National Consumer Disputes Redressal
Hdfc Standard Life Insurance Company ... vs Virpal Nagar on 19 July, 2019
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION NEW DELHI FIRST APPEAL NO. 855 OF 2019 (Against the Order dated 14/03/2019 in Complaint No. 5/2011 of the State Commission Delhi) 1. HDFC STANDARD LIFE INSURANCE COMPANY LIMITED THROUGH ITS AUTHORISED SIGNATORY, SH. ANKUSH SAINI , MANAGER LEGAL , HDFC SL DELHI BIKAJI CAMA PLACE, 131/140, ANSAL CHAMBER-I , BIKAJI CAMA PLACE DLEHI 110066 ...........Appellant(s) Versus 1. VIRPAL NAGAR S/O. LATE RAMPHAL NAGAR R/O. VILLAGE & POST TOGAON FARIDABAD HARYANA ...........Respondent(s)
BEFORE: HON'BLE MRS. JUSTICE DEEPA SHARMA,PRESIDING MEMBER HON'BLE MR. C. VISWANATH,MEMBER
For the Appellant : For the Respondent :
Dated : 19 Jul 2019 ORDER
APPEARED AT THE TIME OF ARGUMENTS
For the Appellant
:
Mr. Jaideep Sethi, Advocate
ORDER
C. VISWANATH
1. The present Appeal is filed by the Appellant under Section 19 of the Consumer Protection Act, 1986 against Order passed by the Delhi State Consumer Disputes Redressal Commission (hereinafter referred to as the "State Commission") in Complaint No. 05/2011 dated 14.03.2019.
2. In the Complaint Case, it was stated that on 05.12.2008, Respondent's/Complainant's late brother Sh. Partap Singh (Insured) had taken a HDFC Term Assurance Policy for Rs.50,00,000/- from the Appellant/Opposite Party by paying a premium of Rs.24,046/-. On receipt of the premium and after getting the Insured medically examined from Apex Diagnostics and Polyclinic and finding him fit, the Appellant issued HDFC Term Assurance Policy bearing No. 12265498 commencing from 05.12.2008 for a term of 20 years. The payment of premium of the policy was fixed on yearly basis. On 23.01.2009, brother of the Respondent died and after his death, the Respondent being the nominee of his late brother, filed a claim with the Appellant under the aforesaid policy. He submitted all necessary and relevant documents as required by the Appellant to process the claim. The Appellant, despite having received the required documents, did not process the claim of the Respondent and delayed the same on one pretext or the other. Vide letter dated 19.04.2010, the Appellant repudiated the claim of the Respondent on the ground of intentional non-disclosure of material fact at the time of issuing the policy. Aggrieved by the repudiation of his claim, Complaint was filed.
3. The Appellant filed Written Statement resisting the Complaint both on technical grounds and on merit. The technical objection was that the Respondent was not a Consumer and hence, not entitled to raise a consumer dispute. On merit, the objection was that there had been concealment of material fact, as the life assured did not specify the ailment he was suffering from and secondly, the life assured did not give details about his occupation. The averment that the life assured was working with Deepak General Store and having an annual income of Rs.2,50,000/- was disputed by the Appellant.
4. The State Commission, vide order dated 14.03.2019, allowed the Complaint and directed the Appellant to allow the claim preferred within a period of two months from the date of receipt of certified copy of the order with simple interest at the rate of 6% from the date the claim was payable on the ground that repudiation done by the Insurance Company on the ground of pre-existing disease or on the ground of non-furnishing of details of the occupation cannot sustain.
5. Aggrieved by the order of the State Commission, the Appellant filed an Appeal before this Commission.
6. Heard the Learned Counsel for the Appellant. He reiterated his contentions as stated above. We have also carefully gone through the evidence placed on record.
7. In this case the claim of the Respondent was repudiated on the ground that he had concealed his prior illness and also gave wrong information about his employment. It is a settled proposition of law that the burden to prove undeclared pre-existing disease is upon the Appellant and they are required to discharge this burden by producing any cogent evidence on record. Learned Counsel for the Appellant has failed to point out any piece of evidence which could prove that the deceased was suffering with any pre-existing disease. The contention of the Appellant is that the deceased was suffering from respiratory disorder and paralysis or multiple scierosis. Our attention is not drawn to any document which could even suggest that the deceased had this existing illness prior to taking the policy. It is also a settled proposition that the pre-existing disease means the disease for which the insured had been hospitalized or undergone operation in near proximity to the Policy. This view has been taken by this Commission in the case of Pradeep Kumar Garg vs National Insurance Company Ltd. [III (2008) CPJ 423]. The State Commission has after discussing the law at length and perusing the evidences on record reached to this conclusion that the Appellant had wrongly repudiated the claim of the Respondent. The Learned Counsel for the Appellant has failed to point out any illegality or infirmity in the impugned order. The impugned order is based on sound proposition of law and the evidences on record. We find no infirmity or illegality in the impugned order. The present Appeal has no merit and the same is dismissed.
......................J DEEPA SHARMA PRESIDING MEMBER ...................... C. VISWANATH MEMBER