Court No. 4 First Appeal No.1126/15

1. Kotak Mahindra Life Insurance Co. Ltd.

4^th Floor, Vinay Bhavya Complex, 159, ACST Road, Kalina, Santa Cruz (E), Mumbai

2. Kotak Mahindra Life Insurance Co. Ltd.

3^rd Floor, Siddhi Vinayak Complex, Opp. Surbhi Mal, Bhavnagar. …Appellant Vs Legal heir of deceased Dhanabhai Manjibhai Rathod Mangiben Manjibhai Rathod At Bhilvas Palitana, Dist. Bhavnagar …Respondents CORAM: Hon’ble Mr. R. N. Mehta, Presiding Member Hon’ble Ms. P. R. Shah, Member APPEARANCE: Darshil Parikh for V. P. Nanavaty, Ld. Adv. for the appellant D. V. Trivedi, Ld. Adv. for the respondent.

Order by Hon’ble Ms. P. R. Shah, Member.

1. The present appeal is filed by the appellant being aggrieved by and dissatisfied with the order passed by the Ld. District Consumer Disputes Redressal Commission of Bhavnagar dated 29.05.2015 in complaint no.183/14.

2. When the matter was called out Ld. Adv. Mr. Darshil Parikh for the appellant and Ld. Adv. Mr. D. V. Trivedi for the respondent were present.

Impugned judgment

3. The Ld. District Commission partly allowed the complaint and directed the opponent to pay to the complainant Rs.10,00,000/- at 6% interest, from the date of order till the actual realization of the amount, and Rs.500/- for litigation cost and Rs.1,000/- for mental harassment.

4. Facts of the case The complainant is the mother of DLA and legal heir and nominee in the policy. It is the case of the complainant that the agent and officials of the opponent insurance company gave deceptive information related to the policies of the opponent, and lured her son/the LA to agree to take the policy of the opponent. Thereafter, the agent of the opponent took the signature of the LA on the form which was in English. On asking to explain the contents of the form in Gujarati, the complainant states that the agent informed that this is just a formality and nothing serious is at risk. The LA paid the premium and the opponent issued policy Kotak term plan policy bearing no.02404642 on 16.11.2011 in the name of the proposer and LA Dhanabhai Manjibhai Rathod for sum assured of Rs.10,00,000/- with policy term of 30 years, with annual premium frequency amount of Rs.2,215/-. The complainant’s son DLA died due to heart attack on 16.10.2012. The complainant submitted the claim form with required documents to the opponent on 20.04.2013. The opponent vide letter dated 25.09.2013 repudiated the claim of the complainant. Alleging unfair trade practice and deficiency in service on the part of the opponent, complainant filed the case before the Ld. District Commission.

Arguments of the appellant/original opponent

5. The appellant contends that the order of the Ld. District Commission is against the law and weight of evidence on record and the inferences drawn and conclusions arrived at by the Ld. District Commission are erroneous. The Ld. Adv. for the appellant contends that the LA has misrepresented his income in the proposal form. It is contended that the LA was BPL card holder but had overstated his annual income in the proposal form as Rs.1,00,000/- in order to make himself eligible for the said policy. It is further contended, that the LA has suppressed materially correct fact that he was already having life insurance policy of Rs.8,00,000/- from the HDFC Standard Life Insurance Co. Ltd. The Ld. Adv. has further argued that the contention of the complainant that the LA was not explained the terms and conditions of the policy does not hold ground as the LA has made a declaration that the terms and conditions were explained in vernacular language by the representative. It is further argued that as per the provision of Section 45 of the Insurance Act, there is violation of the terms and conditions of the policy and therefore, the appellant has rightly repudiated the claim of the complain