Kaur, iv) 1999(2) CRC 636 in LIC Vs. Subhadhra Domaji, v) AIR 1959 Patna 413 in Rattan Lal & Anr. Vs. Metro Politan Insurance Company, vi) 2001 SCC 160 in LIC of India Vs. Asha Goyal, vii) PC Chacko Vs. Chairman LIC of India in Civil Appeal no. 5233 of 2007 decided on 20.11.2007 by Hon’ble Supreme Court of India, viii)AIR 1986 Kerla 201 in P.Sarojam Vs. LIC of India, ix) AIR 1975 Delhi 19 in Smt.Krishnawanti Vs. LIC of India and x) AIR 1968 Madras 324 in LIC of India vs. Janaki Ammal, do no apply to the facts of the present case and are quite distinguishable. <br /> 13. Again having failed in their mission to discard the claim of the complainant, the OPs-LIC went one step ahead by taking the plea that special medical report of the life assured did not tally his signatures and the same had been obtained ‘in absentia’ by stooging some other person who could have gone under medical examination. This plea of the OPs-LIC has also not been substantiated on the file, firstly because there is no direct evidence that Harchand Singh (deceased) life assured got special medical report ‘in absentia’ by stooging some other person at the time of medical examination and preparation of special medical report. Admittedly, Harchand Singh (deceased) life assured was identified by Bhushan Kumar, their own agent at the time of said examination. Till today no action has been taken against aforesaid Bhushan Kumar by the OPs-LIC for his alleged wrong identification for the reasons best known to them. Had Bhushan Kumar wrongly identified some other person in place of Harchand Singh (now deceased), then no explanation is forthcoming as to why OPs-LIC did not take any action against him by cancelling his agency-ship. In this regard, letter Ex.R21 produced by the OPs-LIC that the recovery from the concerned Development Officer Sh.D.S.Sandhu stands made or that the proceedings are still pending against Bhushan Kumar their agent having Agency Code no.462-13U, is of no help because the aforesaid letter dated 06.05.2008 had been issued during the pendancy of the present complaint. Thus, it shows that the OPs-LIC in order to forfeit the claim of the complainant issued the letter Ex.R21 and the same can not be relied upon. Hence, the aforesaid plea raised by the OPs-LIC is based on surmises and conjectures and can not be accepted. <br /> 14. To further strengthen their false plea that Harchand Singh (deceased) life assured had got special medical reports ‘in absentia’, the OPs-LIC has relied upon the report Ex.R2 of Jassy Anand & Associates, Finger Prints and Handwriting Expert. This report Ex.R2 of the Finger Prints and Handwriting Expert can not be believed and was not sufficient to repudiate the claim of the complainant. Sh.Jassy Anand & Associates, Finger Prints and Handwriting Expert compared the admitted signatures of Harchand Singh (deceased) life assured marked S-1 on the proposal form with his disputed signatures Q1 to Q6 on special medical reports on Ex.R6 to Ex.R11. She has not given cogent and convincing reason of differentiation of admitted signatures mark S-1 with that of disputed signatures Q1 to Q6. Moreover, the OPs-LIC has not examined or produced Dr.V.K.Khanna, G.K.Wadhwa and Dr.J.K.Jain who obtained the signatures of Harchand Singh on their reports Ex.R6 to Ex.R11 to prove that Harchand Singh (deceased) life assured had not appeared before them and somebody else had appeared at the time of medical examination. Thus, in the absence of evidence of aforesaid doctors, it can not be concluded that Harchand Singh (deceased) life assured obtained special medical report ‘in absentia’ or somebody else had impersonated him at the time of special medical report. Moreover, it was the duty of the OPs-LIC to have got compared the signatures of Harchand Singh on the special medical reports during his life time and not after his death. Harchand Singh remained alive for one year and 11 months after purchasing the policy, but no effort was made by the OPs-LIC in this regard to prove that he obtained said reports in ‘in-absentia’.<br /> 15. Moreover, it is settled that the evidence of the Finger Prints and Handwriting Expert is weak evidence. They are deemed to be a ‘remunerative witnesses’ and they give reports in favour of a person who engages them. Hence, we discard the report Ex.R2 of Sh.Jassy Anand & Associates, Finger Prints and Handwriting Expert. On this point, no reliance could be placed on the rulings i) 1995(II) CPJ page 1 SC in Laxmi Engineering Works Vs.PSG Industrial Institute, ii) 2006(IV) CPJ Page 1 SC in Oriental Insurance Company vs. Mani Mahesh Patel and iii) II(2008) CPJ 152 of Hon’ble National Commission titled as Babu Singh Vs. LIC of India cited by ld. counsel for the OPs-LIC.<br /> 16. Ld.counsel for the OPs-LIC has further argued that no deficiency in service has been proved against the OPs-LIC because under section 45 of Insurance Act, if the policy has run less than two years, the OPs-LIC is entitled to repudiate the claim of the complainant. This contention of the ld.counsel for the OPs-LIC has no merit. As per the contention of the ld.counsel for the OPs-LIC, the policy in question of Harchand Singh (deceased) life assured had run one year and eleven months while he purchased other three policies i.e. i)policy no.470963831 dated 15.11.2001 for Rs.1 lac obtained from Branch Office Zira, ii) policy no.131623460 dated 15.6.2002 for Rs.2 lacs and iii) policy no. 131803052 dated 28.11.2002 for Rs.1 lac and the payment of the same had been given to the complainant and no objection has been taken for those policies on the ground that they were more than two years old. However, the payment of this policy has not been made on the lame excuse that this policy had run only for a period of one year and 11 months. The deceased life assured had paid the premium of Rs.8002/- on 15.5.2003 while the date of acceptance of risk has been mentioned as 31.7.2003 for the reason best know to the OPs-LIC. The aforesaid act and conduct of the OPs-LIC show that the OPs-LIC are bent upon to repudiate the claim of the complainant on one pretext or the other. For this purpose, firstly they alleged that the deceased life assured had suppressed the material facts of his pre-existing disease of heart ailment to the OPs-LIC, but failed to prove the same. Then they took up the plea that the deceased life assured had obtained the special medical report ‘in absentia’, but again failed to prove the same. Further they took up the plea that under section 45 of Insurance Act the policy has run less than two years and they are entitled to repudiate the claim of the complainant, but this contention also not given any weight. <br /> 17. The aforesaid conduct of the OPs-LIC in repudiating the claim of the complainant who is illiterate and poor widow and rustic villager show that the OPs-LIC wanted to harass her on one pretext or the other. Therefore, she is entitled to all the benefits of the policy in question alongwith compensation for mental tension, harassment and sufferings and involving in unnecessary litigations. Therefore, we hold that the OPs-LIC has committed deficiency in service by repudiating the claim of the complainant. Hence, we hold the repudiation as wrong, illegal and unwarranted and quash the same.<br /> 18. To prove her contention, the complainant has tendered in evidence her affidavits Ex.A1 and Ex.A2, copy of policy Ex.A3, copy of death certificate Ex.A4, copy of letter Ex.A5, copies of receipts Ex.A6 to Ex.A9. On the other hand, no reliance could be placed on the affidavit of Sh.S.D.Balwal Manager Ex.R1, affidavit of Sh.Jassy Anand Ex.R20 and other documents Ex.R2 to Ex.R19 and Ex.R21.<br /> 19. The ld. counsel for the parties did not urge or argue any other point before us.<br /> 20. In view of the aforesaid facts and circumstances, the complaint filed by the complainant has merit and the same is accepted. The OPs-LIC is directed to pay the insured amount of Rs.2 lacs alongwith all its benefits and also interest @ 9% per annum from the date repudiation of the claim i.e. 06.10.2007 till its payment. The OPs-LIC is also directed to pay Rs.10000/- as compensation on account of mental tension, harassment and sufferings caused to her beside Rs.5000/- as litigations expenses within one month from the date of receipt of copy of this order. Copies of the order be sent to the parties free of cost and thereafter, the file be consigned to the record room.<br /> <br /> (Bhupinder Kaur) (Jit Singh Mallah) (J.S.Chawla)<br /> Member Member President<br /> <br /> Announced in Open Forum.<br /> Dated:18.09.2008.<br /> <br /> hrg*<br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />