IMPORTANT POINT
Death claim cannot be repudiated on false grounds.

Ajit Bharihoke, Presiding Member—This appeal is directed against the order of the State Commission Punjab dated 01.06.2017 in complaint case no. 309/2016.

2. Briefly stated, the facts relevant for the disposal of the appeal are that Sukhdev Singh (since deceased), husband of the complainant purchased life insurance policy from the appellant / insurance company in August 2015. The basic sum assured was Rs.24,00,000/-. The agreed premium was Rs.15,000/- per quarter. The first premium was paid on 18.08.2015 upon which cover note was issued on the same day which was followed by insurance policy no.21657741 having commencement date as 23.08.2015. The husband of the respondent/ complainant died on 19.10.2015 due to heart attack. The respondent / complainant being nominee and widow of deceased Sukhdev Singh approached the opposite party / insurance company and submitted the insurance claim. The appellant / opposite party, however, rejected the claim vide letter dated 26.05.2016 on the premise that insurance policy was purchased by practicing fraud by concealing the fact that Sukhdev Singh had already died prior to applying for insurance policy. Being aggrieved of the repudiation of the insurance policy, the respondent Balwinder Kaur filed consumer complaint in the State Commission.

3. The opposite party upon notice filed written statement taking the objection that complainant is not a consumer. There is no legally valid insurance contract between the parties because the life assured had expired on 09.08.2015 prior to the submission of proposal form for the insurance cover dated 18.08.2015 purported to have been submitted by Sukhdev Singh. It is submitted that on receipt of death claim, as it was a case of early death within two months of the issuance of the policy, the appellant / opposite party got the investigation carried out which revealed that death certificate submitted alongwith insurance claim by the complainant was forged and the said death certificate was cancelled by the Registrar of Birth and Death, who confirmed that the insured died on 09.08.2015.

4. The State Commission on evaluation of the pleadings and evidence allowed the insurance claim and directed as under:

“1. to pay Rs.24,00,000/- as the basic sum assured under the policy Ex.C-3 along with interest at the rate of 9% per annum from the date of repudiation of the claim i.e. 26.05.2016 till realization. It is made clear that if the above said amounts of Rs.12,1999.63P and Rs.6.40P were transferred to the account of the complainant, then the same be deducted form the basic sum assured of Rs.24,00,000/- otherwise the entire amount shall be payable by the opposite parties as mentioned above;

2. to pay Rs.2,00,000/- as compensation for harassment and mental agony suffered by the complainant, and;

3. to pay Rs.20,000/- as litigation expenses.”

The opposite parties shall comply with this order within 30 days of the receipt of certified copy of the same, failing which the compensation amount shall also carry interest at the rate of 9% per annum from the date of passing of this order till realization.”

5. Being aggrieved of the order of the District Forum, the appellant / insurance company has preferred this appeal.

6. Mr. Ritesh Khare, Advocate for appellant / insurance company has taken me through the proposal form purportedly submitted by late Sukhdev Singh for purchase of insurance policy as also copy of the insurance policy. It is submitted that from the perusal of the aforesaid documents, it would be seen that as per the stand of the complainant, late Sukhdev Singh applied for insurance policy on 14.08.2015 and policy was issued subsequently mentioning the commencement date of the insurance cover w.e.f. 23.08.2015. It is argued that since the death of Sukhdev Singh took place within a short period from the date of the issue of insurance policy, investigation was got conducted by the appellant and investigation revealed that insurance policy has been obtai