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RAJASTHAN STATE CONSUMER DISPUTES REDRESSAL COMMISSION
Ashok Parihar, President and Shashi Kumar Pareek, Member
AVIVA LIFE INSURANCE CO. INDIA LTD. - Appellant
Versus
MANOHAR BHOGAWAT - Respondent
Appeal No. 1342 of 2011
Decided on : 09-08-2011
Mr. Ajay Tantia, Advocate, for the Appellant; None., for the Respondent
Insurance companies are required to explain all the details and conditions of the insurance policy to the customer, especially when dealing with illiterate individuals, and insurance policies should not be issued and repudiated in a casual manner.
Headnote:
Insurance Claim - Misrepresentation and Concealment - The court held that insurance companies are required to explain all the details and conditions of the insurance policy to the customer, especially when dealing with illiterate individuals. The court emphasized that insurance policies should not be issued and repudiated in a casual manner, and that such practices should be strongly deprecated.
Fact of the Case:
The insured, an illiterate lady belonging to a scheduled tribe, passed away after the insurance policy was issued. The insurance claim was rejected by the appellant due to alleged concealment of previous illness by the insured.
Finding of the Court:
The court found no error or illegality in the order passed by the District Forum and dismissed the appeal, directing the appellant to pay the insurance claim to the respondent.
Issues: The main issue was the rejection of the insurance claim based on the alleged concealment of previous illness by the insured.
Ratio Decidendi: The court emphasized that insurance companies are required to explain all the details and conditions of the insurance policy to the customer, especially when dealing with illiterate individuals, and that insurance policies should not be issued and repudiated in a casual manner.
Final Decision: The appeal was dismissed, and the appellant was directed to pay the insurance claim to the respondent.
ORDER
1. The appeal is directed against order dated 8.6.2011 passed by the District Forum, Ajmer by which while allowing the complaint of the respondent, the appellant has been directed to pay insurance claim of a sum of Rs. 3 lakh with other consequential reliefs to the respondent.
2. The claim of the complainant had been rejected by the appellant mainly on the ground of concealment of previous illness by the insured. There is no dispute that proposal form was sent to the appellant on 9.4.2008 and the policy was issued on 30.5.2008. However, the insured died on 23.10.2008. The insured belong to scheduled tribe namely Sansi community and was an illiterate lady. Only thumb impression of the insured was taken on the proposal form. There is no affidavit of the agent that each and every condition of the policy had duly been explained to the insured or to her attendant. Even the alleged Hospital record have not been proved by way of an affidavit of the doctor concerned or even the hospital Superintendent.
3. Be that as it may in similar matters this Commission has observed that now-a-days Insurance Companies are growing like mushrooms resulting in unhealthy business competition. The agent of the company is required to explain all the details and conditions of the insurance policy sought to the customer. A common man is not supposed to know all the niceties and technicalities of law. Once accepting the premium and having entered into an agreement without verifying the facts, the Insurance Company cannot riggle out of the liability merely by saying that the contract was made by misrepresentation and concealment. The insurance policies should not be issued and repudiated in such a casual mechanical manner. The policy entails the liability on both sides. It is rather exploitation of the customer and more or less fraud on the public. Such practice should be strongly depricated.
4. Having considered all the facts and circumstances of the present case, we find no error or illegality in the impugned order passed by the District Forum so as to call for any further interference in the present appeal. The same is dismissed accordingly as having no merits. The amount deposited by the appellant before the District Forum may now be paid to respondent and remaining compliance be made by the appellant within 30 days.
