National Consumer Disputes Redressal
Pnb Metlife India Insurance Company ... vs Harban Kaur on 24 October, 2025
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION
NEW DELHI
REVISION PETITION NO. NC/RP/1257/2024
(Against the Order dated 9th February 2024 in Appeal A/1131/2022 of the State Consumer
Disputes Redressal Commission Punjab)
WITH
NC/IA/6881/2024 (EXCEMPTION OF FILE TYPED COPIES OF DOCUMENTS)
NC/IA/6882/2024 (SUMMON IN THE RECORD)
NC/IA/6880/2024 (STAY)
PNB METLIFE INDIA INSURANCE COMPANY LIMITED
PRESENT ADDRESS - R/O 4TH FLOOR KUNAL TOWER NO 88 THE MALL ROAD LUDHIANA
PINCODE , LUDHIANA , PUNJAB , LUDHIANA,PUNJAB.
PNB MET LIFE INDIA INSURANCE COMPANY LIMITED LTD
PRESENT ADDRESS - R/0 NO 25 1ST FLOOR THUNGA COMPLEX 32ND A CROSS ROAD
JAYANAGAR 7TH BLOCK OPP BANGALORE INTERNATIONAL ACADEMY BESIDE CITY
COLLEGE BENGALURE KARNATAKA , BENGALURU URBAN , KARNATAKA , BENGALURU
URBAN,KARNATAKA.
.......Petitioner(s)
Versus
HARBAN KAUR
PRESENT ADDRESS - R/O JAMA RAKHAI HITHAR MAMDOT DISTRICT FEROZEPUR
PUNJAB , FIROZEPUR , PUNJAB , FEROZEPUR,PUNJAB.
.......Respondent(s)
REVISION PETITION NO. NC/RP/1258/2024
(Against the Order dated 9th February 2024 in Appeal A/123/2023 of the State Consumer
Disputes Redressal Commission Punjab)
WITH
NC/IA/6885/2024 (SUMMON IN THE RECORD)
NC/IA/6883/2024 (STAY)
NC/IA/6884/2024 (EXCEMPTION OF FILE TYPED COPIES OF DOCUMENTS)
PNB METLIFE INDIA INSURANCE COMPANY LIMITED
PRESENT ADDRESS - BRANCH OFFICE AT 4TH FLOOR KUNAL TOWER NO 88 THE MALL
ROAD LUDHIANA PUNJAB , LUDHIANA , PUNJAB , LUDHIANA,PUNJAB.
PNB MET LIFE INDIA INSURANCE COMPANY LIMITED
PRESENT ADDRESS - NO 25 1ST FLOOR THUNGA COMPLEX 32ND A CROSS ROAD
OPPOSITE BANGALORE INTERNATIONAL ACADEMY 7TH BLOCK JAYANAGAR
BENGALURU KARNATAKA 560082 , BENGALURU URBAN , KARNATAKA ,
.......Petitioner(s)
Versus
HARBAN KAUR
PRESENT ADDRESS - R/O JAMA RAKHAI HITHAR MAMDOT DISTRICT FEROZEPUR
PUNJAB , FIROZEPUR , PUNJAB , FEROZEPUR,PUNJAB.
.......Respondent(s)
BEFORE:
HON'BLE MR. JUSTICE A. P. SAHI , PRESIDENT
HON'BLE MR. BHARATKUMAR PANDYA , MEMBER
FOR THE PETITIONER:
MS SHWETA SINGH PARIHAR, ADV
FOR THE RESPONDENT:
MR RANVIK MEHTA, ADV
DATED: 24/10/2025
ORDER
1. Late Fuman Singh had purchased a life insurance policy for an assured sum of Rs.11,40,000/- and had paid the first instalment of Rs.40,000/- as well. The risk under the policy commenced from 10.02.2015. The proposal form had been signed on 09.02.2015 and the policy had been issued on 10.02.2015. Unfortunately, Fuman Singh died on 28.02.2015. It is this date of death which is the bone of contention between the parties.
2. On the death of the insured, the claim was filed by the Complainant and the Insurance Company instituted an investigation as the death had taken place within a short span of 18 days from the date of the issuance of the policy.
3. The investigator, who tendered the report, doubted the correctness of the date of death mentioned in the death certificate that was produced by the Complainant and came up with an information on the basis of his own efforts that the insured had died long back and according to the investigator, the date of death of the insured was 04.06.2014. The reflection was as if the insurance policy was obtained manipulatively in the name of a dead person.
4. The Insurance Company however, further went on to collect information and then, on the basis of a corrected death certificate, repudiated the claim on 04.08.2015 on the ground that the correct date of death was 28.01.2015. It was therefore, concluded by the Insurance Company that since the insured had died before the issuance of the policy itself, the claim was fraudulent as it was in respect of a policy obtained for a dead person. The reliance of the Insurance Company therefore, was on a correction carried out by hand in the same death certificate allegedly by somebody from the Panchayat level.
5. The District Commission, proceeded on the strength of the aforesaid contention of the Insurance Company and came to the conclusion that the repudiation by the OP of a genuine claim, appears to have been made without application of mind. It also went on to hold that on the quantum part, the claim deserves to be allowed on a non-standard basis and accordingly 70% of the claimed amount was awarded after deducting the refund of the premium that had been made by the Insurance Company. Paragraphs 9 to 11 of the order of the District Commission are extracted herein under:
"9. In such a situation the repudiation made by Opposite Party regarding genuine claim of the complainant appears to have been made without application of mind. It is usual with the insurance company to show all types of green pesters to the customer at the time of selling insurance policies, and when it comes to payment of the insurance claim, they invent all sort of excuses to deny the claim. In the facts of this case, ratio of the decision of Hon'ble Apex Court in case of Dharmendra Goel Vs. Oriental Insurance Co. Ltd., III (2008) CPJ 63 (SC) is fully attracted, wherein it was held that, Insurance Company being in a dominant position, often acts in an unreasonable manner and after having accepted the value of a particular insured goods, disowns that very figure on one pretext or the other, when they are called upon to pay compensation. This 'take it or leave it', attitude is clearly unwarranted not only as being bad in law, but ethically indefensible. It is generally seen that the insurance companies are only interested in earning the premiums and find ways and means to decline claims. In similar set of facts the Hon'ble Punjab & Haryana High Court in case titled as New India Assurance Company Limited Vs. Smt. Usha Yadav & Others 2008(3) RCR (Civil) Page 111 went on to hold as under:-
"It seems that the insurance companies are only interested in earning the premiums and find ways and means to decline claims. All conditions which generally are hidden, need to be simplified so that these are easily understood by a person at the time of buying any policy. The Insurance Companies in such cases rely upon clauses of the agreement, which a person is generally made to sign on dotted lines at the time of obtaining policy. Insurance Company also directed to pay costs of Rs.5000/- for luxury litigation, being rich."
10. Now come to the quantum of compensation. The complainant has claimed the insurance amount as per the policy amounting to Rs.11,40,000/- on the death of Phuman Singh, DLI. Hence, having regard to the position of the law, as has been laid down, by the Hon'ble Apex Court in the various decisions referred to here-in-above and also the view expressed by the Hon'ble National Commission, we are of the considered view that in the present case the complainant, if not entitled for the entire amount of insurance, the Insurance Company definitely ought to have settled the complainant's claim on 'non- standard basis" which in the facts and circumstances taking the assistance of the view expressed by the Hon'ble Apex Court and also by the Hon'ble National Commission, we allow 70% of the assessed amount on 'non-standard' "basis of the insured amount.
11. In view of the aforesaid facts and circumstances of the case, we partly allow the complaint of the Complainant and direct the Opposite Party-Insurance Company to make the payment of Rs.7,98,000/-(Rupees seven lakh ninety eight thousands only) i.e. 70% of the insured amount of Rs.11,40,000/- to the Complainant within 60 days from the date of receipt of copy of this order failing which the complainant shall be at liberty to get the order enforced through the Indulgence of District Consumer, Disputes Redressal Commission, Ludhiana. However, the Opposite Parties- Insurance Company shall be at liberty to deduct the amount of Rs.37,568.32 paisa, if any, already refunded to the complainant (as mentioned above) out of the awarded amount. All pending applications are disposed off accordingly. Copies of the order be furnished to the parties free of cost by District Consumer Disputes Redressal Commission, Ludhiana and thereafter, the file be consigned to record room after compliance."
6. Two Appeals were filed, FA/1131/2022 by the Complainant contending that the District Commission had erroneously allowed the claim for only 70% of the amount without interest and FA/123/2023 by the Insurance Company challenging the entire order on the ground that the District Commission had failed to appreciate the facts on record and the same suffered from perversity. The claim could not have been allowed in the circumstances of the case without even discussing the evidence on record and consequently, the order of the District Commission dated 27.09.2022 was unsustainable and liable to be set aside.
7. The two Appeals before the SCDRC, Punjab have been decided by the impugned decision dated 09.02.2024 whereby the Appeal filed by the Complainant has been allowed extending the benefit of the full sum assured and simultaneously, the Appeal filed by the Insurance Company was dismissed.
8. The Insurance Company has come up assailing the impugned order dated 09.02.2024 on the ground that the corrected death certificate indicates the correct date of death which was 28.01.2015 and that the policy that was issued on 10.02.2015 had been obtained by manipulating the date of death and then getting the benefits under the policy.
9. We have considered the submissions and the case has interestingly raised issues relating to the existence of evidence with regard to the date of death of the insured. What we find is that the investigator opined that the date of death of the life insured was 04.06.2014. This aspect has been considered in detail in paragraphs-18 & 19 of the impugned appellate order that are extracted herein under:
"18. The stand of the OPs is that an investigation was conducted by Probelndia, who had submitted the Investigation Report dated 20.04.2015 (Ex.OP-3) in the Investigation Report is mentioned that the DLA had expired on 04.06.2014 as per Register of Asha Worker, whereas in the written version, the OPs have mentioned that the DLA had died on 10.01.2015 Meaning thereby the stand of the OPs in their written version and the investigator Report is contradictory as two different dates of death of the DLA were mentioned therein.
19. The Investigator had recorded the date of death of the DLA as 04.06.2014 on the basis of the Register of Asha Worker but the copy of the original Register of Asha Worker's Register was not produced on record. Only the typed version was reproduced in the report without any signature and stamp, which cannot be relied upon. The Investigator had also recorded the statements of Panch namely Mukhtiar Singh, neighbour Mahinder Singh, Anganwari Worker Manjit Kaur and ANM Amarjit Kaur. The copies of their statements were duly signed/thumb marked, which were produced on record of the District Commission. All of them had confirmed that the DLA had expired on 28.02.2015. Further, as per the Attending Physician Statement Form-B issued by Dr. Lakshaman Singh at Page-121 of the District Commission's record, the DLA had expired on 28.02.2015 due to heart attack."
10. We have given our thoughtful consideration to the same and we find that the State Commission has correctly arrived at the conclusion that the exercise undertaken by the investigator remained unsupported by any cogent evidence regarding the date of death of the insured as reflected in the register of Asha worker where it was mentioned as 04.06.2014. The State Commission arrived at this conclusion after recording that the original register was not produced and a typed version without any signature and stamp, had been tendered. We are of the considered opinion that such an evidence was rightly disbelieved by the State Commission. As the date of death mentioned by the investigator as 04.06.2014 remained uncorroborated, therefore was based on surmises and conjectures that deserved rejection.
11. Coming to the second interesting part of the corrected death certificate produced by the Insurance Company, it may be pointed out that the original death certificate produced by the Complainant mentions the date of death as 28.02.2015. This fact has been noticed in para-17 of the impugned order by the State Commission which is extracted herein under:
"17. In order to prove her version, the Complainant had produced on record the Death Certificate (Ex.C-3), wherein the date of death of the DLA was mentioned on 28.02.2015. Said Death Certificate was issued by the competent authority i.e. Local Registrar, Birth and Death, Hazara Singh Wala under his seal/stamp and signatures."
12. Curiously enough, the investigator had allegedly recorded the submissions of the Panch namely Mr. Mukhtiar Singh, the neighbour of the insured Mr. Mahinder Singh and a couple of Anganwari workers namely Ms. Manjeet Kaur and Ms. Amarjeet Kaur. All of them had confirmed that the insured had expired on 28.02.2015.
13. The State Commission further noted the fact that the attending Physician on the insured had issued a statement in Form-B that was also filed before the District Commission confirming that the insured expired on 28.02.2015 due to a heart attack. These facts have been noticed in paragraph-19 of the impugned order which has already been extracted hereinabove.
14. However, the investigator further went on to observe that the death certificate relied on by the Complainant had been prepared allegedly in connivance with the ANM worker Amarjeet Kaur who was bribed with Rs.20,000/-. This contention has been disbelieved by the State Commission after discussing the entire facts in paragraph-20 of the impugned order which is extracted herein under:
"20. It has also been mentioned in the Investigation Report that the Death Certificate was prepared in connivance with ANM Amarjeet Kaur, who was given 20,000/- for re-issuance of the Death Certificate. However, no documentary evidence was produced to prove this fact. The Investigator could have approached the office of the Registrar. Deaths and Births to ascertain this fact and some evidence could have been collected from said office, to ascertain the manipulation, if any, in the record of the Death Certificate but no such evidence was produced on record. Simply by mentioning in the Investigation Report that the Death Certificate was prepared in connivance with ANM Amarjeet Kaur is not sufficient. Rather, said version of the Investigator is contrary to the statement of Amarjeet Kaur, ANM at Page-109 of the record of the District Commission as well as the statements of the other persons as mentioned above. It was also mentioned in the Investigation Report that the PNB Agent and the previous Investigator had taken 30,000/- to settle the claim and the Investigator namely Rajneesh Kumar had also taken camera recording of writing the date of death of the DLA as 28.01.2015 by ANM Amarjeet Kaur. However, no documentary evidence was produced to prove the said fact. Two photographs have been produced at Pages-133 & 134 but it is not visible as to what had been written on the paper. Even the face and identity of the person shown in the photographs has not been shown/proved/ascertained."
15. We find no error in the said findings and the learned counsel for the Insurance Company has been unable to point out any evidence apart from that discussed by the State Commission to corroborate the happening of the death of the insured on 28.01.2015. While recording its findings, the State Commission has therefore, disbelieved the corrected date of death as relied on by the Insurance Company as recorded in paragraph-21 which is extracted herein under:
"21. The Complainant has produced the copy of the Death Certificate at Page-22 of the District Commission's record, wherein the date of death had been mentioned as 28.02.2015. Same Death Certificate was produced by the OPs at Page-137, wherein date '28.01.2015' was mentioned by hand alongside the original date of death i.e. '28.02.2015' and a circle has been put on both the dates Signatures of Amarjeet Kaur (ANM) were appended in Punjabi language but no counter signatures of the competent authority are there Further, on the statement of Amarjeet Kaur at Page-109 of District Commission's record as well as at the bottom of the Death Certificate, she had signed in English language. The Death Certificate was issued by the Registrar, Births and Deaths. Any correction in the Death Certificate could be made only by the said competent authority and that too on the basis of some cogent and convincing documentary proof. In case some correction was made in the Death Certificate, the OPs could have produced the relevant record of the office of Registrar, Births and Deaths but no such evidence was produced before the District Commission as well as before this Commission. Meaning thereby the OPs had tried to forge and fabricate the date of death by making undue addition by hand on the Death Certificate without any supporting evidence."
16. The investigation report was also examined by the State Commission and was rejected by the findings recorded in paragraph-22 which is extracted herein under:
"22. It is also relevant to mention Investigation Report, only the name of the authorized person hard been mentioned as Sanjay K. Sharma (Director) but it was not signed and stamped/sealed by the Investigator. Meaning thereby, except the statements of the aforesaid persons the other version as mentioned in the investigation Report is based on conjectures and surmises and no cogent and convincing documentary evidence had been produced in support of the same. Even no past history of any ailment of the DLA had been produced by the Investigator. Rather, as per the statement of aforesaid persons, the DLA had died a natural death due to sudden heart attack."
17. It is after assessing this entire evidence that the State Commission categorically recorded that the Insurance Company cannot probate and reprobate and there was no corroborative evidence to demonstrate the date of death as 28.01.2015.
18. Apart from this, what we find is that the State Commission justifiably accepted the issuance of a policy genuinely, the proposal form whereof was filled up on 09.02.2015 and the policy was issued on 10.02.2015. In the given circumstances, it is evident that the proposal form had been filled up by the agent namely one Komal and the policy had been duly counter-signed and verified by the concerned official Mr. Mohit Malik who has endorsed his signatures on the said policy. Thus, the State Commission was fully justified in concluding that the policy had been genuinely issued.
19. The District Commission even though had not discussed the entire evidence, but the impugned order of the State Commission has thrashed out of the evidence and after sifting them, appropriately has recorded the correct conclusions. The District Commission, even though concluded that the claim was genuine, yet for no valid reason, applied non- standard basis for which we also do not find any justification.
20. Learned counsel for the Petitioner has been unable to convince us on any ground so as to warrant interference in the well written and almost perfect order passed by the State Commission. The Revision Petition lacks merit and is accordingly, dismissed and the order of the State Commission dated 09.02.2024 is hereby confirmed.
..................J A. P. SAHI PRESIDENT ..................
BHARATKUMAR PANDYA MEMBER