Supreme Court - Daily Orders
Mahendra Todi vs Birla Sunlife Insurance Company Ltd on 11 December, 2021
Bench: Dinesh Maheshwari, Vikram Nath
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IN THE SUPREME COURT OF INDIA
CIVIL APPELLATE JURISDICTION
CIVIL APPEAL NO.7638 of 2021
(Arising out of SLP(Civil) No. 25287 of 2018)
MAHENDRA TODI …APPELLANT(S)
VERSUS
BIRLA SUNLIFE INSURANCE COMPANY LTD. …RESPONDENT(S)
O R D E R
Leave granted.
This appeal takes exception to the judgment and order dated 26.10.2017 in Revision Petition No. 546 of 2017, whereby the National Consumer Disputes Redressal Commission, New Delhi (‘the National Commission’) has disapproved the orders passed by the District Consumer Disputes Redressal Forum, Sikar (‘the District Forum’) and the State Consumer Disputes Redressal Commission Rajasthan, Jaipur (‘the State Commission’) in relation to the insurance claim of the appellant on the death of his father. While rejecting the complaint case filed by the appellant, the National Commission has, however, directed the respondent insurance company to refund the premium amount of Rs. 45,000/- together with interest @9% p.a. Signature Not Verified Digitally signed by A short conspectus of relevant facts leading to the Indu Marwah Date: 2021.12.17 18:25:04 IST Reason: present appeal is that the appellant filed the complaint case leading to this appeal essentially with submissions 2 that his late father had taken an insurance policy of Rs. 10,00,000/- after completing all the requisite formalities. The appellant submitted that his father made payment of an amount of Rs. 90,000/- through cheque dated 05.04.2012; and the respondent insurance company issued policy No. 005515236 covering the event of untimely death. The appellant further submitted that he made an insurance claim under the said policy when his father met with his untimely death on 25.04.2012 due to a vehicular accident but, the respondent company failed to honour the claim.
The reasons for rejection of insurance claim made by the appellant were stated by the respondent insurance company in its letter dated 25.03.2013 in the following words:-
“This is with reference to your concern registered with us for the Birla Sun Life Insurance Plan Policy No. 005515236. We wish to inform you that we had received the Application No. A46115297 for Policy Number 005515236, however the same rejected by the underwriting in the initial stage due to medical reasons and the initial premium of Rs.45,000/- was processed through cheque number 482353 and the same was dispatched to your registered address on April 25, 2012; but the same was received undelivered to Head Office….” The District Forum, in its order dated 14.09.2016, accepted the claim of the appellant while rejecting the submissions of the insurance company that the policy was rejected by underwriters for medical reasons and the premium amount was returned; and held that when the policy was issued after completion of all the formalities and the 3 cheque towards amount of premium was encashed, rejection of policy on medical reasons was not proper in law. The District Forum noticed that in the proposal form, the insurance amount was Rs. 4,10,175/- and hence, allowed this amount to the appellant together with interest @9% p.a. from the date of submission of complaint, in case payment was not made within one month from the date of the order.
The complainant was further awarded general damages and expenses to the tune of Rs. 10,000/-.
Being aggrieved by the order so passed by the District Forum, the respondent insurance company approached the State Commission in appeal. The State Commission, by its order dated 08.11.2016, dismissed the appeal and endorsed the decision of the District Forum while observing, inter alia, as under: -
“The appellant has mainly stated that on 25-04-2012 the premium of complainant was returned which was delivered to him. But before Commission letter dated 23-05-2013 was submitted in which it is stated that the cheque which was returned on 25-04-2012, was not delivered to complainant and was returned in Head Office. In this manner the appellant has wrongly stated the fact before District Forum and on this basis the appeal deserves to be dismissed. Beside this no letter of returning the cheque dated 25-04-2012 was submitted before the lower District Forum nor before this Commission.
On the contrary the complainant has clearly stated that he has submitted proposal form and was issued with Policy No. 005515236. On behalf of appellant copy of policy was also not sent to complainant, which in itself is in defective service. In this way the lower District Forum has passed the order after evaluating the facts which did not require any interference and appeal is not maintainable hence the same is 4 dismissed.” While challenging the orders aforesaid, the respondent insurance company approached the National Commission by way of Revision Petition No. 546 of 2017. The National Commission, by its impugned order dated 26.10.2017, allowed the revision petition and rejected the complaint of the appellant but directed the insurance company to refund the premium amount of Rs. 45,000/- received from the deceased father of the appellant. The National Commission accepted the case of the respondent insurance company that the insurance cover had not commenced without acceptance of the application. The National Commission took note of Clause (5) of the receipt that was issued to the deceased at the time of receiving the cheque of Rs. 45,000/- and observed as under:-
“3. …The learned counsel for the petitioner company has drawn my attention to clause 5 of the receipt which was issued to the deceased at the time cheque of Rs.45,000/- was received from him. The aforesaid condition reads as under:
"For application under consideration, the insurance cover shall commence after the said application form for insurance has been examined and accepted by BSLI this shall be communicated separately to you. The prevailing NAV as on date of acceptance/commencement of risk will be applicable."
It would thus be seen that the insurance cover could not have commenced, without the application form having been accepted by the petitioner company and the said acceptance having been communicated to him. There is absolutely no evidence of the proposal 5 submitted by the deceased having been accepted at any point of time. Therefore, the insurance cover never commenced in this case. That precisely seems to be the reason why no policy document was ever issued by the petitioner to the complainant. Since the life of the deceased was never covered by the petitioner company, there could be no question of the petitioner paying the amount of Rs.10 lakh which would have been payable in the event of the proposal being accepted. The impugned orders, therefore, cannot be sustained and are hereby set aside. The complaint is consequently dismissed. The petitioner, however, is directed to refund the premium amount of Rs.45,000/- received from the deceased along with interest on that amount @ 9% p.a. from the date on which the cheque was enchased till the date on which the aforesaid amount along with interest is paid. The revision petition stands disposed of accordingly.” Seeking to challenge the order aforesaid, it has been argued on behalf of the appellant that the National Commission has erred in setting aside the well-reasoned and considered orders passed by the District Forum and the State Commission without any reason and justification and without appreciating that, in fact, an amount of Rs. 90,000/- was paid to the respondent insurance company. It is contended that in view of such payment, the policy had come into effect and the insurance company could not have resiled from the same. Per contra, learned counsel for the respondent has duly supported the order passed by the National Commission with the submission that the proposal having not been accepted, the policy had never come into effect.
We have noticed a few factual aspects, which have 6 otherwise not gone into consideration in any of the orders passed in this matter, whether by the National Commission or by the subordinate fora, that in fact, there had been two payments, of Rs. 45,000/- each, by the late father of the appellant on the same date, i.e., 29.03.2012, purportedly towards two different proposals/applications. The relevant averments in this regard, as stated in the counter affidavit filed in this Court by the insurance company, could be usefully extracted as under:-
“5. …I say that Late Shri Sanwer Mal Todi being the Proposer had vide Proposal Forms dated 29.03.2012 bearing No. A46115297 and A46165361 applied to the Respondent Insurance Company for issuance of life insurance policies being 'BSLI Vision Plan' in his favour. In pursuance thereto, the deceased Proposer had deposited an amount of Rs. 45,000/- vide cheque No. 241039 dated 29.03.2012 along with the proposal form against Application bearing No. A46115297. Further, the Proposer had also deposited an amount of Rs. 45,000/- vide cheque No. 241040 dated 29.03.2012 alongwith the proposal form against Application bearing No. A46165361. In this respect, I state that the allegation raised by the Petitioner by way of the Special Leave Petition qua payment of premium twice to the tune of Rs. 90,000/- is grossly misconceived and misconstrued in as much the aforesaid amount of Rs. 90,000/ comprised of two different payments made by the Petitioner vide cheque Nos. 241039 and 241040 dated 29.03.2012 against two different Applications bearing Nos. A46115297 and A46165361 respectively, and therefore, could not by any stretch of imagination construe as payment of two premiums qua the same policy. Further, before the Hon'ble National Commission, only Application bearing No. A46115297 was subject matter of adjudication, and therefore, cheque amount of only Rs. 45,000/- deposited vide cheque no. 241039 was dealt with. The aforesaid position is also clearly evidenced from the Application bearing no. A46115297 contained at Page 15 and the 7 premium amount of Rs. 45,000/- contained at Page 31, filed by the Petitioner himself before this Hon'ble Court, along with the present Special Leave Petition. The Petitioner, for the first time before this Hon'ble Court, stated that the Petitioner deposited second installment of Rs. 45,000/-, whereas the correct position is that the said was not a second installment and instead cheque qua another Application bearing No. A4616361….” The facts as aforesaid have not been controverted and in fact, all the relevant factual aspects were not specified by the complainant in his complaint. It is noticed that in the complaint filed before the District Forum, the appellant made a cursory submission about payment of Rs. 90,000/- towards policy and gave out policy No. 005515236 but did not specify that it had been a matter of two different payments, of Rs. 45,000/- each, on two different applications bearing Nos. A46115297 and A46165361. In any case, the proposals having not been accepted, the claim of the appellant could not have been countenanced. To this extent, the order passed by the National Commission calls for no interference.
However, so far the proposition for refund is concerned, the respondent insurance company itself has not denied its liability to make such a refund when the proposal for insurance was not accepted by it. In this regard, it appears that the appellant having made reference to one policy in the complaint case, all the submissions of the respondent also remained confined to one policy; and hence, it was stated in the reply that the premium amount 8 of Rs. 45,000/- was returned by cheque No. 482353 dated 25.04.2012. Though there had been want of specifications on the part of the appellant but, in view of the admitted position emerging from the counter affidavit filed before us, we are clearly of the view that the respondent insurance company ought to refund the entire amount of Rs.
90,000/- (as received under two cheques of Rs. 45,000/- each from the late father of the appellant). Indisputedly, the insurance company has received the said amount of Rs. 90,000/-(Rupees Ninety Thousand Only) and, as per its own case, no policy came into effect against the amount so received. In this view of the matter, the said amount of Rs.90,000/-(Rupees Ninety Thousand Only) had not been the property of the respondent insurance company. Hence, and for giving quietus to the present litigation, we deem it appropriate to direct, in modification of order passed by the National Commission, that the respondent company shall make payment of the remaining amount of Rs. 45,000/- to the appellant together with interest @9% p.a. from the date of order passed by the National Commission.
Accordingly, this appeal is partly allowed to the extent and in the manner that apart from the amount of Rs.45,000/- and interest thereupon, as allowed by the National Commission, the respondent insurance company shall pay further an amount of Rs.45,000/- to the appellant together with interest @ 9% p.a. from the date of the order of National Commission i.e., 26.10.2017. 9 All pending applications also stand disposed of.
…………………………………………..J (DINESH MAHESHWARI) ………………………………………..J (VIKRAM NATH) New Delhi December 11, 2021.
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ITEM NO.17 Court 15(Video Conferencing) SECTION XVII-A
S U P R E M E C O U R T O F I N D I A
RECORD OF PROCEEDINGS
Civil Appeal No.7638/2021 Arising out of SPECIAL LEAVE PETITION © NO. 25287/2018 MAHENDRA TODI Appellant VERSUS BIRLA SUNLIFE INSURANCE COMPANY LTD Respondent (IA No. 107421/2018 -FOR EXEMPTION FROM FILING O.T. IA No. 95951/2019 - FOR PERMISSION TO FILE ADDITIONAL DOCUMENTS/FACTS/ANNEXURES) Date : 11-12-2021 These matters were called on for hearing today. CORAM :
HON'BLE MR. JUSTICE DINESH MAHESHWARI HON'BLE MR. JUSTICE VIKRAM NATH For Appellant(s) Mr. Rishi Matoliya, AOR Mr. H D Thanvi, Adv.
Ms. Sumati Sharma, Adv.
Ms. Iti Jain, Adv.
Mr. Rajneesh Sharma, Adv.
For Respondent(s) Ms. Meenakshi Midha, Adv.
Mr. Chander Shekhar Ashri, AOR UPON hearing the counsel the Court made the following O R D E R The appeal is partly allowed in terms of the Signed Order.
All pending applications also stand disposed of.
(SHRADDHA MISHRA) (RAM SUBHAG SINGH) SENIOR PERSONAL ASSISTANT BRANCH OFFICER