State Consumer Disputes Redressal Commission
1.The Lic Of India vs Mudu Devsingh on 13 July, 2022
Before the State Consumer Disputes Redressal Commission
(constituted under the Consumer Protection Act, 2019)
of Telangana, Eruvaka Building, Khairathabad at Hyderabad
FANO.365 OF 2017 AGAINST CCNO.175 OF 2013
ON THE FILE OF DISTRICT COMMISSION, WARANGAL
Between:
1) The Life Insurance Corporation of India,
Represented by its Branch Manager,
Warangal-1 Branch Office,
Opp to MGM Hospital,
Warangal -506 001.
2) The Life Insurance Corporation of India,
Represented by its Senior Divisional Manager,
Balasamudram, Hanamkonda,
Warangal district.
3 The Life Insurance Corporation of India,
Represented by its Zonal Manager,
Zonal Office: Jeevan Bhagya,
Saifabad, Hyderabad.
(Appellant No.3 is deleted as per
Orders dated 30.07.2014, passed
in 1A No.213/2014 in CC No.175/2013).
ppellants/Opposite parties
And
Mudu Devsingh S/o Shevula Naik,
aged 33 years, Occ: Government employee,
R/o Rangaraopally village,
Mulugu mandal, Warangal district.
.Respondent/Complainant
Counsel for the Appellants Ms.T.V.Sridevi
Counsel for the Respondent Sri G.Rajendra Prasad
CORAMI:
*****
Hon'ble Sri Justice MSK Jaiswal President
and
Smt Meena Ramanathan Member
Wednesday, the Thirteenth day of July Two Thousand Twenty Two Oral Order: *** 2 the Opposite parties aggrieved by s 1S an appeal preferred by tne orders dated 29.09.2015 Dassed by the District Consumer Forum, the complaint and directing the warangal in CC No. 175/2013 in allowing Rs.1,00,000/-
to pay
parties therein jointly and severally
POS a n n u m from
the
S u m assured along with interest 7.5% per
vested bonus as
ac ol complaint i.e., 18.11.2013 till realisation plus
and
Lne terms of the and to pay costs Rs. 10,000/- as damages
Pe policy
costs of the complaint, granting time of one month for compliance
2) For the sake of convenience, the parties are referred to as arrayea
in the complaint.
3) It1s the case of Complainant that he is the son of Mudu
Bhadramma, who, during her lifetime had obtained policy No.688077806 Irom the Opposite party No.1 for an assured sum of Rs.1,00,000/- which commenced from 28.12.2007, wherein, the Complainant was shown as nomine. After the death of his mother on 03.01.2012, the Complainant made claim with Opposite parties seeking payment of policy benefits, which, they failed to settle and by letter dated 12.03.2013 they repudiated the claim on the premise that the life assured suppressed her marital status at the time of obtaining policy. Complaining the same to be deficient, filed the present complaint with a prayer to direct the Opposite parties to pay Rs.1,86,000/- covered by policy together with interest @ 24% per annum from the date of complaint till realisation and also to award costs of the complaint.
4) Opposite parties filed their written version admitting issuance of the subject policy and the Complainant to be its nominee. The life assured died on 03.01.2012 and during claim process As per the underwriting rules, the life assured's actual status is "Category-11, Widow-having her own income, self-employed but not filing income tax returns". For women falling under this category, standard age proof is required. The life assured withheld correct information regarding her marital status, as such, Complainant is not entitled for any reliefs. Hence, prayed to dismiss the complaint.
5) During the course of enquiry before the District Forum, in order to prove his case, Complainant filed his affidavit evidence as PW1 and got marked the documents Ex.A1 to A3. On behalf of Opposite parties, one D.V.Pushparaju, their Administrative Officer (Legal & HPF) filed his ndavit to evidence as RW1 and got marked the documents Ex.BI B*
6) he District Forum after considering the material availa ble on 2013, by orders Ora, allowed the complaint bearing CC No.175 of dated 29.09.2015, as stated, at paragraph No. 1, supra.
preferred the present 7) Aggrieved by the said orders, the Appellant appeal contending that the forum below failed to appreciate the fact that the life assured failed to disclose her marital status of widowhood in the
proposal as also the evidence brought on record in proper perspective and came to an erroneous conclusion of allowing the complaint. Hence, prayed to allow the appeal and set aside the orders impugned.
The point that arises for consideration is whether the impugned
8) or order as passed by the District Forum suffers from any error interfered irregularity or whether it is liable to be set aside, modified or with, in any manner? To what relief?
9) Having heard the submissions of the learned counsel appearing for
the material record, we have no
both sides and carefully perusing on
hesitation in observing that the repudiation as made by the insurance severe condemnation for the fact company is obnoxious and warrants that having issued the policy and when the event occurred, repudiating a claim of a nominee on the ground that has been taken for repudiation is reprehensible.
10) The facts in brief are that Mudu Bhadramma has taken the insurance policy on 31.12.2007 for a sum assured of Rs. 1,00,000/- for a period of 20 years agreeing to pay the annual premium at Rs.5,854/ which itself comes to Rs.1,17,018/-. As against the premia to be collected, the policy was issued only for Rs.1,00,000/-. The last date for payment of the premia was 28.12.2026. The date of birth of the life assured was 01.07.1962 which makes her age as in 2001 to be 39 years. In the policy bond and proposal, she said that her husband name is Shevula Naik and that he is an agriculturist earning Rs.40,000/- per annum.
403.01.2012 leaving behind her son
11) The said Bhadramma died on When the claim was made, Shevula Naik as the nominee of the policy.
the 12.03.2013 has repudiated the insurance company vide Ex.A2 dated at the time claim on the ground that the deceased life assured was widow of taking the policy and had she mentioned the correct marital status in the proposal, the insurance company would not have issued the policy and that the life assured has suppressed the material fact and obtained the policy.
12) As already stated, repudiation of a claim on the ground that incorrect disclosure of information about the marital status of a person in any way affects the insurability of the life assured. May be the factor Such as suppressing the existing ailment, the income, the number of policies or other factors can be a factor which weighs with the insurance company to accept or to reject a proposal for issuing an insurance policy but certainly the fact that either the person is a widow or widower or married or unmarried will in any way affect the insurability of any life assured.
13) Be that as it may, the learned counsel appearing for the insurance company vehemently argued that the said Shevula Naik died on 03.04.2001. When such a stand is taken, it is for the insurance company to establish by cogent and convincing evidence that the said Shevula Naik who was the husband of the life assured died on 03.04.2001. Reliance is placed upon Ex.B3 which is said to be an extract of Births and Deaths Register maintained by the Gram Panchayat. We have carefully perused Ex.B3 and the relevant entry is at serial number 11/1. At the outset, it can be said that giving a serial number as 11/1 itself is improper and the number should run in chronological manner as has been the case with several other entries. The fact that it is given a sub-number 11/1 smacks off as interpolation and manipulation with the entries in the revenue records. Furthermore, the record show that one Mudu Shevula Naik, son of Uma Naik, aged 70 years, died on 03.04.2001 leaving behind one son by name M.Bhoja Rao. None of the details mentioned in Ex.B3 tallies with that of the husband of the life assured. Merely because the surname is same, it cannot be inferred that the person referred to in Ex.B3 is the husband of the life assured. Cogent evidence is required if they want to contend that the nusband of the deceased life assured pre-deceased her nearly Six years prior to her death. It is als0 noticed that as per Ex.B3, the deceased Mudu Shevula Naik was 70 years of age at the time of his death in 2001.
This also creates any amount of doubt for holding that the Shevula Naik referred to in Ex.B3 is the husband of the deceased life assured for the reason that there is almost double the age in between the deceased lile assured and the person who is said to have died on 03.04.2001.
When Shevula Naik mentioned in Ex.B3 died on 03.04.2001 was
14) aged 70 years, the deceased life assured whose date of birth is 1962 should have been of the age of 39 years when her husband Shevula Naik died as per Ex.B3. This also creates any amount of doubt as to whether the person named in Ex.B3 is the same person to whom the deceased life assured was married. Except for this evidence, nothing is produced by the insurance company to show that the deceased life assured had the policy was suppressed the fact that she is a widow on the date when taken even though her husband died nearly six years prior to submitting the proposal.
The learned counsel appearing for the Appellant insurance
15) Court reported in Civil company relies upon the decision of the Supreme AppealNo.3397/2020 (arising out of SLP (C) No. 10652 of 2020) in the matter of Branch Manager, Bajaj Allianz Life Insurance Company Ltd., and others versus Dalbir Kaur, decided on 09.10.2020 which lays down the undisputed legal proposition insofar as the matters of the contract of insurance are concerned. In the said Judgment, the Supreme Court has observed in paragraphs-11 and 12 as follows:
"11. Recently, this Court in Reliance Life Insurance Co., Ltd., vs. Rekhaben Nareshbhai Rathod (5 (2019) 6 SCC 175), has set aside the judgment of the NCDRC, whereby the NCDRC had held that the failure of the insured to disclose a previous insurance policy as required under the policy proposal form would not influence the decision of a prudent insurer to issue the policy in question and therefore the insurer was disentitled from repudiating its liability...
12. The decision of this Court in Sulbha Prakash Motegaonkar vs Life insurance Corporation of mdia, which has been relied upon by the NCDRC, is clearly distinguishable. In that case, the assured suffered a myocardial infarction and succumbed to it. The claim was repudiated by the insurance company on the ground tnat here was a suppression of a pre-existing humbar spondylitis. It was in this background that this Court held that the alleged concealment was of such a nature that would not disentitle the deceased from getting his life insured. In other words, the pre-existing ailment was clearly unrelated to the cause of death. This Court had also observed in its decision that the ailment concealed by the deceased was not life-threatening a disease. This decision must, therefore, be distinguished from thefactual position as it has emerged before this Court."
16) There are catena of authorities on the subject which clearly lay down that an insurance company can repudiate the claim on the grounds of suppression of material facts such as existing ailment, having been admitted in hospital prior to the proposal but not stating the same, misstating the age, wrongly giving the income, or suppressing the fact that he/ she has more policies than the one which is proposed to be taken. No authority has been brought to our notice which says that an insurance company can repudiate the claim only on the ground that the life assured has suppressed the fact as to whether she is a widow or a married woman on the date when the proposal is submitted. That apart, Section-45 of the Insurance Act clearly puts an embargo on the insurance company to raise such a contention more than four years after the policy was issued. In the instant case, when the policy commenced on 31.12.2007, the life assured died on 03.01.2012. After four years, such a ground cannot be taken for repudiating the claim.
17) Upon careful perusal of the above material available on record, absolutely, we have no hesitation in holding that the repudiation as made by the insurance company is wholly unjustified, unfounded and is intended to subject the nominee of the deceased life assured to untold harassment and victimisation which is not expected from a State owned life insurance corporation.
118) As a matter of fact, it is a fit case where huge compensation shoula be awarded in favour of the Respondent/ Complainant for the said acts o the insurance company but we refrain ourselves from doing so for the Simple reason that the Respondent/Complainant has not come in any appeal and therefore we could not award anything other than that has been granted by the District Forum.
19) In view of the foregoing discussion, the appeal fails and the same is dismissed. The costs of the present appeal are quantified at Rs.25,000/- which should be paid by the Appellants/Opposite parties to the Respondent/Complainant in addition to the costs imposed by the District Forum below.