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UTTAR PRADESH STATE CONSUMER DISPUTES
REDRESSAL COMMISSION, LUCKNOW
Hon’ble Mr. Justice K.C. Bhargava, President; Mr. D.D.
Bahuguna, Sr. Member & Mrs. Rachna, Member
LIFE INSURANCE CORPORATION OF INDIA & ANR.—Appellants
versus
SHAUKEEN & ANR.—Respondents
Appeal No. 3138/SC of 2000—Decided on 11.6.2001

Advocates:
Counsel for the Parties :
For the Appellants :Mr. Arjun Bhargava, Advocate.
For the Respondents:Mr. R.K. Gupta, Advocate.

The central legal point established in the judgment is that the application of Section 45 of the Insurance Act requires the insurance company to prove intentional fraud or deliberate submission of false information by the insured to justify the repudiation of an insurance claim.

Headnote:

Insurance - Life Insurance Policy - Insurance Act, Section 45 - The court discussed the application of Section 45 of the Insurance Act, which allows the insurance company to repudiate a claim if the insured has concealed any material fact. The court analyzed the evidence related to the age of the deceased and the alleged fraudulent intention, ultimately confirming the judgment of the District Consumer Forum.

Fact of the Case:

The complainant's father had a life insurance policy with the opposite party. After the father's death, the complainant sought to claim the insurance amount, but the opposite party repudiated the claim citing fraudulent intention due to the deceased's alleged misrepresentation of age.

Finding of the Court:

The court found that the insurance company's repudiation of the claim was not justified as it failed to prove intentional fraud or deliberate submission of false information by the deceased. The court confirmed the judgment of the District Consumer Forum, directing the opposite party to pay the claim amount and additional compensation to the complainant.

Issues: The key issue was the alleged fraudulent intention due to the deceased's misrepresentation of age in the insurance proposal form, leading to the repudiation of the insurance claim by the opposite party.

Ratio Decidendi: The court held that the insurance company failed to prove intentional fraud or deliberate submission of false information by the deceased, and therefore, the repudiation of the claim was not justified.

Final Decision: The appeal was dismissed, and the judgment and order of the District Consumer Forum were confirmed. The opposite party was directed to pay a sum of Rs. 2,000/- as cost to the complainant.

ORDER

Mr. D.D. Bahuguna, Sr. Member—This is an appeal against the judgment and order dated 25.11.2000 passed by District Consumer Forum, Rampur in Complaint Case No. 210/1997.

2. Briefly stated the facts of the case are as follows :

The complainant’s father late Sri Ali Ahmad had taken a Life Insurance Policy of Rs. 10,000/- from the opposite party on 24.8.1995. Half-yearly premium of Rs. 392/- was to be paid by the complainant’s father. The first premium of Rs. 392/- has been paid to the opposite party. The complainant’s father died on 5.12.1995. The information of the death was given by the complainant, the nominee in the policy to the opposite party. Thereafter the complainant has been approaching the opposite party time and again for settlement of the insurance claim but with no result. The complainant even gave a legal notice through his Advocate to the opposite party on 23.5.1996. The opposite party, Life Insurance Corporation of India then asked for certain documents from the complainant. The documents were sent on 28.9.1996. The opposite party asked for copy of voters list which too was submitted but the claim has not been settled even after 1½ years which was deficiency on the part of the opposite party. The officials of the opposite party have been demanding money from the complainant for settlement of the claim and if the money is not given the claim will be repudiated. The complainant, therefore, lodged a claim before the District Forum seeking the amount of insurance along with 24% interest per annum. Besides this, a compensation of Rs. 50,000/-, Rs. 1,000/- for correspondence and Rs. 2,200/- as cost was also claimed.

3. In the written statement before the Consumer Forum, the opposite party, Life Insurance Corporation of India admitted the insurance and the receipt of first premium of Rs. 392/- against the policy on 31.8.1995, the receipt for which was issued on the same day. It is also admitted that the complainant was the nominee of the deceased. The allegation of the complainant that the money was demanded by the officials was baseless and highly defamatory. It was also stated that it was the duty of the insured to mention each and every information rightly and if any concealment of any material fact is found then the contract of insurance will be void and all the premium paid by the life assured are to be forfeited in view of Section 45 of the Insurance Act. In para 4 of the written statement, it has been stated that if the death of the person occurs within two years from the date of commencement of policy, the Life Insurance Corporation of India is required to investigate all the matters thoroughly and satisfy itself about the genuineness of the claim. The complainant informed the opposite party about the murder of the person assured on 5.12.1995 through his letter dated 26.4.1996. Since this was an early claim the Life Insurance Corporation of India had to investigate the matter thoroughly and came to know that the person assured had grossly understated his age in his statement at the time of proposal. The actual age of the person assured was 65 years at the time of proposal but it was shown intentionally and malafidely as 45 years. If the correct age had been shown by the person assured then the insurance policy would not have been given. The policy was thus taken by the person assured by playing fraud upon the Life Insurance Corporation of India. This fact was also evident from the post-mortem report and the voters list in which the age of the person assured has been shown as 65 years. The claim was, therefore, rightly repudiated under Section 45 of the Insurance Act and the complainant was informed of the repudiation on 26.11.1997. The repudiation was done with full application of mind.

4. In the complaint case before the District Consumer Forum the agent concerned of the Life Insurance Corporation of India was also made opposite party. This opposite party No. 3 in his written version before the District Foru












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