Judicial Analysis Court Copy Headnote Facts Arguments Court observation

NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
Ram Surat Ram Maurya, Presiding Member
Life Insurance Corporation of India and Anr. – Appellants
versus
Vijay Pal Singh and Anr. – Respondents
First Appeal No.778 of 2013 and First Appeal No.297 of 2014 with IA/3207/2014 (Condonation of delay), IA/8956/2014 (Condonation of delay)
Decided on 3.11.2021

Advocates:
Counsel for the Parties:
FA778/2013
For the Appellants:Mr. Neeraj Gupta, Advocate
For the Respondents:Mr. Anil Kumar Mishra, Advocate
FA297/2014
For the Appellants:Mr. Anil Kumar Mishra, Advocate
For the Respondents:Mr. Neeraj Gupta, Advocate

IMPORTANT POINTS
1) Non-disclosure of 3 policies obtained from Pvt. insurance co. not a material fact to repudiate the claim of the Respondents.
2) Impugned policies are not the mediclaim policies nor the death of the insured had occurred due to any disease.
3) For any omission or commission of an Insurance Agent, the insured or his or her LRs cannot be made to suffer.

Headnote:
Consumer Protection Act, 1986 – Section 19 - First Appeal [Consumer Protection Act, 2019 – Section 51] – Against Order dt. 19.09.2013 passed by State Commission - Respondent/Vijay Pal Singh filed Consumer Complaint as his deceased son (died in road accident) had taken various LIC policies wherein respondent was the nominee – Respondent had submitted insurance claims of policies with reminders and notice and even RTI application was filed - State Commission directed the Insurer to pay Rs.1600000/-, along with interest @ 9% p.a. for 2 policies from 23.05.2008 till the date of payment and Rs.10000/- as cost of litigation – Hence, appeals - Policies obtained from HDFC Standard Life Insurance Co. Ltd. dated 04.01.2005 and TATA AIG Life Insurance Co. Ltd. were not disclosed by the policy holder - Expression fraud has been defined under the Insurance Act, 1938 & Supreme Court has held that explanation to Sec. 19 of the Contract Act, 1872 is irrelevant for the purposes of insurance policies – Appellant Insurer has nowhere stated that under any circular/rules of LIC of India, in case policies obtained from Pvt. Insurance Co. would have been disclosed then the insurer has either rejected the proposal or had charged extra premium for grant of the policy under the Tariff rules - Findings of this Commission: Non-disclosure of 3 policies obtained from Pvt. insurance co. not a material fact to repudiate the claim of the Respondents - Impugned policies are not the mediclaim policies nor the death of the insured had occurred due to any disease - For any omission or commission of an Insurance Agent, the insured or his or her LRs cannot be made to suffer - No material on record that the assured person was not keeping good health at the time of taking insurance policy in large number, but paying huge sums of insurance premium. (Paras 2, 8, 11, 12, 15 & 18)
Result: First Appeal No.778 of 2013 of the Petitioner is dismissed. First Appeal No.297 of 2014 of the Respondent is allowed. Petitioner insurer is directed to pay accrued bonus and double amt. of sum assured to the Respondent along with interest @9% p.a.

ORDER

Ram Surat Ram Maurya, Presiding Member.—Heard Mr. Neeraj Gupta, Advocate, for Life Insurance Corporation of India and Mr. Anil Kumar Mishra, Advocate, for Vijay Pal Singh, in both the appeals.

2. Life Insurance Corporation of India (the opposite party) (hereinafter referred to as the Insurer) filed First Appeal No. 778 of 2013 and Vijay Pal Singh (the complainant) filed First Appeal No. 297 of 2014, from the order of State Consumer Disputes Redressal Commission U.P. dated 19.09.2013 passed in Consumer Complaint No. 25 of 2008, whereby the complaint was partly allowed and the Insurer was directed to pay Rs.1600000/- along with interest @ 9% per annum, from 23.05.2008 till the date of payment and Rs.10000/- as costs to the Insured. Both the appeals arise from same order as such they were consolidated and heard together and are decided by a common judgment.

3. FA778/2013 has been filed with delay of 23 days. The appellant has filed IA No.7027 of 2013, for condonation of delay in filing the appeal. It has been stated that after receiving certified copy of the impugned order, it was sent to Zonal Office for granting approval for filing the appeal. After approval, it was sent to Regional Manager (Legal), Delhi, where, it was received on 30.10.2013. Then the papers were handed over to the Advocate, who drafted the appeal etc. and filed it on 11.11.2013. Cause shown is sufficient. Delay in filing the appeal is condoned.

4. FA297/2014 has been filed with delay of 201 days. The appellant has filed IA No.8956 of 2014, for condonation of delay in filing the appeal. It has been stated that after receiving the certified copy of the impugned order, the appellant consulted with an advocate at Delhi on telephone for filing the appeal, who informed that limitation for filing the appeal was 90 days and advised to come along with all the papers of the complaint. In December, 2013, he met in an accident and remained in treatment/physiotherapy till April, 2014. Thereafter, he could come to Delhi and the appeal was prepared and filed on 09.05.2014. Cause shown is sufficient. Delay in filing the appeal is condoned.

5. Vijay Pal Singh filed Consumer Complaint No.25 of 2008, for directing the Insurer to pay insurance claim of (i) Rs.1200000/- under Insurance Policy No.254243993, Rs.400000/- under Insurance Policy No.253721300, Rs.500000/- under Insurance Policy No.252860717 and Rs.500000/- under Insurance Policy No.253176933,(total Rs.2600000/-), with interest @ 10% per annum from the date of death of Anil Kumar, life insured, till its realization, (ii) Rs.50000/- for mental and physical harassment (iii) Rs.100000/- and Rs.20000/- for financial loss (iv) Cost of litigation and (v) any other or further relief which may deem fit and proper in the circumstances of the case.

6. It has been stated in the complaint that Anil Kumar, son of the complainant, obtained Life Insurance Policy No.253176933, (sum insured was Rs.5 lacs) on 02.04.2003 (proposal dated 27.10.2003), Life Insurance Policy No.252860717 (sum insured was Rs.5 lacs) on 28.04.2003 (proposal dated 19.04.2003), Life Insurance Policy No.253721300 (sum insured was Rs.4 lacs) on 28.05.2005 (proposal dated 21.06.2005) and Life Insurance Policy No.254243993 (sum insured was Rs.12 lacs) on 16.03.2006 (proposal dated 28.04.2006), from the Insurer. In all these policies, the complainant was nominee. Anil Kumar was a cloth merchant and was paying premium of the policy regularly. Anil Kumar died on 31.07.2006, in a car accident on Kariappa Road, police station Rakabganj, district Agra. Anil Kumar was himself driving his Santro car, registration No. U.P.-41 Z-2255, on 31.07.2006 at 2:00 AM, which was burnt during drive, in front of PWD Colony Rakabganj and Anil Kumar died on the spot. The incident was informed to police station Rakabganj, district Agra, who investigated the incident and sent the dead body for post mortem. The complainant submitted his insurance claim under the aforesaid policies on 06

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Cases Referred (3)