State Consumer Disputes Redressal Commission
Life Insurance Corporation Of India vs Balbir Kaur Widow Of Sh. Balwinder ... on 13 August, 2012
STATE CONSUMER DISPUTES REDRESSAL COMMISSION, PUNJAB,
SECTOR 37-A, DAKSHIN MARG, CHANDIGARH
First Appeal No. 25 of 2007
Date of institution : 4.1.2007
Date of Decision : 13.8.2012
Life Insurance Corporation of India through its Authorised Officer, Manager
(L&HPF) (D.M., Divisional Officer) Sector 17, Chandigarh.
....Appellant.
Versus
1. Balbir Kaur widow of Sh. Balwinder Singh, Resident of Village & Post
Office Hotian Tehsil Khadur Sahib, Distt. Amritsar.
2. Kanwaljit Kaur daughter of Sh. Balwinder Singh W/o Sh. Jaswant
Singh R/o Village Vain Poin, Tehsil Tarantaran, Distt. Amritsar.
3. Jagwinderjit Singh S/o Sh. Balwinder Singh, resident of Village & Post
Office Hotian, Tehsil Khadur Sahib, Distt. Amritsar
4. Harjit Kaur D/o Sh. Balwinder Singh R/o Village Verpal Tehsil & Distt.
Amritsar.
5. Rajwant Kaur &
6. Sukhbir Kaur both Daughters of S/o Sh. Balwinder Singh, resident of
Village Post Office Hotian, Tehsil Khadur Sahib, Distt. Amritsar.
...Respondents.
First Appeal against the order dated 13.11.2006 of
the District Consumer Disputes Redressal Forum,
Amritsar.
Before:-
Shri Piare Lal Garg, Presiding Member.
Shri Baldev Singh Sekhon, Member.
Present:-
For the appellant : Sh. B.J. Singh, Advocate
For the respondent : None.
PIARE LAL GARG, PRESIDING MEMBER:
This is an appeal filed by the appellant-Life Insurance Corp. Ltd. (hereinafter called 'the appellant') against the order dated 13.11.2006 of the District Consumer Disputes Redressal Forum, Amritsar(hereinafter called the 'District Forum') by which the complaint of the First Appeal No. 25 of 2007 2 respondents/complainants (hereinafter called 'the respondents') was allowed by the District Forum.
2. Brief facts of the case are that Balwinder Singh, husband of respondent No. 1 and father of respondents No. 2 to 6, had purchased life insurance policy No. 471237138 for Rs. 1,00,000/- from the appellant. Proposal form was filled on 19.5.2004 and at the time insured had told his date of birth as 16.2.1951 and age as 53 years and voter card was handed over to the agent of the appellant as proof of his age. Respondent No. 3 was nominated as nominee by the insured. Insured was medically examined by the approved doctor of the appellant. Balwinder Singh- insured died on 22.12.2004. It was pleaded that the insured was hale and hearty at the time of filing the proposal form and was not suffering from any ailment and he died as natural death. Respondents lodged the claim which was repudiated by the appellant vide letter dated 31.3.2005 on false, baseless and flimsy grounds. Complaint was filed on the ground that the appellant was deficient in service and prayed that the appellant may be directed to pay Rs. 1,00,000/- of insured amount with interest @ 18% per annum, Rs. 50,000/- as compensation on account of deficiency in service. It was also prayed that Rs. 5,000/- may be awarded for harassment as well as for litigation expenses.
3. Upon notice, the appellant replied by taking preliminary objections that the insured had given mis-statement regarding his age as 53 years when he was of 60 years at the time of filling the proposal form and tried his best to play fraud with the appellant and grab the public money for his legal heirs, did not disclose his true age at the time of filling the proposal form on 30.5.2004, material facts regarding ailment i.e. suffering from heart disease and valve were not disclosed by the insured, the complaint was hopelessly prematured as other remedies like Insurance First Appeal No. 25 of 2007 3 Ombudsman available to the respondents were not availed, the insured induced the appellant to accept risk of his life by way of impersonation and forgery and deliberately did not appear before the medical examiner at the time of his medical examination and someone else impersonated on his behalf just to play fraud with the appellant, as per handwriting expert report dated 8.4.2005, the standard signature of insured Balwinder Singh on proposal form dated 30.5.2004 did not tally with the disputed signature marked as 'Q-1' at the bottom of the last page of the proposal form dated 30.5.2004, 'Q-2' on the statement dated 30.5.2004 and 'Q-3' on the medical examiner's consolation report dated 30.5.2004, respondent did not fall under the definition of 'consumer', the insurance is a contract of utmost good faith but the insured did not disclose his correct age and had not given correct answer regarding his health at the time of filling of the proposal form, the complaint is bad for mis-joinder and non-joinder of necessary parties and liable to be dismissed.
4. On merits, it was admitted that the deceased was insured for some of Rs. 1 Lac with the appellant but he has not disclosed his correct age as well as ailments at the time of filling the proposal form. All other allegations were denied and dismissal of the complaint was prayed.
5. Learned District Forum after hearing the learned counsel for the parties and going through the record, partly allowed the complaint and the appellant was directed to pay Rs. 1,00,000/- with interest @ 8% p.a. from the date of repudiation of the claim till payment and also pay Rs. 1,000/- as litigation expenses. It was also ordered that out of the entire amount, 25% of the amount would go to respondent No. 1 and 15% each would go respondents No. 2 to 6 and deposit the amount of respondents No. 2 to 6 in the shape of FDRs in a Nationalized Bank.
6. Hence, the appeal.
First Appeal No. 25 of 2007 4
7. We have gone through the pleadings of the parties, perused the record of the learned District Forum and heard the arguments of the learned counsel for the appellant.
8. The present appeal has been filed by the appellant on the grounds that the District Forum has failed to appreciate the preliminary pleas taken by the appellant, failed to appreciate the scope of inquiry in summary proceedings, erred in assessment of evidence and decided the case on conjectures and surmises, did not appreciate the relevant case law on the subject, awarded the interest @ 8% per annum when there was no contract regarding the interest between the parties. The appellant pleaded that the order of the District Forum is liable to be set-aside.
9. It is admitted case of the appellant that the deceased was insured with the appellant for a sum of Rs. 1 lac and Balbir Kaur i.e. respondent No. 1 was nominee in the policy. The death of the insured is also not disputed between the parties. The claim of the respondents was repudiated vide letter dated 31.3.2005(Ex. C-5) on the following grounds:-
"The Evidence in our possession goes to show that deceased was not less than 60 years of age and he willfully and fraudulently misstated his age to avoid special reports. Had he stated his correct age, we would have asked for special reports and our underwriting decision would have different. Moreover, he was not keeping good health at the time of insurance and managed to get favourable medical report by impersonation."
10. So from the perusal of the repudiation letter, the claim of the respondents was repudiated on the following two grounds:-
(i) the insured had mis-stated regarding his age;
(ii) the insured did not disclose regarding his previous ailment of heart at the time of filling the proposal form and did not First Appeal No. 25 of 2007 5 present himself before the Doctor at the time of examination and produced someone else for medical examination.
11. The appellant produced three identity/voter cards issued by Election Commission of India (Ex. R-7) of Kamaljit Kaur daughter of Balwinder Singh (insured) in which age of the voter is mentioned as 26 years, Harjit Kaur daughter of Balwinder Singh in which the age of the Voter was mentioned as 23 years as well as the insured, whose age is mentioned as 43 years. The abovesaid cards were issued by the Election Commission of India on 1.1.1994.
12. The version of the appellant is that when on 1.1.94 the age of his daughter was 26 years it was not possible that he was 43 years old on 1.1.94 i.e. only 17 years elder than his daughter. No iota of evidence was produced by the appellant to prove that the age of the deceased was 60 years at the time of filling the proposal form and he deliberately misstated his age as 53 years. If we count the age of deceased as 43 years as mentioned in the Voter card, he had given his correct age as 53 years i.e. on 30.5.2004 when the proposal form was filled 10 years after the issuance of the voter card. The appellant had not produced any evidence to prove that the age of his daughters mentioned in the voter card is correct and the age of the insured was mentioned incorrectly. There is no evidence produced by the appellant to discard the voter card/identity card issued by the Election Commission of India and it is also admitted case of the appellant that at the time of filling the proposal form the insured had produced voter card in proof of his age. No demand of any other document regarding age was made by the Agent of the appellant to verify the correctness of the age mentioned in the voter card. If once the appellant had accepted the age of the insured as 43 years mentioned in the voter First Appeal No. 25 of 2007 6 card now at the time of payment of claim the appellant cannot raise the question on correctness of the age.
13. We have also perused Form No. 3260, which relates to the statement to be submitted by the proposer/agent/divisional officer when a standard age proof viz school/university/birth certificate is not submitted alongwith the proposal. The relevant para of the same is reproduced:-
"I have discussed the question of standard proof of age with the proposer and I am satisfied that he can not submit a standard proof of age for the following reason :
REASONS OTHER PROOF OF AGE NOT AVAILABLE. I further certify that according to my estimation his apparent age is 53 years.
Sd/-
Date ......... Name of the Dev. Officer Signature of the Agent "I have discussed the question of standard proof of age with the proposer and I am satisfied that he can not submit a standard proof of age for the following reason :
REASONS OTHER PROOF OF AGE NOT AVAILABLE. I further certify that according to my estimation his apparent age is 53 years.
Sd/-
Date ......... Name of the Dev. Officer Signature of the Dev. Officer"
14. There is no force in the argument of the appellant counsel that a person, who is only 17 years old; cannot become a father of a child because in rural areas people do get married at the age of 16 and they can become father at that age after attaining the age of puberty which as per experts varies between 10 to 14 years in case of girls and 12 to 16 years for boys.
15. The counsel for the appellant has cited the judgments of Hon'ble Supreme Court of India titled as "Oriental Insurance Co. Ltd. Versus Munimahesh Patel", IV (2006) CPJ 1 (SC), Hon'ble National Commission titled as "Life Insurance Corporation of India versus Smt. Minu Kalita", III (2002) CPJ 10 (NC) and Hon'ble M.P. State Consumer Disputes First Appeal No. 25 of 2007 7 Redressal Commission, Bhopal titled as "Ramesh Chandra Shakya versus Life Insurance Corporation of India", 2000(2) CPC 640 in support of his contentions. But these are not applicable to the facts and circumstances of the present case as no evidence is produced by the appellant that the insured had misstated his age at the time of filling the proposal form.
16. The version of the appellant is that the insured has not appeared before the Doctor for his medical examination at the time of filling the proposal form and issuance of the policy as he had procured the policy after producing someone else before the Doctor for the medical examination, who impersonated the appellant at the time of medical examination as he was suffering from heart disease at the time of filling the proposal form.
17. To prove its version the appellant tendered into evidence Ex. R-2 i.e. report of Jassy Anand, Fingerprints and Handwriting Expert.
18. We have perused the report of Fingerprints and Handwriting Expert, who had opined that disputed signatures marked as 'Q1' at the bottom of the last page of proposal form dated 30.5.2004, 'Q2' on the statement dated 30.5.2004 and 'Q3' on the medical examiner's confidential report dated 30.5.2004 have not been signed by Sh. Balwinder Singh, whose standard signatures have been marked as 'S-1'. The disputed signatures Q1 to Q3 are the result of copied forgery. But no photographs were produced by the appellant, which were if taken by the Fingerprints and Handwriting Expert to tally the standard signatures with the signatures Q1 to Q3. Even in his report the handwriting expert had not mentioned that he had taken the photographs of the signatures of the insured. The appellant neither examined the handwriting expert nor tendered his affidavit to prove the report of the handwriting expert. Not producing the handwriting expert or affidavit shows that the appellant concealed the First Appeal No. 25 of 2007 8 relevant evidence to prove its allegation that the insured had not appeared before the Doctor for his medical examination.
19. We have also perused Ex. R-4 Form No. LIC-03-001 regarding medical examiner's confidential report. The column No. 3 relates to the name and designation of the person, who introduced the insured to the Doctor at the time of medical examination. The insured was introduced to the Medical Examiner by Miss Davinder Kaur, who also signed the above certificate as introducer. Miss Davinder Kaur was the agent, who filled the proposal form and produced the insured before the Medical Examiner for his medical examination. It is not the case of the appellant that the insured impersonated the appellant with the connivance of its agent Davinder Kaur. If someone else had appeared before the Medical Examiner, who was introduced by the Agent of the appellant, then what action had been taken by the appellant against its Agent? No document has been produced by the appellant to prove that any action was taken against its agent when it has come into the notice of the appellant that the insured himself was not medically examined and someone else appeared before the medical examiner instead of the insured.
20. It is also alleged by the appellant that the insured had also concealed facts regarding his ailment of heart disease at the time of filling the proposal form. The claim of the respondent was not repudiated on this ground. Even the appellant had not produced any evidence that the insured was taking any medicine from any doctor or hospital. Only Photostat copy of prescription slip Ex. R-6 was produced by the appellant of one Tur Homeopathic Clinic. The name of the father as well as address of the patient is not mentioned in the prescription slip. No affidavit of the Doctor of the abovesaid clinic was tendered into evidence by the appellant to prove its version that at the time of filling the proposal form the insured First Appeal No. 25 of 2007 9 was suffering from heart disease. Nature of the disease was also not given in the said prescription slip.
21. The appellant has badly failed to prove its version that the insured was suffering from heart problem at the time of filling the proposal form.
22. The claim of the respondents was repudiated on the sole basis of the report Ex. R-12 of Hansraj, who was appointed as Investigator by the appellant to inquire the claim. But Sh. Hansraj was not produced by the appellant to prove his report Ex. R-12. Even his affidavit was also not tendered into evidence by the appellant especially when he was the employee of the appellant. The appellant has badly failed to prove that the repudiation is legal.
23. The order passed by the learned District Forum is legal and valid and there is no ground to interfere with the same. The appeal, being without any merit, is dismissed and the impugned order of the District Forum is affirmed and upheld. No order as to costs.
24. The arguments in this appeal were heard on 2.8.2012 and the order was reserved. Now the order be communicated to the parties.
25. The appellant had deposited an amount of Rs. 25,000/- with this Commission at the time of filing the appeal. This amount of Rs. 25,000/- with interest accrued thereon, if any, be remitted by the registry to respondent No. 1 by way of a crossed cheque/demand draft after the expiry of 45 days under intimation to the learned District Forum and to the appellant.
26. Remaining amount shall be paid by the appellant to the respondents as per the directions of the District Forum within 30 days from the receipt of the copy of the order.
First Appeal No. 25 of 2007 10
27. The appeal could not be decided within the statutory period due to heavy pendency of Court cases.
(Piare Lal Garg)
Presiding Member
August 13, 2012. (Baldev Singh Sekhon)
as Member