State Consumer Disputes Redressal Commission
Reliance Life Insurance Co. vs Pushpa Devi on 26 February, 2018
Daily Order STATE CONSUMER DISPUTES REDRESSAL COMMISSION HARYANA, PANCHKULA First Appeal No : 1237 of 2017 Date of Institution: 16.10.2017 Date of Decision : 26.02.2018 1. Reliance General Insurance Company Limited, Delhi Road, Dayanand Nagar, Bahadurgarh 124507, District Jhajjar through its Branch Manager. 2. Reliance General Insurance Company Limited, Registered Office H Block, Dheeru Bhai Ambani Knowledge City, Navi Mumbai (Maharashtra) through its Managing Director/Chairman. Appellants-Opposite Parties Versus Pushpa Devi wife of late Mitter Sen, resident of Bhatnagar Colony, Rohtak Road, Jind, Tehsil and District Jind. Respondent-Complainant CORAM Hon'ble Mr. Justice Nawab Singh, President. Shri Balbir Singh, Judicial Member.
Argued by : Shri Rohit Goswami, Advocate for the appellants. Shri Sansar Kundu, Advocate for the respondent. O R D E R NAWAB SINGH J.(ORAL)
This opposite parties'-Reliance General Insurance Company Limited (for short, 'Insurance Company') appeal is directed against the order dated July 28th, 2017 passed by District Consumer Disputes Redressal Forum, Jhajjar (for short 'District Forum'), whereby it directed the Insurance Company to pay Rs.3,95,000/-, that is, sum assured and Rs.20,000/- harassment to Pushpa Devi-complainant on account of death of her son Anil Kumar-life assured.
2. The life assured purchased policy (Annexure-1) under Money Multiplier Plan (Rev) from the Insurance Company. The date of commencement of the policy was July 31st, 2015. The policy term was 15 years. The date of benefit expiry was July 31st, 2030. The frequency of payment was yearly. The installment of the premium was Rs.48,262.05. The sum assured was Rs.3,95,000/-. The life assured died on August 23rd, 2015 due to heart attack. The complainant filed claim before the Insurance Company but the same was repudiated on the ground that at the time of purchase of the policy, the life assured did not disclose about his previous policy purchased from HDF Life Insurance Company Limited.
3. The ground taken by the Insurance Company to repudiate the claim is not tenable. The life assured was not suffering from any ailment. He died due to heart attack. Hon'ble National Consumer Commission, New Delhi in Aviva Life Insurance Company Limited & Others Vs. Rekhaben Ramjibhai Parmar, II (2017) CPJ 463 (NC) held as under:-
"16. Keeping in view the facts and circumstances of this case, in our opinion, the non-disclosure of the other insurance policies does not fall within the ambit of Section 45 of the Insurance Act, as the concealment was neither wilful nor fraudulent. To reiterate, the Agent himself admitted that it is the normal practice that in non-mediclaim policies, the question regarding existence of other insurance policies is not asked and that he himself had filled the proposal form. By no stretch of imagination it can be held to be a material fact fraudulently suppressed, entitling the Insurance Company to repudiate the claim on the stated ground."
4. In addition to the above said ground, the Insurance Company has also taken the plea that at the time of purchase of the policy, the life assured declared his annual income of Rs.4,00,000/- whereas in another policy purchased from HDFC Life Insurance Company Limited his gross yearly income from all sources was shown to be Rs.265000/-.
5. The Insurance Company has taken the plea outside the scope of the repudiation letter which in any manner is not permissible. What is the spirit of Insurance Policy, should be kept in mind by the officials dealing with the genuine claims of the sufferers and the same should not be rejected on methodological grounds in a mechanical manner. The tendency of Insurance Companies in rejecting genuine claims is the reason of increasing litigation between the insurers and the insureds/their legal heirs. The order passed by the District Forum is perfectly right and requires no interference. The appeal is, therefore, dismissed.
6. The statutory amount of Rs.25,000/- deposited at the time of filing the appeal be refunded to the respondent-complainant against proper receipt and identification in accordance with rules, after the expiry of period of appeal/revision, if any.
Announced 26.02.2018 (Balbir Singh) Judicial Member (Nawab Singh) President UK