The complainant Lalvachan Mandal has filed this complaint petition against Branch Manager, TATA AIA, life Insurance Company Ltd. and one another (o.ps) for realization of Rs. 7,50,000/- ( sum assured), Rs. 50,000/- for compensation of mental agony and physical harassment , Rs. 30,000/- as litigation cost and 18 % p.a. interest on the total sought amount since the date of death of (L.A) insured person till realization.
The, brief, facts of the case is that complainant has filed this complaint petition in the capacity of nominee & proposer and father of L.A. namely Usha Kumari. Further case is that after being satisfied with soundness of health, age and other formalities as required by said company pertaining to insure person, aforesaid company (o.p.) gave a proposal form to the complainant /proposer on 08-09-2014 and the complainant purchased said policy in name of his daughter Usha Kumari for marriage purpose. The complainant paid Rs. 20,993/- as premium amount on the same day i.e . 08-09-2014 to the company and purchased a policy for sum assured amount Rs. 7,50,000/- along with other monetary benefits. The further case is that the entire proposal form was filled up by company’s agent in the presence of company’s officials and the complainant namely Lalvachan Mandal only put the signature wherever agent told him to do so, in good faith. The further case is that L.A. was minor, so the complainant put his signature wherever it was necessary and paid the premium amount. After accepting the premium amount against policy no. C215915155, aforesaid company issued premium receipt and bond in the name of L.A. person namely Usha Kumari and started risk coverage of her life from 10-09-2014 with sum assured Rs. 7,50,000/- along with other monetary benefits. The further case is that in the fatal, morning of 11/11/2014, all of a sudden L.A. Usha Kumari died with extreme chest pain and heart attack. The further case is that thereafter the complainant and proposer of the policy filed death claim against policy No.- C215915155 to the aforesaid insurance company with all the relevant documents, but after persistent demands and several requests made by the complainant, the company did not respond positively and repudiated his claim on the ground that the complainant had not disclosed about the prior policy detailed and has suppressed the information. The further case of the complainant is that after accepting the premium amount, and issuing the policy the company under rule of estoppels cannot declined the death claim.
The complainant has filed the following documents with the complaint petition - photocopy of first premium receipt annexure-1-, photocopy of death certificate of Usha Kumari annexure-2-, photocopy of income tax return for the year 2013-2014 of Lal Vanchan Mandal annexure-3-, photocopy of income tax return for the year 2014-2015 of Lal Vachan Mandal annexure-4-, photocopy of Pan Card of Lal Vachan Mandal- annexure-5-, photocopy of repudiation letter annexure-6.
On issuance of notices o.ps didn’t appear before the forum, so after being satisfied with the service of notices, forum proceeded Ex. Party against the o.ps vide order dated 09-01-2019.
The complainant has examined himself as AW-1 and has filed his evidence on affidavit. He has also exhibited the Xerox copies of documents already filed as exhibit 1 to 6,
On perusal of repudiation letter annexure-6, it transpires that the Tata AIA Life Insurance Company Ltd. has repudiated the claim of the complainant on the ground that (L.A) was already covered under the multiple insurance policy with the multiple insurance companies at the time of filing of application of the policy, and as such the company was misleaded in issuing above policy. It has been further mentioned in the repudiation letter that the above policy have been purchased by suppressing material facts regarding the matters referred above with the intent to defraud the company.
In the case of Sahara India Ltd. Vs. Rajani Ramanjaneyulu decided on 08-01-2014 by the Hon’ble National Commission, it has been observed that the insurance company cannot repudiate the claim of the complainant on the ground of none disclosure of material facts relating to her earlier policy with various other insurance company.
The complainant has filed the first premium receipt as Annexure-1, photocopy of death certificate of Late Usha Kumari (L.A) as annexure-2, photocopy of return of income tax for assessment year 2013-2014 as annexure-3, photocopy of return of income tax for assessment year 14-2015 annexure-4, photocopy of Pan Card of Lal Bachan Mandal annexure-5. The above documents shows that the policy was issued in the name of Usha Kumar who died on 11-11-2014. The complainant has also deposed on affidavit regarding the facts of the case. Nothing is on record against the above evidence adduced on behalf of complainant. It is also clear from the above judgment of the Hon’ble N.C. that the o.p company cannot repudiate insurance the claim of the insurance of the complainant on the ground of suppressing of material facts of other policies.
This fact has also been decided by Hon’ble N.C. in case No.- FA/1696/2016 AEGON Religare Life Insurance Company Ltd. Vs. Rajendra Ray on 31-05-2018 and it has been held that suppressing of polices cannot be sole ground for repudiation.
In the circumstances, we are of the considered opinion that the complainant has established his case and the o.ps are liable for the relief claimed.
Accordingly, complaint petition is allowed Ex. Party and the o.ps are directed to pay Rs. 7,50,000/- ( sum assured) to the complainant with 8 % p.a. interest from the date of filing of complaint petition, Rs. 20,000/- as mental agony and physical harassment and Rs. 10,000/- as litigation cost within one month from the receipt of the copy of the order, on failure they shall be responsible for payment of aforesaid amount with 9 % interest p.a. till realization. Let a copy of this order be furnished to both the parties as per rule.
