Insurance claims cannot be repudiated based solely on minor discrepancies in age documentation if the insured was truthful at the time of policy issuance.

Order : (Per Smt.Meena Ramanathan, Hon’ble In-charge President)

1. This appeal is filed by the Appellant/Complainant under Section 15 of Consumer Protection Act , 1986, praying this Commission to set aside the orders dated 29.10.2019 made in CC.No.57 of 2016 by the District Consumer Disputes Redressal Forum, Warangal and consequently allow the complaint as prayed for and pass such other further orders as deemed fit and proper by this Commission in the circumstances of the case.

2. For the sake of convenience, the parties are described as arrayed in the complaint. The Appellant is the Complainant and the Respondents are the Opposite Parties in CC.No.57/2016.

3. Briefly stated, the facts are that – the Complainant is the son of the E.Venkat Rao who died on 14.06.2012 due to fever. The said E.Venkat Rao during his life time obtained TATA AIG Life Insurance Policy from the Opposite Party No.1 vide Policy No.C226497044 for a sum assured of Rs.5,40,000/-. The commencement of policy was from 27.03.2011 and the premium was Rs.49,426/- per year. The policy was in force at the time of death of the policy holder. It is submitted that the agent of the Opposite Parties obtained signatures of the life assured on blank proposal form which was in English language and filled up the blanks as per his will and his convenience.

4. The Complainant being the nominee approached the Opposite Parties with all necessary documents and requested to settle the claim. The Opposite Parties repudiated the claim vide their letter dated 12.12.2012 which was received by the Complainant on 18.12.2012. The claim was repudiated on the ground that the insured had submitted a „forged date of birth certificate as age proof while applying the policy‟. The Opposite Party No.2 refunded an amount of Rs.17.36 towards full and final settlement of claim.

5. It is submitted that the life assured obtained date of birth certificate from the Head Master of Primary School, Kalleda Village but the same was misplaced at his residence. The panel doctor of Opposite Parties have examined the life assured while processing the insurance policy and the age of the life assured was confirmed. Despite several requests, the Opposite Parties have not settled the claim of the Complainant. All the efforts of the Complainant went in vain. This act of Opposite Parties clearly shows deficiency in service, as such the Complainant filed the complaint as prayed below:

To direct the Opposite Parties to pay accidental death benefit under the policy No.C226497044 a sum of Rs.5,40,000/- and damages of Rs.50,000/- in total Rs.5,90,000/- with interest @ 24% p.a. from the date of death of the deceased life assured/policy holder with future interest till realization of the same to the Complainant.

6. The Opposite Parties filed their written version denying the allegations made by the Complainant. It is submitted that the Complainant cannot be described as a Consumer since he doesn‟t fulfil any of the requirements of the definition of „Consumer‟ within the meaning of Section 2(1)(d) of the Consumer Protection Act , 1986. The provisions of law under which the complaint seems to have been filed has no application to the facts of the case on hand and on this ground alone, the complaint is liable to be rejected.

7. It is admitted that E.Venkat Rao during his life time had taken a policy bearing No.C226497044 for a sum of Rs.5,40,000/- on 27.03.2011. The Complainant E.Ravinder Rao is the nominee for the said policy. The Opposite Parties issued the policy to E.Venkat Rao in good faith, believing that the information given in the pr