2021 Supreme(Online)(Guj) 450
GUJARAT STATE CONSUMER DISPUTES REDRESSAL COMMISSION, AHMEDABAD
Not mentioned, Not mentioned
Kantaben Jayantibhai Chenva – Appellant
Versus
Reliance Life Insurance Com. Ltd. – Respondent
Consumer Complaint No. 226 of 2016 | Appeal No. 731 of 2017
For the Appellants/Petitioners: Mr. V.M. Pancholi
For the Respondents: Mr. Chaitanya Joshi
The repudiation of an insurance claim based on misrepresentation of material facts is justified under S.45 of the Insurance Act, 1938.
Headnote:The appellant challenged the dismissal of her consumer complaint alleging deficiency in service by the insurance company in repudiating a claim based on income misrepresentation. The court held that misrepresentation was material to policy issuance under S.45 of the Insurance Act, 1938 and confirmed the lower forum's decision, noting that correct information, if disclosed, would have altered the policy underwriting. The appeal was thus dismissed.
| Table of Content |
|---|
| 1. factual appeal regarding insurance policy acquisition and related claims. (Para 2) |
| 2. arguments on the proper representation of income and denial of claim. (Para 3 , 5) |
| 3. court's observations on misrepresentation and its implications for the claim. (Para 4 , 7 , 8 , 9) |
| 4. finality of decision and rejection of the appeal. (Para 10) |
1. This Appeal is by the Complainant.
2. The Complainant - Kantaben Jayantibhai Chenva, filed consumer Complaint No. 226 of 2016 with CDRF, Sabarkantha at Himmatnagar, that her brother Mukeshbhai Chenva obtained one policy namely Reliance Classic Plan - 2 from the agent of the opponent - Reliance Life Insurance Com. Ltd. on 23.6.2014 for Rs. 6 lakh with half - yearly premium of Rs. 10,000, wherein she was appointed as nominee as her father was aged. Her brother and she were the only children, his father and grandfather has no agricultural land. Her father and brother were doing agricultural labour that is doing agricultural work in partnership. His brother was doing agricultural labour in partnership in 5th part in his and other village and was earning Rs. 2 to 3 lakh. For the last three years, he was doing such agricultural work in the field of Amrutbhai Nathabhai Patel and his son Bharatbhai Amrutbhai Patel in Bhandvalni and Jamrela. They were earning Rs. 10 lakhs from vegetable products and his brother thereby 2-3 lakh. At that time his brother obtained the policy No. 51692084, the premium whereof was being given by this person and were deducting from his account. His brother came to their village Pahada on occasion of rakshabandhan on 29.8.2015 but on 10.9.2015 he died of heart attack before any treatment. The claim form was obtained on 24.2.2016 and was submitted together with the documentary proof. The Insurance Company asked for medical papers, discharge card etc. by letter dated 25.2.2016, which could not be true as there was no question of any treatment, he having died before any treatment. The investigator of the company came to village, thereafter no claim - letter was sent on 13.4.2016 stating that the false details of the business and income were given in proposal form and therefore, the claim is denied. There was no agricultural land in name of her father or grandfather and it was wrongly stated by the agent. They should have seen the correct fact and for their mistakes insured should not suffer. After having demanded Rs. 30,000 towards one and half years of premium, the claim should not have been repudiated without any reasonable cause. The investigator having taken all the papers, the complainants asked for copies by letter dated 8.7.2006 which have not been given to the complainant, which also is deficiency in services. The company have not paid any amount even after the cheque was returned. For this deficiency, she claims for Rs. 6 lakh with 9% interest, Rs. 15,000 towards mental pain and Rs. 10,000 towards costs.
3. The Forum records defence vide written version as: the deceased has shown his income at Rs. 1 lakh in the proposal form whereas as per the investigation report, he was having BPL card and yearly income of the family was 11,000. In the proposal form the business was shown whereas he was agricultural labour. Thus, material facts having been suppressed in the proposal form. The claim was rightly repudiated.
4. The CDRF, Banaskantha by its judgment dated 3.10.2017 dismissed the complaint on the ground that in the proposal form against source of income, business, against nature of duties, land owner, and against the annual income Rs. 1,00,000 were written. In the BPL card the names are of the deceased, his parents, wife and two children are mentioned. BPL Card is issued when the annual income of the family is less than 11,800. The complainant has admitted in the complaint that his brother was doing agricultural labour with Amrutbhai Nathabhai therefore, the deceased having obtained policy by suppression of material fact of the income and business, the claim has