Punjab

StateCommission

A/695/2015

DHFL Premerica LIC - Complainant(s)

Versus

Bhuram Singh - Opp.Party(s)

Ashok Arora

27 Feb 2017

ORDER

                                                               FIRST ADDITIONAL BENCH

 

STATE  CONSUMER  DISPUTES  REDRESSAL COMMISSION,            PUNJAB

          SECTOR 37-A, DAKSHIN MARG, CHANDIGARH.

                             First Appeal No.695 of 2015

 

                                                          Date of Institution: 29.06.2015

                                                          Order Reserved on :23.02.2017

                                                          Date of Decision  : 27.02.2017  

 

DLF Pramerica Life Insurance Co. Ltd., (Earlier known as DLF Pramerica Life Insurance Co. Ltd.), 4th Floor, Building no.9, Tower B, DLF City Phase-III, Cyber City, Gurgaon 122002.

 

 

                                                                       Appellant/Opposite party     

        Versus

 

Buharh Singh, son of Mr. Sahib Singh, resident of Bhane Wali Basti, Dhani Sahib Singh Wali, Tehsil Ferozepur, District Ferozepur

 

 

                                                                       Respondent/Complainant

 

First Appeal against order dated 19.03.2015 passed by the District Consumer Disputes Redressal Forum,  Ferozepur.

Quorum:-

          Shri J. S. Klar, Presiding Judicial Member.

            Shri.H.S. Guram, Member.

Present:-

          For appellant                : Sh.Ashok Arora, Advocate

          For respondent            : Sh. Pankaj Katia, Advocate

          . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

 J.S KLAR, PRESIDING JUDICIAL MEMBER :-

         

         

          The appellant directed this appeal against order dated 19.03.2015 directing the appellant to pay the insured amount of policy to the respondent of this appeal with vested bonus and accrued benefits and interest @ 9% from the date of repudiation of the claim till realization and cost of litigation of Rs.5000/-. The respondent of this appeal is the complainant in the original complaint before District Forum and appellant of this appeal is opposite party therein and they be referred as such hereinafter for the sake of convenience.

2.      The complainant has filed the complaint U/s 12 of The Consumer Protection Act, 1986 (in short, "the Act") against the OP on the averments that he was nominee in the policy purchased by his father from the OP. The deceased life assured was got insured, vide policy no.000056668 for a sum of Rs.12,00,000/-. The premium for the said policy was fixed by OP and same was paid by the deceased life assured. The life assured had died on 01.05.2011 as natural death at home. The factum of the death of his father was duly registered with Registrar Birth & Death Punjab. It was averred that after death of the life assured, the complainant lodged the claim with the OP for release of the sum assured, as per procedure laid down by the company. It was further averred that in the month of January 2013, the complainant received a letter from the opposite party, vide which it was conveyed that claim has been rejected on the basis of age i.e. at the time of purchasing the policy of the assured. The OP repudiated the claim of the complainant on false basis. The complainant contacted the office of OP to know the status of the claim, but OP delayed the matter on one pretext or the other. The complainant alleged deficiency in service and unfair trade practice on the part of OP. The complainant has, thus, filed complaint directing the OP to release the insured amount of the DLA along with interest @ 12% p.a from the date of death of life assured, besides Rs.50,000/- as compensation for mental harassment to complainant, as his nominee.

3.      Upon notice, OP appeared and filed written reply and contested the complaint of the complainant vehemently. It was averred that at the time of filing and signing the proposal form, the DLA (deceased life assured) had misrepresented his age, which amounts to suppression of material facts on which the policy was issued. It was averred that after duly understanding all the terms and conditions of the policy "DLF Assured Money + Plan" was issued to complainant and after being satisfied with the plan, DLA with intention to purchase the policy submitted duly filled in and signed the proposal form bearing no. AF000011165 dated 09.02.2011 for an assured sum of Rs.5,00,000/-. It was further averred that under the said policy, a model premium of Rs.45,346/- was to be paid half yearly for the period of 10 years. On page no.1 of the application, the DLA had provided his date of birth as 10.11.1956 i.e. around 55 years at the date of signing of proposal form and submitted his voter ID Card as age proof. In the application form, the policy was issued to the DLA bearing policy no.000056668 with the commencement date 17.03.2011 and same was delivered to DLA. Thereafter, on 03.02.2012, OP received death claim intimation from complainant, whereby OP was given to understand that the DLA suddenly expired on 01.05.2011 due to Dehydration. On receipt of claim intimation, the OP issued condolence letter on dated 23.02.2012 and requested to provide necessary documents for processing the claim. OP also sent reminders to complainant on 26.07.2012 and on 18.10.2012 in this regard, but complainant failed to do so. Rest of the averments were denied by OP and it prayed for dismissal of the complaint.

4.      The complainant tendered in evidence his affidavit Ex.C-1 along with copies of documents Ex.C-2 to Ex.C-8.  As against it; OP tendered in evidence affidavit of Amit Raheja AV Company Secretary & Legal and duly constituted attorney of DHFL Pramerica Ex.OP-1/9 along with copies of documents Ex.OP-1/1 to Ex.OP-1/8.  On conclusion of evidence and arguments, the District Forum Ferozepur accepted the complaint of the complainant by virtue of order dated 19.03.2015. Dissatisfied with the order of the District Forum Ferozepur dated 19.03.2015, opposite party now appellant, carried this appeal against the same.

5.      We have heard learned counsel for parties at considerable length and have also examined the record of the case.

6.      The counsel for appellant submitted that the insured signed the proposal form bearing no. AF000011165 dated 09.02.2011 for the assured amount of Rs. 5 lac with premium amount of Rs.45,346/- to be paid half yearly for the period of 10 years. He submitted that date of birth as 10.11.1956 around 55 years at the date of signing the proposal form and voter I.D Card as age proof was submitted by the assured. The insured also signed declaration authorization regarding particulars set out therein. The proposal form was explained to insured in vernacular language. The policy was issued to DLA bearing no. 000056668 with date of commencement as 17.03.2011. The insurance claim was lodged on 09.02.2011 regarding sudden death of insured. The insured submitted forged proof of his date of birth by means of voter card. Whereas as per electoral role of 2007, deceased insured was 74 years old and as per electoral role of 2008, he was 74 years old in 2011. He submitted forged voter card as  his age proof and, thus, committed fraud upon the insurance company. The Contract of Insurance was repudiated, vide letter dated 26.12.2012 by OP in this regard on account of forged document regarding date of birth of life assured as used by him. This is only point contended during the arguments before us. The counsel for the respondent of this appeal argued to the contrary by submitting that genuine voter card was used as proof regarding date of birth of insured Sahib Singh. It was submitted by counsel for complainant now respondent in this appeal that no forgery has been committed in this case and Sahib Singh submitted his date of birth as 10.09.1972 in the proposal form on the basis of voter list only. OP subsequently maneuvered the wrong date of birth of insured in the subsequent voter list just to repudiate the contract of insurance.

7.      The evidence on the record has to be referred to by us to settle the dispute between the parties in this case. The complainant tendered his affidavit Ex.C-1 on the record stating that medical of the insured was conducted by panelled doctor of OP and then policy was issued to him. The deceased life assured paid premium of the policy. The life assured Sahib Singh died on 01.05.2011 due to natural death at home. OP illegally rejected the claim on the basis of the varied date of birth, as relied by the  insured. Ex.C-2 is letter sent by OP to complainant as legal heir of Sahib Singh insured stating that Sahib Singh was 77 years of age prior to date of proposal application, whereas maximum entry of age for the insurance plan is 60 years. Ex.OP-3 is proposal form, wherein date of birth of Sahib Singh is recorded as 10.09.1972. Sahib Singh relied upon voter card, as his age proof as recorded in proposal form Ex.C-3. To counter this evidence, OP relied upon proposal form Ex.OP-1/1 of insured. Ex.OP-1/2 is policy document containing the terms and conditions of the policy. Ex.OP-1/3 is the death claim form put in by complainant regarding death of Sahib Singh insured. Ex.OP-1/4 is condolence message. The final investigation report submitted by Bijan B. Biswa Managing Director NNB Investigation Pvt. Ltd is Ex.OP-1/5. We find that this is the photocopy of the report only. There is no affidavit of the investigator in support of this report on the record. The original report has also not been produced being primary evidence on the record nor it has been attested to be the correct copy of the original by the OP. In the absence of investigator's affidavit, it is difficult to rely upon this report, which has not been substantiated on the record. Voter list for the year 2007 relied upon by OP is Ex.OP-1/6. This is amended voter list, wherein at serial no. 286 date of birth of Sahib Singh son of Sunder Singh is recorded as 73 years.

8.      Now, we are confronted with this point, as to whether the voter list is conclusive proof of the date of birth or not. The point is not res integra. The National Commission has held in Life Insurance Corporation of India and another versus Gopal Singh, reported in 2011(2) CPJ (NC) 7 that in the matter of suppression of material facts regarding date of birth, the assured while filing the proposal form gave his date of birth incorrectly on the basis of voter list, as contended by the insured. The contention is not acceptable to us.  Age given in voter list can not be taken as sure test to determine exact age of a person. It is common knowledge that frequently small mistakes with regard to residence, age, parentage, do occur while preparing voter list. There is no conclusive evidence on the record to reveal that assured had mentioned his age incorrectly with malafide intention with any ulterior motive. In the absence of any conclusive evidence on the record, it would be assumed that assured had correctly mentioned his age in proposal form. In view of this observation recorded by National Commission, we are bound to hold that voter list is not sure test to determine the exact age of a person. No birth certificate, passport or educational testimonial of insured has been produced on the record by OP to prove this fact that he intentionally gave the wrong date of birth in the proposal form to take the benefit of the insurance policy. The mistake in preparing voter list can occur at various stages at the time of collecting information and transmitting the same to the printing press or in the printing press itself. This is not conclusive to hold that assured mentioned his date in the proposal form wrongly. Reliance of appellant on law laid down by Hon'ble Supreme Court in case titled as Satwant Kaur Sandhu versus New India Assurance Company in Civil Appeal no. 2776 of 2002 decided on 10.07.2009  would not be applicable in this case, in view of our finding as recorded at above because no material facts affecting the validity of the policy has been concealed by the assured.

9.      As a result of our above discussion and on the basis of law laid down by National Commission in above authority, we find no illegality or material infirmity in the order of the District Forum and same is affirmed in this appeal and appeal of the appellant is hereby dismissed.

10.    M.A 1568 of 2016 for correction of name has been filed by respondent of this appeal as Buharh Singh @ Boorh Singh. We have gone through the record and find that the name of the respondent is shown in policy document as Buharh Singh. Accordingly, his name is corrected as Buharh Singh instead of Bhuran Singh.

10.    The appellant no.1 had deposited an amount of Rs.25,000/- with this Commission at the time of filing the appeal. This amount  with interest, if any, accrued thereon, be refunded by the registry to the complainant of this appeal by way of crossed cheque/demand draft after the expiry of 45 days. Remaining amount, if any, due shall also be paid to complainant by the appellant within 45 days from receipt of the copy of this order.

11.    Arguments in this appeal were heard on 23.02.2017 and the order was reserved. Copies of the order be communicated to the parties as per rules.

12.    The appeal could not be decided within the statutory period due to heavy pendency of court cases.

                                                                          (J. S. KLAR)

                                                          PRESIDING JUDICIAL MEMBER

                    

                                                                          (H.S.GURAM)

                                                                               MEMBER

February 27,  2017                                                             

(ravi)