Punjab

StateCommission

FA/361/2013

TATA AIA Life Insurance Co. Ltd. & others. - Complainant(s)

Versus

Muqtar Ahmad & Anr. - Opp.Party(s)

S.C. Thatai & Nitin Thatai

27 Jan 2016

ORDER

                                                               FIRST ADDITIONAL BENCH

 

STATE  CONSUMER  DISPUTES  REDRESSAL COMMISSION,                                 PUNJAB

          SECTOR 37-A, DAKSHIN MARG, CHANDIGARH.

                      

                   First Appeal No.361 of 2013

 

                                                Date of Institution: 01.04.2013

                                                Date of Decision:  27.01.2016

 

1.      TATA AIA Life Insurance Co. Ltd., (Formerly known as TATA AIG Life Insurance Co. Ltd), having Corporate Registered Office, 5th & 6th Floor, Peninsula tower, Peninsula Corporate   Park, Ganpatrao Kadam Marg, Lower Parel, Mumbai 400013           through its Legal Manager, Sh. Rahul Dhanotia.

 

2.      TATA AIA Life Insurance Co. Ltd., (formerly known as TATA   AIG Life Insurance Company Limited), Branch Office Leela         Bhawan Market, Patiala.

 

3.      Ms. Ankita Chhavi, Claim /Assistant Manager , 5th -6th Floor, Peninsula tower, Peninsula Corporate Park, Ganpatrao Kadam        Marg, Lower Parel, Mumbai 400013.

 

 

                                                               …Appellants/Opposite parties

                             Versus

 

 

Muqtar Ahmad son of Jahoor Ahmad, resident of 36-B, Khalsa College Colony, Patiala.

 

                                                          ..Respondent /Complainant

 

                            

First Appeal against order dated 29.01.2013 passed by the District Consumer Disputes Redressal Forum,  Patiala.

 

Quorum:-

 

          Shri J. S. Klar, Presiding Judicial Member.

            Shri.H.S.Guram, Member

Present:-

 

          For the appellants                 : Sh.Nitin Thatai, Advocate

          For the respondent                : Sh.Manish Jain,  Advocate         

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

 

         J.S KLAR, PRESIDING JUDICIAL MEMBER :-

         

          The appellants of this appeal (the opposite parties in the complaint) have directed this appeal against the respondent of this appeal (the complainant in the complaint), challenging order dated 29.01.2013 of District Consumer Disputes Redressal Forum Patiala, accepting the complaint of the complainant by directing the OPs to make the payment of the benefits on the death of the insured to the nominee, as per the terms and conditions of the two policies with interest @9% per annum from the date of the filing of the complaint, besides cost of litigation of Rs.5,000/-. The instant appeal has been preferred against the same by the opposite parties now appellants in this appeal.

2.      The complainant Muqtar Ahmad has filed the complaint U/s 12 of the Consumer Protection Act, 1986 (in short, "the Act") against the OPs on the averments that he is nominee appointed by Lat Sh. Ateeq Ahmad, who was son of the complainant, and his son purchased two policies bearing no.C188719996 and U159584833 dated 13.09.2010. OPs issued policy information page containing policy date, schedule of benefits, premium and the receipt about the payment of premium. Sh. Ateeq Ahmad/assured met with a road accident, when he was away to Chitarkut Thana Mau and he died in the roadside accident caused by some unidentified vehicle. FIR No. 41/11 dated 17.05.2011 was registered on the complaint of one Sahib Lal at police station Mau, District Chitarkut. The complainant approached the OPs many a time at their branch office at Leela Bhawan Market, Patiala through e-mail and telephonically, but to no effect. The request of the complainant was recorded and every time when he contacted the OPs, he was falsely assured that, his claim amounts would be released within short span of time. False assurances were given to complainant by the OPs even on telephone to release the amount of benefits to him. The complainant supplied required documents to OPs to their entire satisfaction but they failed to release the amount of benefits. The complainant has, thus, filed the complaint directing the OPs to pay benefit of the policy along with interest, besides compensation of Rs.50,000/- for mental harassment.

3.      Upon notice, OPs appeared and filed written reply and contested the complaint of the complainant. It was averred in preliminary objections by the OPs that complaint of the complainant is pre-mature and merits dismissal. The claim of the complainant has not yet been decided and the same is pending and is under investigation and as soon as the investigation is complete, the decision of the claim would be taken. The complaint is alleged to be not maintainable and is without cause of action against the OPs. It was further averred that, as per guidelines of IRDA, the assured was given detailed description about the features of the said plan. The assured took policy by concealing true and material facts at the time of filing application form and he knowingly concealed the same. The matter is under investigation for genuineness of the claim and complaint is pre-mature. On merits, it was averred by the OPs that life assured (since deceased) took two policies from OPs and complainant was nominated, as nominee therein. OPs traversed other allegations of the complainant and prayed for dismissal of the complaint.

4.      The complainant tendered in evidence, his affidavit Ex.CW-1/A along with copies of the documents Ex.C-1 to Ex.C-16. As against it; OPs tendered in evidence affidavit of Rahul Dhanotia Zonal Legal Manager TATA AIA Life Insurance Company Ex.R-1 along with copies of documents Ex.R-2 to Ex.R-12. On conclusion of evidence and arguments, the District Forum Patiala, accepted the complaint of the complainant by virtue of order dated 29.01.2013. Dissatisfied with the order of the District Forum Patiala dated 29.01.2013, the opposite parties now appellants have preferred this appeal against the same.

5.      We have heard learned counsel for the parties and have also examined the record of the case. Pleadings of the parties have been duly considered by us on the record. This fact is not in dispute that Ateeq Ahmad was insured with OPs, as he purchased two policies, vide no.188719996 and U159584833 from OPs against premium. The policy were annual and premium thereof was Rs.5630/- of policy no.C188719996 and premium of Rs.15,000/- for policy no.U159584833. Similarly, there is no dispute about this fact that Ateeq Ahmad met with a road accident and he expired therein and FIR No.41/11 dated 17.05.2011 was registered in this regard. Evidence of Muqtar Ahmad complainant being legal heir of Ateeq Ahmad insured Ex.CW-1/A has been examined by us on the record. Ex.C-1 is copy of ration card showing the names of family members of Muqtar Ahmad and name of Ateeq Ahmad is also recorded in it and address is given as H.No.2, Ajit Nagar, Patiala. Policy information page is Ex.C-2. The receipt of premium amount of Rs.15,000/- from Ateeq Ahmad insured is Ex.C-3. Receipt for amount of Rs.5103/- is Ex.C-4. Ex.C-5 is first premium receipt of Rs.5630/-. Ex.C-6 is copy of DDR lodged about the accident of Ateeq Ahmad, as per which insured Ateeq Ahmad died and his dead body lay on the road. Death certificate of Ateeq Ahmad is Ex.C-8 on the record. Ex.C-12 is pan-card of Ateeq Ahmad on the record issued by Income Tax Department and income tax report of Ateeq Ahmad is Ex.C-13 and Ex.C-14 on the record. Income Tax Returns verification form of Ateeq Ahmad is Ex.C-15 and its acknowledgment is Ex.C-16.  To refute this evidence, OPs tendered in evidence affidavit of Rahul Dhanotia Zonal Legal Manager of TATA AIA Life Insurance Company Ltd is Ex.R-1. Ex.R-2 is authority letter. Ex.R-3 and Ex.R-4 are proposal form filled in by Ateeq Ahmad. Policy details are Ex.R-5 and Ex.R-6. The claim of the complainant with regard to death of insured Ateeq Ahmad was repudiated and conveyed to complainant, vide letter dated 03.10.2012 Ex.R-7 on the record. This witness has deposed that insured submitted his insurance application with driving license, PAN Card, which were found not genuine during the investigation. Office order no.DTP/P/12-13/8846 dated 01.10.2012 of DTO Patiala is Ex.R-8 and report of Assistant Director (Systems) Chandigarh of Income Tax is Ex.R-9 dated 26.09.2012. Ex.R-10 are terms of the insurance policy. Similarly, we have also examined other documents Ex.R-11 and Ex.R-12 placed on record by the OPs.

6.      The only point for adjudication in this appeal is whether the repudiation of the claim by the OPs on the ground that age proof of deceased was found incorrect in Pan Card, which was found not genuine and address given by the insured was found incorrect in the driving licence submitted by him and hence the insurance claim is liable to be repudiated is sustainable. The District Forum repelled this contention as raised by OPs now appellants in this case. We find that accident took place on 17.5.2011 resulting into death of assured and there is no dispute between the parties about this factum of death of life assured in the accident, which occurred on 17.05.2011. In ration card, Ex.C-1 the address of insured is mentioned as H.No.2 Ajit Nagar Patiala and ration card is joint with his father Muqtar Ahmad.

7.      The sheet-anchor of the case of the OPs is on point that insured furnished wrong information regarding his age in the pan card, which was found false. The OPs placed reliance upon copy of letter Ex.R-9 of Rajdeep Singh, Assistant Director (System) office of Commissioner of Income Tax Chandigarh it is dated 26.09.2012 after the death of life assured, which took place on 17.05.2011 in the accident. Similarly, the order passed by the DTO with regard to his cancellation of driving licence is after death of life assured.

8.      The counsel for complainant now respondent in this appeal relied upon Section 19 of the Motor Vehicle Act, 1988. Section 19 of the Motor Vehicle 1988 lays down that if a licensing authority is satisfied after giving the holder of a driving licence an opportunity of being heard that he has committed any such act to disqualify from holding a driving licence, his driving licence can be cancelled after giving an opportunity of being heard to him. The sine qua non of Section 19 of Motor Vehicle Act 1988 is that licence can be revoked only after giving an opportunity of being heard to licence holder.  There is no question of giving any opportunity of being heard to him because his licence was revoked by DTO Patiala on the complaint of OPs after death of licence holder only. The order of DTO Patiala is in violation of Section 19 of the Motor Vehicle Act 1988 because no opportunity of being heard has been given to licence holder before revoking his licence. Similarly, the reliance of OPs is on Ex.R-9, the copy of letter dated 26.09.12 regarding the fact that pan card was found fake after verification by concerned officer. This is a simple letter and substance of it is not established. The insurance companies are generally interested in taking premium from the gullible customers by inducing them and thereafter they find ways to repudiate the same on one pretext or the other. The very point is significant that the insurance company does not verify the particulars/documents provided by the applicant before issuing the policy. This has been done after death of the life assured only just to avoid payment of the insured amount to the complainant, who is a poor person. The insurance company cannot be permitted to fleece the innocent customers by these manners. Consequently, we are in agreement with the findings of the District Forum recorded in the order under challenge in this case. There is no question of any concealment as the ration card of the complainant on the record proves the residence of the complainant and insured Ateeq Ahmad at H.No.2, Ajit Nagar, Patiala, which has not been found to be false. Resultantly, we find no illegality or material infirmity in the order of the District Forum calling for any interference therein. We affirm the order of the District Forum under challenge in this case.

9.      As a result of our above discussion, we do not find any merit in the appeal and same is hereby dismissed.

10.    The appellant has 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 by way of crossed cheque/demand draft after the expiry of 45 days. Remaining amount shall be paid by the appellants to the complainant after 45 days from the date of receipt of copy of this order.

11.    Arguments in this appeal were heard on 21.01.2016 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

 

January 27,  2016                                                               

(ravi)