West Bengal

Dakshin Dinajpur

CC/18/2013

Motaja Bibi, W/O- Late Jabbar Ali - Complainant(s)

Versus

The Branch Manager, LICI, Balurghat Branch - Opp.Party(s)

24 Oct 2013

ORDER

 

            In brief, the case of the complainant / petitioner is that her husband Jabbar Ali, since deceased, obtained one Life Insurance policy being No. 453645612 on 28.7.2004 sum assured Rs. 2,00,000/- under table & term 14/15 from the OP No.1. During continuation of the said policy her husband Jabbar Ali died on 20.6.2005 due to heart attack. It is the further case of the complainant that she being the nominee of the aforesaid policy submitted claim form claiming the death benefits from that policy along with relevant papers. In spite of several reminders given by her OP Nos. 1&2  failed to pay the policy amount as death benefits. Ultimately, OP No. 2 repudiated her claim on the strength of a letter dt. 6.6.2012.

 

            Both the OP Nos. 1&2 have contested the present case by filing a written statement inter- alia denying all the material allegations made by the complainant in her petition of complaint. It is the main contention of both the OPs ( so far it can be gathered from their written statement) that in the instant case the claim of the complainant is called as an ‘early claim’ because policyholder died within two years from the date of commencement of the policy. OPs  have further stated in their written statement that the policyholder did not give correct statement in respect of his age at the time of obtaining the policy by filling in the proposal form. It is also of the case of the OPs that the policyholder disclosed his age as 49 years at the time of obtaining the policy. But, in fact, he was 75 years old at the said time. Due to suppression or concealment of such material information, claim under insurance policy was repudiated. Present case is malafide one. So these OPs prayed for dismissal of the petition of complaint.

 

            From the materials on record we have come to the following finding.

 

                                                                                                

 

FINDING with reasons

            Before passing this judgement we have carefully perused the petition of complaint, written statement and the other materials on record. It is admitted position that one Jabbar Ali, since deceased, who is the husband of the complainant Motaja Bibi, obtained one policy being No. 453645612 sum assured Rs.2,00,000/- under the table & terms 14/15 on last 28.7.2004 from the OP-1 and the said policyholder died on 20.6.2005 leaving behind his wife (complainant). It is also admitted position that the present complainant is nominee of the aforesaid policy. It is the main contention of the complainant / petitioner that being nominee of late Jabbar Ali (policyholder), she submitted claim form claiming the death benefit from that policy with relevant papers. In spite of her several reminders OP Nos. 1 & 2 failed to pay the policy amount as death benefits. Ultimately, they repudiated her claim on the strength of a letter dated 6.06.2012.

 

            Now, we will consider as to whether claim of the complainant was repudiated by the OP Nos. 1 & 2 in accordance with law or not. At the time of hearing Ld. Counsel on behalf of OPs submitted before this Forum that there is / was no any error on the part of  OPs 1 & 2 in repudiating the claim of the complainant as the policyholder did not make correct statement in the personal history column of personal form in respect of his age as required for contract of insurance at the time of obtaining the policy by filling in the proposal form. According to Ld. Counsel the policyholder Jabbar Ali insured his life with LICI Balurghat Branch on 28.7.2004 under the table & terms 14-15, sum assured of Rs. 2,00,000/-. It is / was the further submission of the Ld. Counsel on behalf of the OPs that the aforesaid policy can be obtained by a person up to his age of 65 years i.e. maximum age for obtaining such policy is 65 years. In support of his above contention Ld. Counsel has filed certain papers / documents. But in the instant case the policyholder disclosed his age as 49 years at the time of obtaining the policy, although,  he  was  75  years  old  at  the  material  point  of  time.

 

                                                                                                

So, the complainant is not entitled to get any amount against death benefits. Ld. Counsel on behalf of OPs further submitted before this Forum that the insurance policy is a contract and it is the duty of the policyholder to make a true and full disclosure of information within his knowledge to the questions asked in the proposal form and if the policyholder does not give any correct information that amounts to violation of the terms & conditions of the contract. In such cases the Insurance Company is entitled to repudiate the claim. Ld. Counsel also submitted before this Forum that the policy was obtained suppressing the material information as to his age by the policyholder, which is relevant to the contract of Insurance and attracts the provisions of Sec.45 of the Insurance Act, 1938. We have already stated above that the policy under table & terms 14-15, which was obtained by the policyholder in the instant case, can be obtained by a person up to his age of 65 years. It is seen from the materials on record that the policyholder disclosed his age as 49 years at the time of submitting the proposal form i.e. on 25.2.2005. No tangible paper / document is forthcoming from the side of the complainant to show that at the time of submission of proposal form her husband/ policyholder Jabbar Ali was 49 years old. It is to be noted here that the complainant has filed xerox-copy of Ration Card standing in the name of Jabbar Ali (policyholder) to prove his age. We have carefully perused xerox-copy of such ration card. It seems to us that age of Jabbar Ali has been over-written / manipulated on the xerox-copy of such ration card. So, we do not place any reliance upon such document. In our opinion it was the duty of the complainant to produce the original ration card of her husband Jabbar Ali to prove his age. But she did not dare to produce the same. No explanation is forthcoming from the side of the complainant for withholding the original ration card of the policyholder Jabbar Ali. It is well- settled that suppression or destruction of useful evidence naturally leads to the inference that evidence if produced, would go against the party who withholds it. So, it was rightly pointed out by Ld. Counsel on

 

                                                                                                

behalf of OPs that the complainant did not produce the original ration card as her husband i.e. the policyholder was above 65 years old at the time of obtaining the policy. On the other hand, it reveals from the copy of voter list, which was published in the year 2003, filed in this case on behalf of OPs that the policyholder Jabbar Ali was 73 years old in the year 2003. So, it can be safely be said that at the time of obtaining the policy he was 74 / 75 years old.

            It was again rightly pointed out by the Ld. Counsel on behalf of OPs that the policyholder Jabbar Ali obtained the policy fraudulently suppressing his actual age. 

 

            Considering all these aspects we are of the view that the OPs repudiated the claim of the complainant legally and as such, she is not entitled to get any relief / reliefs as prayed for.

 

            In these premises, the instant case must fail. Hence, it is

                                                O R D E R E D

 

            that the instant petition of complaint be and the same is dismissed on contest against the OPs 1 & 2, but in the circumstances without any cost.

 

            Let plain copy of this order be furnished to the parties forthwith free of cost.