State Consumer Disputes Redressal Commission
Shardabenbhagvandas Padhiyar vs H D F C Standard Life Ins Co Ltd on 30 June, 2023
Details DD MM YY
Date of disposal 30 06 2023
Date of filing 04 01 2016
Duration 26 05 07
BEFORE THE CONSUMER DISPUTES REDRESSAL COMMISSION
GUJARAT STATE AHMEDABAD.
COURT NO: 03
Consumer Complaint No.1 of 2016
Shardaben Bhgwandas Padhiyar
(Wife-Nominee of late Bhagwandas Parbhaji Padhiyar)
166, A-71, Aalampura, Opp. Ice Factory,
Dudheshvar Road, Shahibaug,
Ahmedabad-380004. ...Complainant.
V.s
1. HDFC Standard Life Insurance Co. Ltd.
First Floor, Akansha Arcade,
Showroom No.115-117
Opp. Memnagar Fire Station,
Near Ambuja House,
Navrangpura, Ahmedabad-380009
2. HDFC Standard Life Insurance Co. Ltd.
Lodha Excels, 13th Floor, Apollo Mill Compound,
N.M. Joshi Marg, Mahalaxmi,
Mumbai-400011 (Maharashtra) ...Opponents.
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BEFORE: Mr. I. D. Patel, Judicial Member
Ms. A. C. Raval, Member
APPERANCE: P. V. Patel, L.A. for the complainant,
P. R. Jani, L.A. for the opponent.
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ORDER BY Mr. I. D. PATEL, JUDICIAL MEMBER.
JUDGMENT
1. The present complaint has been filed by the complainant Shardaben Bhagwandas Padhiyar (herein after referred to as the complainant) Akshay CC/1/16 Page 1 of 14 under Section 17 of Consumer Protection Act (for short "The Act") against the opponent HDFC Standard Life Insurance Company Ltd. (herein after referred as the opponent) claiming Rs.20,00,000/- with 9% interest as sum insured of the policy and also Rs.5,000/- for mental harassment and Rs.25,000/- as cost of litigation as prayed for in para 8 of the complaint.
Brief facts of the complaint
2. That the complainant is deceased husband namely Bhagwandas Parbhaji Padhiyar had taken life insurance policy from the opponent Insurance Company namely HDFC Life Clock 2 protect policy for the period of 10 years of sum insured of Rs.20,00,000/- bearing policy no.16894831 by paying yearly premium of Rs.14,699/- as on 11.06.2014. It is further the case of the complainant that thereafter on 28 April, 2015, DLA Bhagwandas Parbhaji Padhiyar expired on account of sudden chest pain, therefore, the complainant being nominee of the policy in question lodged the claim on account of demise of the DLA with the opponent Insurance Company along with the necessary document. It is further the case of the complainant that opponent Insurance Company vide letter dated 6th October, 2015 repudiated the claim of the complainant's husband DLA Bhagwandas Parbhaji Padhiyaron for false and flimsy ground and that DLA had suppressed the correct date of birth in the proposal form and thereby opponent Insurance Company committed deficiency in service and therefore, complainant claimed the relief against the opponent Insurance Company in terms para 8 of the complaint.
Defense of the opponent
3. That on behalf of the opponent Insurance Company Ld. Adv. P. R. Jani has submitted the written statement denying all the contents of the complaint namely contents mentioned in para 1 to 7 and Insurance Akshay CC/1/16 Page 2 of 14 Company put forth their defense in para 12 to 24 whereby the Insurance Company categorically stated that DLA Bhagwandas Parbhaji Padhiyarhas submitted proposal form with the opponent Insurance Company for taking life insurance policy wherein he has mentioned the birth date as 1.5.1963 and in support of his age proof, DLA has submitted the copy of the Pan card. Furthermore, the Insurance Company has also submitted in written statement that the contents of the proposal form were duly explained to DLA in Gujarati language and after understanding the same DLA made declaration that he had understood the contents of the proposal form. Therefore, on the basis of the information given by the DLA in the proposal form, Insurance Company issued the policy in question in good faith in favour of the DLA Bhagwanji Parbhaji Padhiyar. It is also submitted by the Insurance Company in their written statement that during the course of the investigation, the opponent Insurance Company found that actually DLA was 60 to 61 years old at the time of proposing for the said policy. That even as per the copy of document submitted by complainant along with her claim form, the age of DLA was 62 years at the time of his death on 28.4.2015 which means on the date of proposal i.e. on 6th June, 2014 the DLA was aged 60 to 61 years. Thus, as per the submission of the Insurance Company DLA fraudulently showed his age 9-10 less for taking higher risk coverage on his life and thereby DLA suppressed the material facts by giving wrong information and false fact about his age and thereby the DLA had committed breach of terms and condition of the insurance policy and the declaration made by him in the proposal form and thereby played fraud upon the opponent and therefore Insurance Company has rightly repudiated the claim of the DLA and Insurance Company has not committed any deficiency in service and accordingly, the opponent Insurance Company has prayed for dismissal of the consumer complaint with cost.
Akshay CC/1/16 Page 3 of 14Evidence of the complainant
4. Complainant has filed counter affidavit page 78 and 79 against the reply filed by the Insurance Company wherein complainant has categorically denied defense put forth by the Insurance Company and reiterated facts stated in the complaint. Over and above the Complainant has also filed documentary evidence namely copy of the proposal form, death certificate of the DLA, repudiation letter of the Insurance Company, IT Return of the DLA, electricity bill of the DLA and also produced the birth certificate of the DLA issued by the Ahmedabad Municipal Corporation.
Evidence of the opponent
5. Opponent Insurance Company has produced the various documentary evidence at page 45 to page 77 submitted by the complainant with the death claim form. More particularly, proposal form, claim form, copy of the election card, PAN Card, ration card, receipt of funeral of crematorium of DLA and copy of the aadhar card of the Complainant as well as repudiation letter and Insurance Company has also produced birth certificate issued by the Ahmedabad Municipal Corporation of the DLA showing the date of birth of DLA 28.05.1955 page 84 and copy of the reply of the RTI application of the Insurance Company/information given by public officer of the Ahmedabad Municipal Corporation. Page 95 and 96.
Arguments of the complainant
6. The Complainant has submitted written arguments page 109 to 111 and Ld. Adv. Shri P. V. Patel on behalf of the Complainant also made oral submission in this case. That in the written argument the Complainant has reiterated facts stated in the complaint as well as rejoinder affidavit. That the Ld. Adv. of the Complainant Shri P. V. Patel has submitted that DLA Bhagwandas Parbhaji Padhiyarhad had taken Akshay CC/1/16 Page 4 of 14 life insurance policy of sum insured of Rs.20,00,000/- as on 11.06.2014 from the opponent Insurance Company and in the said proposal form, DLA has mentioned his date of birth 01.05.1963. He has also submitted the copy of the PAN Card for the proof of his age. Furthermore, Ld. Adv. Shri P. V. Patel has also submitted that after the demise of the DLA the Complainant lodged the claim with the opponent Insurance Company along with necessary documents. However, by letter dated 06.10.2015, Insurance Company has falsely repudiated the claim of the DLA on the ground that DLA had suppressed the correct date of birth in the proposal form and thereby the DLA had not declared the correct information in the proposal form. But as per the submission Ld. Adv. P. V. Patel, Complainant has also produced a copy of the birth certificate issued by the Ahmedabad Municipal Corporation page 81 wherein also the date of the birth of the DLA was shown as 01.05.1963 as shown in the copy of the PAN card and as per the proposal form. So as per the submission of the Ld. Adv. P. V. Patel, DLA had not suppressed any material fact, more particularly the date of birth in the proposal form and he had shown the correct date of birth in the proposal form and that is supported by the birth certificate issued by the Ahmedabad Municipal Corporation. Furthermore, Ld. Adv. Shri P. V. Patel has also submitted that the birth certificate produced by the Insurance Company of DLA page 94 state the date of registration 28.05.1955 on which date DLA was born. So, it is totally unnatural and not believable and therefore, the said birth certificate produced by the Insurance Company cannot be said to be authentic one in comparison of the documentary evidence produced by the Complainant. Furthermore, Ld. Adv. Shri P. V. Patel has also submitted that the age or date of birth shown in the election card, ration card and receipt of the crematorium where the funeral of the DLA took place was not correct and the said document cannot be said to be a genuine and authentic and only the birth date shown in the Pan Card and birth Akshay CC/1/16 Page 5 of 14 certificate issued by the competent authority can be said to be genuine and authentic. Therefore, the submission of the Ld. Adv. Shri P. V. Patel is that the Insurance Company has wrongly repudiated the genuine claim of the Complainant and thereby committed deficiency in service and therefore, the Complainant is entitled to get the relief as claimed in para 8 of the consumer complaint from the opponent Insurance Company. Hence, he prays to allow the complaint.
Argument of the opponent
7. On behalf of the opponent Insurance Company, Insurance Company has filed written argument page 112 to 118 wherein, the Insurance Company reiterated the facts stated in the written statement and thereby justified the repudiation of claim made by the Insurance Company of the DLA. Furthermore, Ld. Adv. Ms. S. R. Shelat on behalf of Ld. Adv. P. R. Jani has also made oral submission wherein she has categorically submitted that the policy in question issued in favour of the DLA on the basis of the proposal form page 45 and as per the important guidelines of the said proposal form, "the policy will be issued on the basis of the disclosure made/information given and the Date of Birth mentioned in this application form and all information in the electronic proposal form and annexure shall be relied on and has to be accurate, complete and true in all respects for processing the proposal quickly. And all information by the DLA be true and any false information or declaration be make Insurance Company liable for rejection of the proposal form and the contract of insurance." Furthermore, Ld. Adv. of the opponent Insurance Company submitted that in the proposal form DLA had mentioned his date of birth as 01.05.1963 page 45. LA and opponent Insurance Company has further submitted that thereafter but where the DLA died as on 28.04.2015 and the Complainant his wife being a nominee lodged the claim with the Insurance Company and submitted documents along with the claim Akshay CC/1/16 Page 6 of 14 form and during course of investigation, the opponent Insurance Company found that actually DLA was 60 to 61 years old at the time of proposing for the said policy. That even as per the copy of documents submitted by Complainant along with her claim form, the age of DLA was 62 years at the time of his death i.e.28.04.2015 which means on the date of proposal i.e. on 06.06.2014, DLA was 60 to 61 years. Thus, fraudulently showed his age 9-10 year less for getting higher risk coverage on his life. Thereby, the DLA suppressed the true facts by giving wrong information and documents about his age. Therefore, DLA has committed breach of terms and conditions of policy and declaration made by him in the proposal form and thereby played fraud upon the opponent.
8. The Ld. Adv. of the Insurance Company place reliance upon the documentary evidence submitted by the Complainant along with the death claim form of DLA produced on page 45 to page 76 which are the copy of the copy of the receipt of the crematoria of DLA, election card of DLA, ration card of DLA wherein, the age of the DLA was mentioned 60 to 62 years. Furthermore, Ld. Adv. of the Insurance Company Ms. S. R. Shelat has also submitted that the Complainant has not produced the copy of the birth certificate issued by Ahmedabad Municipal Corporation showing the date of DLA 01.05.1963 along with the Complainant and the Complainant produced the said certificate page 81 along with rejoinder affidavit that shows the lack of bonafide on the part of the Complainant. Furthermore, Ld. Adv. of Insurance Company has also submitted that the Insurance Company has also obtained the birth certificate from the Ahmedabad Municipal Corporation of DLA page 94 wherein the date of the birth of DLA was shown as on 28.05.1955. So on perusal of the same and on perusal of the documentary evidence produced by the Complainant along with the death claim form, it appears that DLA had not mentioned the correct Akshay CC/1/16 Page 7 of 14 date of birth in his proposal form while taking insurance policy. Furthermore, Ld. Adv. of the Insurance Company has also submitted that on account of 2 different birth certificate issued by the Ahmedabad Municipal Corporation of DLA showing 2 different birth date namely 28.05.1955 and 01.05.1963, the opponent Insurance Company has filed a RTI application before the AHMEDABAD MUNICIPAL CORPORATION and Corporation has replied the same by its letter dated 28.08.2018 page 95-96 wherein birth and death department of the Ahmedabad Municipal Corporation has stated that the facts stated in the certificate issued by the Ahmedabad Municipal Corporation of the Daryapur Kajipur Ward wherein the birth date of DLA was shown as 28.05.1955 is registered with the birth register of the Ahmedabad Municipal Corporation however, the facts stated in the birth certificate showing the date of birth of DLA being 01.05.1963 viz. date of birth registration number and date of registration is not available in the birth register of the Ahmedabad Municipal Corporation. So as per the submission of the Ld. Adv. Ms. S. R. Shelat, the birth certificate issued by the Ahmedabad Municipal Corporation showing the date of birth of DLA 01.05.1963 is not genuine and authentic and birth certificate showing the date of birth of DLA dated 28.05.1955 is genuine and authentic as per the RTI reply of the Ahmedabad Municipal Corporation and as against the said evidence, the Complainant has not produced any evidence to disprove the birth certificate showing the date of the DLA 28.05.1955 and reply of the RTI given by the Ahmedabad Municipal Corporation. So as per the submission of the Ld. Adv. of the Insurance Company when DLA had made false declaration regarding this birth date in the proposal form as per the provision of Section 45 of the Insurance Act, the Insurance Company is well within its right to cancel the policy and the claim of the DLA and accordingly, the opponent Insurance Company has not committed any deficiency in service as stated by the Complainant.
Akshay CC/1/16 Page 8 of 149. Ld. Adv. of the Insurance Company has also placed reliance upon the decision of the Hon'ble Apex Court in P. C. Chacko and another Vs Chairman, L.I.C. of India and Others reported in 2008 ACJ Page 456 and submitted that the contract of insurance is based on utmost good faith and the DLA suppressed the material facts in the proposal form deliberately than the contract of the policy is vitiated in law as per the provision of Section 45 of the Insurance Act. Furthermore, Ld. Adv. of the Insurance Company has also placed reliance upon the decision of the Hon'ble National Commission in Gulab Singh V/s HDFC Standard Life Insurance Co. Ltd. and Anr. Reported I (2019) CPJ 157 and submitted that when DLA declared false or wrong age in the proposal form means he had committed the violation of the policy condition and therefore, the repudiation of the Insurance Company can be said to be justified. That the Ld. Adv. of the Insurance Company has also placed reliance upon the decision of the Hon'ble National Commission in Bharti and Ors. Vs. Bajaj Allianz Life Insurance Company Ltd. reported in I (2014) CPJ 502 and submitted that misrepresentation of age in the proposal form can be said to be misrepresentation of age for obtaining insurance policy and therefore the policy becomes null and void.
Findings and Conclusion
10. That the present complainant has filed the complaint against the opponent Insurance Company alleging deficiency in service on the part of the Insurance Company by repudiating genuine and death of claim of DLA Bhagwanji Parbhaji Padhiyar. Therefore, as the decision of the Hon'ble Apex Court in the case of Ravneet Singh Bagga Vs KLM Royal Dutch Airline reported in 4 (2009) I SCC 66. The onus of proof of deficiency in service is on the complainant under the Consumer Protection Act, 1986. It is the complainant who had approached the Commission therefore, without any proof of deficiency the opposite Akshay CC/1/16 Page 9 of 14 party cannot be held responsible for deficiency in service. Hon'ble Apex Court held that burden of proving the deficiency in service upon the person who alleges it. The deficiency in service cannot be alleged without attributing fault, imperfection, short coming and inadequacy in the quality of nature and manner of performance which is required to be performed by a person in pursuance of a contract or otherwise in relation to any service. Hon'ble Apex Court in the case of Indigo Airlines Vs Kalpna Rani also held that initial onus to substantiate factors of deficiency in service committed by the opposite party was primarily on the Complainant. If the Complainant is able to discharge its initial onus the burden would then shift to opposite party in the complaint. Therefore in view of the said decision of the Hon'ble Apex Court, we have to decide or to adjudicate the present consumer complaint filed by the complainant against the opponent Insurance Company.
11. That it is an admitted fact that on the basis of the proposal form dated 11.06.2014 page 45, opponent Insurance Company had issued Life Insurance Policy namely HDFC Life Clock 2 Protect for a period of 10 years commencing from 11.06.2014 bearing Policy no.16894831 in favour of DLA Bhagwanji Parbhaji Padhiyar. Copy thereof is produced by the Insurance Company on page 102. That it is not in dispute between the parties that DLA Bhagwandas Parbhaji Padhiyarexpired on 28.04.2015 on account of sudden chest pain as per the death certificate page 60 issued by the competent authority. That the main dispute between the party is that the birth date shown by the DLA in the proposal form being 01.05.1963 is correct date or not? That as per the case of the complainant in the proposal form DLA Bhagwanji Parbhaji Padhiyar shown the date of birth 01.05.1963 on the basis of the PAN Card and in support of the said facts the complainant has also placed reliance upon the birth certificate issued by the Ahmedabad Municipal Corporation showing the date of birth of DLA 01.05.1963 Akshay CC/1/16 Page 10 of 14 page 81 but as against the said documents of the Complainant, Insurance Company has placed reliance upon the certain documents produced at page 40 to page 77 and page 94 to 96. If we perused the said documents more particularly, documents submitted by the Complainant herself along with the death claim form by self attesting, in the receipt issued by the crematorium where the funeral of the DLA was performed dated as on 28.04.2015 wherein the age of DLA was shown as 62 years page 66 and also the same age was shown in the cash memo issued by the Dudheshvar Crematorium page 67 of funeral of DLA Bhagwanji Parbhaji Padhiyar. Not only that even in the election card of DLA page 68, age of DLA was shown 40 years as on 01.01.1995. So as on the date of proposal form the DLA had completed 59 years. Likewise, looking to the ration card of the family members of the DLA, the age of DLA was shown 55 years as on 01.01.2010. So on 6th June, 2014, DLA had completed 59 years. Furthermore, we perused the birth certificate issued by the Ahmedabad Municipal Corporation of Dariyaput Kajipur ward of DLA page 94 wherein the date of the birth of DLA was shown as 28.05.1955 which is produced by the opponent Insurance Company. That the Complainant has produced the birth certificate of DLA page 81 wherein the date of the birthdate of DLA was shown 01.05.1963. So there are 2 different dates shown as DLA birthdate in 2 different certificate issued by the Ahmedabad Municipal Corporation but on perusal of the RTI reply given by the Ahmedabad Municipal Corporation birth and death department to the insurance company page 95-96 the facts stated in the birth certificate of delay showing the date of birth 28.05.1955 is registered with birth record of the Ahmedabad Municipal Corporation whereas the facts stated in the birth certificate showing the date of birth of DLA 01.05.1963 viz. date of birth, registration number, date of registration are not registered or not mentioned in the birth records of the Ahmedabad Municipal Corporation. So on perusal of the RTI reply of the Ahmedabad Akshay CC/1/16 Page 11 of 14 Municipal Corporation, the birth certificate showing the date of DLA 28.05.1955 issued by Ahmedabad Municipal Corporation can be said to be more authentic and genuine than the birth certificate showing the date of birthdate 01.05.1963 of DLA produced by the Complainant. Not only that against the birth certificate produced by the opponent Insurance Company showing the date of birth of DLA 28.05.1955 and reply of RTI, the complainant has not produced any evidence to disprove the said documentary evidence. Even documentary evidence namely election card, ration card, receipt of crematorium and aadhar card of the DLA which were submitted by the Complainant to the Insurance Company by self attesting also shows the age of DLA between 60 to 62 years and that also leads to believe that DLA's age was about 60 years at the time of proposal from 11.06.2014. Therefore, we do not agree with the submission made by the Ld. Adv. of the complainant Shri P. V. Patel that the documentary evidence in form of birth certificate produced by the Insurance Company cannot be said to be authentic and genuine.
12. That as per the important guidelines of the proposal form page 45 the policy in question issued on the basis of disclosure made/information given and the date of birth mentioned in application and DLA has to provide correct and true information in the proposal form. But looking to the documentary evidence produced by the opponent Insurance Company in this matter, it appears that DLA Bhagwandas Parbhaji Padhiyar had made false declaration in the respect of the date of birth 01.05.1963. Accordingly, he has not shown the correct date of birth in the proposal form and thereby he had committed the breach of terms and conditions of the policy. The policy in question issued in favour of the DLA as on 11.06.2014 and DLA Bhagwandas Parbhaji Padhiyar died on 28.04.2015 that is within the period 2 years from the date of issuance of the policy and when the policy holder expire within 2 years Akshay CC/1/16 Page 12 of 14 of taking the said policy and policy holder made a false declaration or suppressed the material facts in the proposal form then the policy can be called in question by insurer on the ground of suppression of material fact. As per the provision of Section 45 of the Insurance Act here in this case, DLA Bhagwandas Parbhaji Padhiyarhas made false declaration regarding his birth date in the proposal form and thereby suppressed the material fact and violated the terms and conditions of the insurance policy. Therefore, as per the decision of the Hon'ble Apex Court in P. C. Chacko and another V/s Chairman, L.I.C of India and others reported in 2008 ACJ 456 of the Hon'ble Apex Court of India and as per the decision given by the National Commission in the case of Gulab Singh V/s HDFC Standard Life Insurance Co. Ltd. and Anr. Reported in I (2019) CPJ page 157, the Insurance Company has rightly repudiated the death claim of the DLA Bhagwandas Parbhaji Padhiyarvide vide repudiation letter dated 6th October, 2015, accordingly, opponent Insurance Company has not committed any deficiency in service as alleged by the Complainant and the present complainant miserably failed to prove the deficiency in service committed by the opponent Insurance Company as per the decisions of the Hon'ble Apex Court. Therefore, based on foregoing discussions, we do not find any merit in the present consumer complaint against the opponent Insurance Company and accordingly the complainant is not entitled to get any relief in terms of para 8 of the complaint from the opponent Insurance Company and accordingly, present consumer complaint deserves to be dismissed in terms of the following final order.
ORDER
1. The consumer complaint no.1/2016 filed by the complainant Shardaben Bhgwandas Padhiyar against the opponent HDFC Standard Life Insurance Company Ltd. is hereby stands disposed off as dismissed.
Akshay CC/1/16 Page 13 of 142. There shall be no order as to costs.
3. A copy of this order be provided to the parties free of cost.
4. The order be uploaded forthwith on the website of the commission for the perusal of the parties.
Pronounced in the open Court today on 30th June, 2023.
[A. C. Raval] [I. D. Patel]
Member Judicial Member.
Akshay CC/1/16 Page 14 of 14