National Consumer Disputes Redressal
Meena Sanjay Bare vs Sbi Life Insurance Co. Ltd. on 15 January, 2016
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION NEW DELHI CONSUMER CASE NO. 118 OF 2011 1. MEENA SANJAY BARE 3/41, Abhinandan Row House, Kishore Suryawanshi Marg Borgad Colony,
Borgad, Nasik - 422 004. Maharashtra ...........Complainant(s) Versus 1. SBI LIFE INSURANCE CO. LTD. Central Processing Centre, 8th Floor, Godrej Coliseum, Behind Everard Nagar, Sion, Trombay Road, Sion (E), Mumbai - 400 022. Maharashtra. ...........Opp.Party(s)
BEFORE: HON'BLE MR. JUSTICE J.M. MALIK, PRESIDING MEMBER HON'BLE DR. S.M. KANTIKAR, MEMBER
For the Complainant : Mr. Sukumar Pattjoshi, Sr. Advocate with
Mr. Vikas Nautiyal, Advocate For the Opp.Party : Mr. D. Vardarajan, Advocate
Dated : 15 Jan 2016 ORDER
PER JUSTICE J.M. MALIK, PRESIDING MEMBER
The complainant through Sanjay Shinde and wife of insured Mrs. Meena Sanjay Bare have filed four complaints in respect of four policies against different insurance companies. Therefore, we will decide this case separately.
2. Mr. Sanjay Sawaliram Bare the insured since deceased paid a huge annual premium of Rs.80,730/- in favour of SBI Life Insurance Co. Ltd., the OP in this case and obtained the SBI Life - Shield Insurance Policy bearing No.16000407307 for the period 31.3.2005 to 30.3.2030 for the sum assured in the sum of Rs.1 crore. Mr. Sanjay Sawaliram Bare was merely 12th pass and was not well-versed with English language. The opposite party asked him to put his signatures on the proposal form and the needful was done. Mr. Sanjay Sawaliram Bare went on paying the annual premium of Rs.80,730/- to the OP from 4.4.2005 till 2009.
3. Unfortunately, Mr. Sanjay Sawaliram Bare met with an accident and passed away on 2.1.2010. Smt. Meena Sanjay Bare his wife as well as the nominee filled up the claim form. It is submitted that there was no column in the proposal form asking Mr. Sanjay Sawaliram Bare to disclose any property details and the OP did not ask any such information from Sanjay Sawaliram Bare at the time of opting insurance policy. However, the OP repudiated the claim vide its letter dated 10.12.2010. The relevant extract of the repudiation letter runs as follows:-
"Investigation revealed that late Sanjaykumar Sawleran Bare did not own the Assets declared in the financial questionnaire which forms the part of the proposal papers for obtaining insurance."
4. The complainant has challenged the repudiation letter and filed the complaint before this Commission on 3.6.2011 with the following prayers:-
"a. To hold and declare the Opposite Parties to be guilty of deficiency in service and unfair trade practice as per the provisions of the Consumer Protection Act, 1986.
b. To direct the Opposite Party to pay to the complainant the sum of Rs.1,00,00,000/- which is the claim amount as per the policy issued by the opposite party.
c. To direct the Opposite party to pay the interest @ 18% on the sum of Rs.1,00,00,000/- from the date of death i.e. from 02.01.2010 till the date of realization of the same.
d. To direct the Opposite party to pay to the complainant Rs.15,00,000/- (Rupees Fifteen Lakhs only) being the compensation for the mental agony and stress suffered by the Complainant.
e. To direct the Opposite party to pay to the complainant Rs.1,00,000/- ( Rupees One Lakh only) towards the Legal and incidental charges incurred by the Complainant.
f. For such other and further reliefs as the nature and circumstances of the above numbered complaint may deem fit and proper."
5. The OP could not file the written statement within time prescribed by the law. Therefore, its right to file the written statement was forfeited on 22.5.2013. The Hon'ble Supreme Court has upheld the authority of Dr. J.J. Merchant & Ors. Vs. Srinath Chaturvedi-III (2002) CPJ 8 (SC) 8, in the latest authority by the Hon'ble Supreme Court reported in New India Assurance Co. Ltd. Vs. Hilli Multipurpose Cold Storage Pvt. Ltd., Civil Appeal Nos. 10941-10942 of 2013, decided on 04.12.2015. Consequently, the right to file the written statement by the OP, stands forfeited.
6. We have heard learned counsel for the parties.
7. Counsel for the OP has raised few objections. He submitted that all these complaints are similar in nature and cut and paste method has been applied. Counsel for the OP attempted to travel outside the repudiation letter and submitted that the case of the insured is contradictory as some time he submits that he is 12th pass and on the other instances, he submits that he is a Graduate. Again he did not disclose about the remaining three other policies. He contended that the complainant is playing fraud with the law, insurance company and this Commission.
8. All these arguments are lame of strength. The charge of suppression of material facts cannot be attributed on the part of the insured. We have perused the proposal form. There was no column and he did not suppress anything material. We are dealing with four cases which are being decided together. A bare reading of all the four cases clearly go to show that the facts and circumstances of this case do not smack of malafides on the part of the insured. He had immediately furnished all the details which were asked from him from the two other financial institutions. He cannot be held guilty of suppression of truth. The proposal form furnished by the OP does not have this column. The OP complainant could not put the blame on the complainant. On the contrary it rather goes to show the malafide intention on the part of the opposite party. The opposite party should have made this fact clear so that the persons who believe in law are attracted by these insurance policies. The absence of this particular item clearly goes to show that it will go a long way to support the persons dealing with illegal money.
9. The arguments raised by the OP pale into insignificance due to the law laid down by the Apex Court. We are able to locate the authority of the Supreme Court in the case of CEO, Sahara India Life Insurance Company Limited & Anr. Vs. Rayani Ramayanjneyulu, decided by the Apex Court while dismissing the Special Leave to Appeal (Civil) No. No.30740 of 2014, decided on 21.11.2014 upholding the order of this Bench in Revision Petition No.1117 of 2014 decided on 1.8.201. In which, in para No.3, we observed as under:-
"We are of the considered view that these authorities rather go to help the complainant/respondent. The Para 17 of the Apex Court order is crucial and significant. It is difficult to fathom as to why these facts would influence the judgment of a prudent insurer in fixing the premium or determining the cover or whether he would like to take the risk. This appears to be a mistake committed by the agent. Agent is the villain and for his omissions and commissions, the insured or her LRs should not suffer. On the contrary, the repudiation on this ground alone smacks of malafide intention on the part of the OP. By no stretch of imagination it can be held to be a material fact. It rather puts the insured in a solid and impregnable position."
10. Counsel for the complainant also cited authorities reported in M/s Modern Insulators Ltd. Vs. Oriental Insurance Co. Ltd. [I (2000) CPJ 1 (SC) and National Insurance Co. Ltd. Vs. D.P. Jain [III (2007) CPJ 34 (NC) in support of his case.
11. Consequently, we allow the present complaint and direct the opposite party to pay a sum of Rs.1,00,00,000/- minus the amount already paid with interest @ 4% p.a. from the date of filing of this complaint till its realisation. The complainant is also awarded costs of the litigation at Rs.10,000/- which be paid within 90 days from the date of receipt of the copy of the order otherwise, it will carry interest @ 6% p.a. till its realisation.
12. The complaint stands disposed of accordingly.
......................J J.M. MALIK PRESIDING MEMBER ...................... DR. S.M. KANTIKAR MEMBER