Reserved

State Consumer Disputes Redressal Commission

U.P., Lucknow.

Appeal No.493 of 2017

Future Generali India Life Insurance Co. Ltd.,

6^th Floor, tower 3, India Bulls Finance Centre,

Senapati Bapat Marg, Elphinstone Road (West)

Mumbai-400013, Maharastra                              ...Appellant. 

Versus

1- Balvinder Singh s/o Late Sh. Harnek Singh,

    Village Chokhandi, Post, Khas,

    Distt. Rampur Uttar Pradesh

2- Satya Prakash s/o Bhajan Lal,

    Village & Post, Chokhandi, Tehsil, Savar,

    Distt. Rampur Uttar Pradesh.                        ..Respondents.

Present:-

Hon’ble Mr. Rajendra Singh, Presiding Member.

Hon’ble Mr. Vikas Saxena, Member.

Ms. Pooja Tripathi, Advocate for Appellants.

Mr. P.K. Rai, Advocate for respondent no.1.

None for the  respondent no.2.

Date:  2.3.2023

                                         JUDGMENT

Per Mr. Rajendra Singh, Member: The present appeal has been filed against the judgment and order dated 27.10.2016 passed by the Ld. District Forum, Rampur in  complaint case no.49 of 2015, Balvinder Singh Vs. Future Generali Life Insurance Co. Ltd. & anr.

          The brief facts of the appeal are that, that the deceased life assured i.e. Mr. Harnek Singh had approached Meerut Office of appellant company and applied for two life insurance policies under the Future Assure insurance plan vide policy no.01149430 & 01135664 with a sum assured amount of Rs.6,10,000.00 each with following details.

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          That through the proposal forms, the Deceased Life Assured had signed and submitted a declaration, stating that “I hereby declare that the sales literature and illustration containing important information in relation to the product being purchased by me have been provided to me and that the contents of this proposal form have been fully explained to me and I have fully understood the significance of the proposed contract. I hereby declare that I have understood the questions in the proposal form and I have answered them truthfully, completely and correctly. I further declare that I have not withheld and material fact or material information which may affect the decision of FUTURE GENERALI INDIA LIFE INSURANCE COMPANY LIMITED (the “company”) in underwriting the risk under the proposal. I understand and agree the replies given and the statements made by me in the proposal and in any supplementary questionnaire answered by me as to the insurability of the Life to be assured shall be the basis of the contract between me and the company and in case of any incorrect reply or

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wrong statement, the contract shall be null and void and the company shall be entitled to forfeit all premiums paid under the policy subject to the provisions of Section 45 of the Insurance Act, 1938….”. The Life Assured was additionally informed of the provisions of Section 45 of the Insurance act 1938 through the proposal forms. Further, the company had ensured that an independent third person had explained the contents of the proposal forms to the Life Assured, had read out and confirmed as correct from the Life Assured, the responses provided by him in the proposal forms, and had satisfied, that the same were understood and agreed upon by the Life Assured. 

          Thereafter, the company issued insurance policy no.01135664 on 6.8.2013 with a risk commencement dated of 7.8.2013 and life insurance policy no.01149430 on 29.9.2013. It is pertinent to note that the life assured never approached the company. The company has sent copies of the duly filled and signed proposal forms to the life assured to the record and perusal. The appellant received two death claims on 23.7.2014 from the respondent no.1/complainant informing that the life assured expired on 15.10.2013 due to heart attack at home. Therefore, the company appointed an independent investigator agency. During investigation, investigating agency retrieved the voter list from the Election office for 2014 of Rampur District in which age of insured is mentioned as 76 years and his name is marked with “deleted due to death”. This shows that the life assured has submitted a fabricated document of age proof. At the time of taking the policies the age was mentioned as 53 years. On this false entry company repudiated the claim of the complainant under

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both policies and refunded the premium amount of Rs.47,464.00 each under both policies in accordance with clause on “Statement of age”, the insured was not insurable under the policy pursuant to the company’s underwriting rules, the policies shall be void and the company will refund the premiums paid within interest after deducting all payments made under the policy and indebtedness, if any.

          Thereafter, the appellant company received two legal notices from the complainant duly replied. The company’s agent Mr. Satya Prakash was found guilty and FIR has been lodged against him. The complainant filed complaint before he ld. District Forum and it was awarded by the ld. District Forum on 17.10.2016. Operative portion is as follows:-

          “परिवादी का परिवाद विपक्षी संख्‍या 1 व 2 के विरूद्ध एक पक्षीय रूप से स्‍वीकार किया जाता है।

विपक्षी संख्‍या 1 – फयूचर जनरली इण्डिया लाईफ इंश्‍योरेंन्‍स कम्‍पनी लिमिटेड को निर्देश दिया जाता है कि वह परिवादी को उसके पिता की मृत्‍यु होने के बाद कुल बीमित धनराशि 120000.00 निर्णय की तिथि से 60 दिन के भीतर जरिये चैक फोरम के कार्यालय में जमा करे।

निर्धारित अवधि के भीतर धनराशि न देने पर उपरोक्‍त धनराशि पर 9 प्रतिशत वार्षिक ब्‍याज भी निर्णय की तिथि से विपक्षी संख्‍या 1 को देना होगा।

परिवादी वाद व्‍यय के रूप में 2000.00 मय 9 प्रतिशत ब्‍याज निर्णय की तिथि से भुगतान की तिथि तक प्राप्‍त करने का अधिकारी है।”

     The ld. District Forum has no jurisdiction to try the case. A mere perusal of the impugned order would reveal that the ld. District Forum has merely recapitulated the averments and allegations made by the respondent no.1 and directly proceeded to order for payment of sum assured under both polices. It is settled principles of law that whether any fraud or fabrication is involved the same could not be agitated in summary proceeding and can only be agitated in the civil court after holding proper trial leading substantive evidence.  Therefore, it is most humbly prayed that this Hon’ble

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Commission may be pleased to allow this appeal and set aside the impugned judgment and order.

          We have heard ld. Counsel for the appellant Ms. Pooja Triapthi and ld. counsel for the respondent no.1 Sri. P.K. Rai. None appeared for the respondent no.2. We have perused all the pleadings, evidence and documents present on record.

          Before the ld. District Forum notice on the opposite party no.1 Future Generali Life Insurance Co. Ltd. has been held sufficient and the opposite party no.2 the said agent was present before the ld. District Forum.

          We have seen the traditional proposal form in which date of birth has been mentioned as l1.2.1960. The company in its repudiation letter dated 30.11.2014 has stated that on the basis of investigation carried out by us, we are satisfied that the aforesaid date mentioned in the application is false in as much as we hold the documentary proof to show that the life assured was 74 years as on the date of application. This is  cause of repudiation. The appellant has filed scholar’s register and transfer certificate of Manpur Junior High School, Manpur Swar, District Rampur in which date of birth has been mentioned as 11.2.1960. The deceased Harnek Singh left the school on 25.7.1981 after class 8^th. He failed in all the three years but promoted. This school going certificate is admissible in evidence.

          We have also perused the Pariwar Register in which date of birth of deceased Harnek Singh is mentioned as 11.2.1960. No document or evidence has been filed against these documents. The appellant did not bother to summon Principal of the concerned school for verification of the record. These records will prevail over every record.

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          There is proposal form duly accepted by the insured person and the appellant company, so it is a valid contract and now the insurance company cannot go behind the contract. There is no supportive evidence as forensic report etc. to support forgery. So in these circumstances,   we are of the opinion that there is no ground  to interfere in the judgment of the ld. District Forum. The appeal is liable to be dismissed.

ORDER

The appeal is dismissed.

  The stenographer is requested to upload this order on the Website of this Commission today itself. 

          Certified copy of this judgment be provided to the parties as per rules.       

       (Vikas Saxena)                              (Rajendra Singh)

            Member                                    Presiding Member

Jafri, PA I

Court 2

Judgment dated/typed signed by us and pronounced in the open court.

Consign to record.

       (Vikas Saxena)                              (Rajendra Singh)

            Member                                    Presiding Member

Jafri, PA I

Court 2