IMPORTANT POINT
Insured made a misrepresentation to the insurer on a material fact which influenced the decision of the insurer.

ORDER

V.K. Jain, Presiding Member

Late Smt. Golla Lakshmi Devi (hereinafter referred to as the ‘insured’) obtained an insurance policy from the petitioner company on her life, on 06.2.2014. She having died on 20.8.2014 within two years of taking the policy, a claim for payment of the benefit in terms of the policy was lodged by the complainant with the petitioner company. The claim was repudiated vide letter dated 2.9.2015, which to the extent it is relevant reads as under:

“We wish to inform you that as per the facts available with us, it is evident that Late Lakshmidevi Golla was older than the age declared by her at the time of signing the proposal form and had misstated her age in the proposal form. Had the correct age been disclosed in the proposal form, late Lakshmidevi Golla would have been found ineligible for entering into the SBI Life – Shubh Nivesh Endowment Plan.

In this connection, you are requested to refer Clause 9.8 of Policy document which states the following:

9.8 Misstatement of age.

9.8.1 If we find that the correct age of the life assured is different from that mentioned in the proposal form, we will check your eligibility for the life cover as on the date of commencement.

9.8.3 if not eligible.

9.8.3.1 We will terminate your policy.

Hence the claim is hereby repudiated in view of the policy terms and conditions stated above.”

2. Being aggrieved from the rejection of her claim, the complainant approached the concerned District Forum, by way of a consumer complaint.

3. The complaint was opposed by the petitioner primarily on the ground on which the claim had been repudiated.

4. The District Forum having dismissed the complaint, the complainant / respondent approached the concerned State Commission by way of an appeal. Vide impugned order dated 21.5.2019 the State Commission allowed the appeal and directed the petitioner to pay an amount of Rs.4,50,000/- to the complainant, along with interest, compensation and cost of litigation. Being aggrieved the petitioner is before this Commission by way of this revision petition.

5. The only question involved in this petition is as to whether the insured had made a false statement, with respect to her age at the time of taking the insurance policy or not. A perusal of the proposal submitted to the petitioner company would show that she gave her date of birth to be 02.9.1981. The proposal having been submitted on 04.2.2014, she claimed to be already 33 years old at the time the proposal was submitted in the year 2014. Around the same would be her age in August, 2014. In the consumer complaint instituted in the year 2016, the complainant who is the daughter of the insured claimed to be 30 years old. This would mean that she was about 28 years old in the year 2014, when the proposal was submitted by her mother for taking an insurance cover on her life. Obviously, the difference between the age of the mother and the daughter could never have been only five years. This by itself proves that a false statement with respect to her age was made by the insured, while taking the insurance cover.

6. The insured at the time of taking the insurance cover had submitted a voter ID Card, purporting to be issued by Election Commission of India. On verification at the website of the Election Commission of India, no such record was found. This would indicate that the said Voter ID was a forged document and that is the reason no record of its issuance was found on the website of the Election Commission of India.

7. The investigator appointed by the petitioner company obtained a copy of the Aadhaar Card of the insured. As per the Aadhaar Card, which is an authentic document, evidencing the age of the holder, the insured was born in the year 1960. Thus, there cannot be any dispute that the insured had made a false statement with respect to her age for the purpose of taking an insurance cover.

8. The learned counsel for the petitioner submits that had the insured disclosed her correct age in the p