Reserved
State Consumer Disputes Redressal Commission
U.P., Lucknow.
Appeal No. 1834 of 2016
Future Generali India Life Insurance Co. Ltd.,
6th Floor, tower 3, India Bulls Finance Centre,
Senapati Bapat Marg, Elphinstone Road (West)
Mumbai-400013, Maharastra ...Appellant.
Versus
1- Mohan Dei w/o Late Sh. Ramesh Chandra,
Village & Post, Tanda Banshidhar, Tehsil
Shahbad, 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 10.8.2016 passed by the Ld. District Forum, Rampur in complaint case no.22 of 2015, Smt. Mohand Dei Vs. Future Generali Life Insurance Co. Ltd. & anr.
The brief facts of the appeal are that, that the deceased life assured i.e. Mr. Ramesh Chandra had applied for a life insurance policy under the Future Assure insurance plan on 28.12.2012 under application baring no.T01291239 with a sum assured amount of Rs.3,00,000.00. The appellant on believing the information given in the proposal form to be true and correct all respects and as per underwriting norms of the company issued life insurance policy bearing
(2)
no.01058784 in favour of the husband of the respondent no.1 on 31.12.2012. The appellant received death claim intimation on 24.7.2013 from the respondent no.1 informing that the life assured had passed away on 21.3.2013 due to stomach pain. That the respondent no.1 had signed and submitted a declaration in the request for death claim stating that “I, Smt. Mohan Dei, do hereby declare that the information given on this death claim request form is true and complete to the best of my knowledge and belief and all documents submitted are genuine and duly authenticated. I understand that in case any of the above information is found to be false or fabricated, the company at its discretion may repudiate the claim amount and take necessary action against me…”
The appellant investigated the matter and during investigation a RTI application dated 2.8.2013 was filed before the Election Commissioner, Rampur District in response to which a report has been forwarded from Tehsildar in which it has been stated that the life assured has already passed away a year ago. Thereafter, the appellant repudiated the claim on the ground of false and fabricated. The respondent no.1/complainant moved an application on 11.4.2014 for reconsidering the claim. The Review Committee dismissed the review petition. Thereafter, the appellant received a legal notice from the respondent no.1 and responded accordingly. After that the complainant filed a complaint before the ld. District Forum which was allowed by the ld. District Forum.
The impugned order is arbitrary and contrary to the documentary records. The ld. District Forum did not consider
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the documents as forged and fabricated. The ld. District Forum did not trace the report of Tehsildar and observed that the appellant failed to produce any affidavit of the agent Mr. Satya Prakash, the respondent no.2. The ld. District Forum has totally failed to appreciate the basic fact duly pleaded by the appellant that claim is paid by any insurance company out of the common pool of funds belonging to all policyholders of the company and the insurance company has to check the genuineness of the claim before honouring it. The complainant filed the complaint with dishonest intention and concealed the material facts. Therefore, it is most humbly prayed that this Hon’ble 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.
We have seen the repudiation letter in which it has been written that “the death certificate and the request for death claim submitted by you, state that Mr. Ramesh Chandra (the applicant) expired on 21.3.2013. However, the company holds indisputable proof to show that the applicant died even before signing the application for insurance. Thus, there is no valid contract of insurance under the said application and no benefits are payable thereunder.” In the letter detailed reason of repudiation has not been indicated.
Now, we have seen the death report of Mr. Ramesh Chandra. This death report shows that the date of death as 21.3.2013. It is a government record and it prepared during
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official procedure which is admissible in evidence. Nothing adverse has been shown by the appellant against it. Voter list is not ultimate proof of death or birth.
The Hon’ble NCDRC, in Life Insurance Corporation of India & anr. vs. Gopal Singh,(II(2011) CPJ 7 (NC) has said that:-
“Counsel for the petitioner strenuously contended that the date of birth i.e. 26-5-1955 given in the school certificate is that of Panna Singh Rawat son of Chhotu Singh and not that of the Chhotu Singh and the State Commission has erred in taking the date of birth of Chhotu Singh as 26-5-1955 given in the school certificate. We find substance in the submission made by the learned counsel for the petitioner that the date of birth i.e.26-5-1955 mentioned in the school certificate is that of Panna Singh Rawat and not of Chhotu Singh and the State Commission has wrongly taken the said date to be the date of birth of Chhotu Singh. Be that as it may, the burden to prove that insured had concealed his real age was on the petitioner as per its assertion which the petitioner has failed to discharge by leading any cogent evidence. The only evidence produced by the petitioner is the voters list where the age of the assured is given as 62 years. The age given in the voters list cannot be taken as a sure test to determine the exact age of a person. It is common knowledge that frequently small mistakes regarding the residence, age, parentage, do occur while preparing the voters list. The mistakes can occur at various stages i.e. at the time of collecting the information or transmitting the same to the printing press or in the printing press itself. Apart from the voters list the petitioner did not produce any evidence to show that the assured had given his age incorrectly while filling the proposal form. Gopal Singh, the respondent herein, has clearly stated in his affidavit that his father was of 45-46 years of age at the time of taking the policy. Gopal Singh was not cross-examined by the petitioner. There is no conclusive evidence on record to show that the assured had mentioned his age incorrectly with malafide intention with any ulterior motive. In the absence of any conclusive evidence we would assume that the assured had correctly mentioned his age in the proposal form.”
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When any person takes an insurance policy, first a proposal form is filled and thereafter, the policy is issued. If the proposal is accepted, it means everything filled in the proposal has been accepted. The Tehsildar’s report says that name of Ramesh Chandra s/o Dal Chandra has been entered in the list of deleted. He expired about a year ago but not death certificate of Gram Pradhan has been annexed thereto. When no specific date has been given, it cannot be presumed that the deceased was not alive on the date of filling the proposal form for insurance. If there is death certificate, it will prevail over voter’s list unless proved otherwise. Therefore, we come to the conclusion that the judgment passed by the ld. District Forum needs no interference by this Commission. 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
