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2025 Supreme(Online)(SCDRC) 31813
STATE CONSUMER DISPUTES REDRESSAL COMMISSION
J. G. Mecwan, Presiding Member
Meetaben Subhashbhai Dixit – Appellant
Versus
Birla Sun Life Insurance Co. Ltd. – Respondent
COMPLAINT NO.24 OF 2010
For the Appellants/Petitioners: Pratik Joshi, S. G. Shah
For the Respondents: Milan Dudhia
An insurer must strictly prove allegations of material suppression of facts to repudiate a claim. Electronic records produced as evidence must comply with mandatory statutory certification requirements; failing this, the evidence is inadmissible and the burden of discharge remains unmet.
Headnote:(A) Insurance Act, 1938 - Section 45 - Suppression of material facts - Life insurance claim repudiation - Burden of proof rests upon the insurer to establish material suppression of facts - Non-disclosure of pre-existing insurance policies must be proven with admissible evidence. (Paras 5, 8, 9)
(B) Indian Evidence Act, 1872 - Section 65B - Admissibility of electronic records - Mandatory requirement of the certification of electronic evidence (email correspondence) as a condition precedent - Oral evidence cannot suffice for mandated statutory compliance - Secondary evidence lacking such certification is inadmissible. (Para 9)
Facts of the case:
The complainant sought the claim amount following the death of the life assured. The insurer repudiated the claim alleging material suppression of facts regarding existing life insurance policies held by the deceased with other companies. The matter was previously remanded to the State Commission for fresh consideration, with directives to allow evidence to be led by both parties. The insurer failed to produce admissible evidence to prove the alleged suppression, relying on uncertified email communications.
Findings of Court:
The commission found that the insurer failed to conclusively prove the allegations of material suppression. The electronic evidence (emails) submitted by the insurer failed to meet the mandatory certification requirements under Section 65B of the Indian Evidence Act, 1872, rendering them inadmissible. Consequently, the contention of suppression was not established.
Issues: The main issue was whether the insurer had sufficiently proven the allegation of material suppression of facts regarding other insurance policies taken by the deceased, and whether the electronic records submitted as evidence were admissible.
Ratio Decidendi: Where an insurer seeks to repudiate a claim based on material suppression of facts, the burden of proof lies heavily on the insurer to provide admissible evidence. Electronic records, specifically emails, fail to satisfy the evidentiary threshold if they do not comply with the mandatory certification requirements prescribed by law. Without such proof, the mere allegation of suppression cannot sustain the repudiation of a claim.
Result: Complaint allowed; Insurer directed to pay the claim amount.
| Table of Content |
|---|
| 1. procedural history and factual background of the insurance claim dispute. (Para 1 , 2 , 3 , 4) |
| 2. parties' contentions regarding non-disclosure of policies and evidentiary submissions. (Para 5 , 6 , 7) |
| 3. admissibility of electronic evidence under section 65b of the indian evidence act. (Para 8 , 9 , 10 , 11 , 12) |
ORDER BY DR. J. G. MECWAN, PRESIDING MEMBER
JUDGMENT
1. Factual Matrix:
Late Shri Subhash Bhupendrabhai Dixit took an Insurance Policy from the opponent for a sum assured of Rs. 20 lacks after paying premium amount Rs.96,165/-. After death of Subhash Bhupendrabhai Dixit (deceased of life assured – D.L.A.) on 26.12.2009, his wife sent claim papers to opponent Insurance Company to get claim amount but the claim was repudiated vide latter dt. 8.02.2010 on the ground that DLA had taken several policies of his life from other Insurance Companies.
2. Being dissatisfied with the reason given by opponent Insurance Company complainant has filed Consumer Complaint before this State Commission to get claim amount Rs.20 lacks from date 08.02.2010, Rs.2 lacks for mental torture and Rs. 50,000 for the cost of complaint.
3. After hearing both the parties, coordinating bench of this State Commission has dismissed the complaint of the complainant.
4. Being aggrieved by the impugned order of this Learned State commission, complainant has filed first appeal on 07.11.13 before Hon’ble NCDRC wherein Hon’ble NCDRC set aside the order of the state commission and matter was remitted to decide the complaint as a fresh and ordered to give opportunities to the parties to lead evidence.
Furthermore it has been directed by Hon'ble NCDRC to examine Smt. Gitaben Chapatwala as a court witness and after giving opportunity to both the parties for cross examine of Smt. Gitaben Chapatwala.
In perusing of the order passed by Hon’ble NCDRC the complainant has submitted an application for issuing summons to examine Smt. Gitaben Chapatwala (agent of Birla Sun life Insurance Company ) as a witness and on dated 24.07.2019 State Commission has passed order as under:
It is pertinent to note that letter dated 20.05.2010 is produced on 04.12.2012 but there is no endorsement of other side on the list, no order is passed on the said application nor the same is mentioned in the rojkam dated 04.12.2012. There is also no signature on this list of advocate. Considering this fact in our opinion if complainant is relying upon letter dated 20.05.2010, then she should file the affidavit of Ms. Gitaben Bharatbhai Chapatwala before us and after filing the affidavit if we think fit, then question will arise to call her for examination. If affidavit will not be placed on record by the complainant on or before 09.08.2019, then necessary order will be passed against the complainant. Copy of this order be provided to the respective parties. S. o. to 09.08.2019.
Thereafter on dated 20.06.19 Smt. Gitaben Chapatwala has filed affidavit which is on record at Page no. 186 and 187 wherein she has stated as under:
સદર વિમા પોલીસી ના સમય દરમ્યાન સુભાષભાઇનુ અકસ્માત માાં અિસાન થિાથી તેમના પરીિાર દ્રારા વિમા કાંપની માાં કલેઇમ કરલે અનેકલઇે મ પ્રોસેસ િખતેમારી વિમા કાંપની દ્રારા મનેઓરલી જણાિેલ કેતમો એ માત્ર એક પોલીસી ની વિગત પ્રપોઝલ માાં લીધેલ છે બાકીની કેમ લીધી નથી તે અનુસાંધાને મેં તારીખ 06/03/2010 તથા 20/05/2010 ના રોજ વિમા કાંપની ને બીજી વિમા પોલીસી મર્ુુમ સુભાષ ભાઇ દ્રારા જણાિેલ પરાંતુ કયા કારણ થી પ્રપોઝલમાાં એક જ વિમા પોલીસી ની વિગત લખેલ છે અને બાકીની કેમ લખેલ નથી તે બાબતનો લેખીત ખુલાસો મેવિમા કાંપનીનેકરલે આ ખુલાસો વિમા કાંપની દ્રારા મનેઓરલી જણાિેલ તેમજુ બ મેંવિમા કપની ને કરલે છે.સદર બાંન્ને તારીખ 06/03/2010 તથા 20/05/2010 ના પત્રે મારા દ્રારા જ કલેઇમ પ્રોસીઝર િખતે વિમા કાંપની દ્રારા મારો ખુલાસો ઓરલી માાંગેલ તે માટે મે આપેલ છે, જેબાંનેપત્રો મા મારી સર્ી છેજને ેર્ુાં ઓળખી બતાિુ છુ અને તેમાાં લખેલ તમામ વિગત ખરી છે. મર્ુુમ સુભાષભાઇ દ્રારા તેમનો મેડીકલ ચેકઅપ પણ કાંપની ની પોલીસી મુજબ કરાિેલ અને પ્રપોઝલ ફોમુમાાં
