IMPORTANT POINT
Insurance company has to prove misrepresented of material facts in proposal form.

ORDER (ORAL)

V.K. Jain, Presiding Member.—Late Sh. Harbhajan Singh husband of the complainant obtained an insurance policy from the appellant. In the proposal form submitted by him, he had claimed annual income of Rs.2.5 lacs. He having died, a claim in terms of the insurance policy was lodged by the complainant she being his widow. The claim was rejected vide letter dated 08.05.2018 which to the extent it is relevant, reads as under:

We would like to inform you that the company had covered the risk for the above said policy on the basis of the facts mentioned in the proposal form. However, on receiving the death claim intimation for the above said policy, the various investigations done/the various medical records received reveal certain facts, which were known to the deceased life assured and were not disclosed to us. Hence, the death claim under above mentioned policy has been declined for the following reasons:

It is a case of misrepresentation of material facts - Life assured was BPL card holder.

2. Being aggrieved from the rejection of the claim, the complainant approached the concerned State Commission by way of a Consumer Complaint.

3. The complaint was resisted by the insurer primarily on the ground that the deceased did not have the income claimed in the proposal he being the holder of a BPL card and he had made a misrepresentation with respect to his annual income. This is also the submission of the learned counsel for the appellant that had the deceased disclosed his correct income to the insurer, the policy of Rs.19.80 lacs would not have been granted to him since the extent of the insurance coverage depends upon the income of the insured.

4. The State Commission having allowed the Consumer Complaint, the insurer is before this Commission by way of this appeal.

5. The only issue involved in this appeal is as to whether the deceased had inflated his income while submitting the proposal. No documentary evidence of the income of the deceased such as income tax return or a salary slip was produced either by the insurer or by the complainant. The appellant placed on record what purports to be a certificate issued by the Sarpanch of Village Dassuwal Mandi certifying therein that late Sh. Harbhajan Singh was a farmer and a BPL card holder, known very well to him. The respondent also placed on record what purported to be a certificate issued by Harpal Singh, an officer of the Food & Supplies Department stating therein that the complainant Sukhjit Kaur is a BPL card holder.

6. The complainant on the other hand, placed on record a certificate purporting to be issued by Block Development and Panchayat Officer informing therein that the name of Harbhajan Singh was not recorded in the BPL.

7. The appellant did not examine the Sarpanch of Village Dassuwal Mandi to prove the certificate purporting to have been issued by him. No affidavit of the above referred Sarpanch was filed before the State Commission to prove the said certificate. Similarly, neither Mr. Harpal Singh of Food & Supplies Department was examined to prove the document purporting to be issued by him nor was his affidavit filed by way of evidence, to prove the said document. The complainant also did not file the affidavit of the Block Development and Panchayat Officer to prove the certificate purporting to be issued by him on 08.10.2018.

8. The onus was upon the insurer to prove that the deceased had made a misrepresentation in the proposal with respect to his income. As noted earlier, no income tax return of the deceased was produced before the State Commission. Though it was claimed in the certificate purporting to be issued by Sarpanch of the Village that the deceased was holding a BPL card, even the number of any such card was not given in the said document. As far as the document purporting to be issued by the Food & Supplies Department is concerned, it is nowhere stated in the said document that late Sh. Harbhajan Singh was holding a BPL ca