IN THE DELHI STATE CONSUMER DISPUTES REDRESSAL COMMISSION Date of Institution: 16.07.2018 Date of Hearing: 17.07.2025 Date of Decision: 28.07.2025 FIRST APPEAL NO.-317/2018 IN THE MATTER OF MS. MINAKSHI DEVI, W/o Late Shri Harish Kumar, H-10, Mann Nagar, Dera Baba Nanak Road, Batala, District Gurdaspur, Punjab-143505.

(Through: Mr. Sidharth Aggarwal, Advocate)

…Appellant VERSUS

1. MAX LIFE INSURANCE COMPANY LIMITED, (Formerly known as Max New York Life Insurance Co. Ltd.)

Having its Registered Office at:

Max House, 3^rd Floor, 1 Dr. Jha Marg, Okhla, Phase-III, New Delhi-110020.

2. MAX LIFE INSURANCE COMPANY LIMITED, (formerly known as Max New York Life Insurance Co. Ltd.)

Through its Executive-Claims, Customer Service Unit, 11^th & 12^th Floor, DLF Square, Jacaranda Marg, DLF City, Phase-II, Gurgaon-122002

3. MAX LIFE INSURANCE COMPANY LIMITED, (formerly known as Max New York Life Insurance Co. Ltd.)

Through its Branch Manager, 17-18-19, Lala Lajpat Rai Marg, Kailash Colony, New Delhi-110048.

(Through: Mr. Inderdeep Singh, Advocate)

…Respondents CORAM:

HON’BLE JUSTICE SANGITA DHINGRA SEHGAL (PRESIDENT)

HON’BLE PINKI, MEMBER (JUDICIAL)

Present: Mr. Sidharth Aggarwal, counsel for the Appellant appeared through VC.

Mr. Ish Preet Singh & Mr. Piyush Sehgal, counsel for the Respondent.

PER: HON’BLE JUSTICE SANGITA DHINGRA SEHGAL, PRESIDENT

JUDGMENT

1. The facts of the case as per the District Commission record are as under:

“The case of the complainant is that her husband, Late Sh.

Harish Kumar, took four Life insurance policies from OP-3 and at the time of submission of the proposal form, the agent/advisor of the OPs had duly satisfied himself of the correctness of all the material particulars filled in by the husband of the complainant in the proposal forms. It is submitted that the agent advisor of OP-1 has given a declaration to the effect that the proposer Sh. Harish Kumar does not suffer from any physical or mental abnormality or has/had been hospitalized, undergone any surgery or treatment at the time of obtaining the aforesaid policies and/or has suppressed any material fact with regard to his state of health. The proposal form of the husband of the complainant was accepted by OP-3 and after fully verifying the material particulars as submitted in the proposal form, following polices were issued by OP-3:-

a) Policy No. 244154217 dated 15/07/2004 for sum of Rs.3,00,000/-

b) Policy No 244154209 dated 15/07/2004 for sum of Rs

1,00,000/-

c) Policy No.251591194 dated 20/12/2004 for sum of Rs.5,00,000/-

d) Policy No. 251591129 dated 20/12/2004 for sum of Rs

3,00,000/-

Before issuance of these policies, the husband of the complainant filled up proposal form and the agent of OP duly satisfied about the particulars given by the husband of the complainant. On 23.07.2005 at about 6.25 P.M., the husband of the complainant was shot dead by some unidentified person and he died on the spot The matter was reported to the police immediately and for that FIR was recorded.

The complainant is the widow of late Sh. Harish Kumar, who has taken the policy, is his nominee. The complainant immediately intimated the Claim Department of OP1 i.e. OP-2 on 26.07.2005 about the death of her husband and submitted the claim.

OP-2 vide its letters dated 11.08.2005 and 26.09.2005 sought certain documents in order to complete the claim formalities. The complainant in compliance of the aforesaid letters submitted the original policies alongwith Claimant Statement. In order to harass the complainant, OP again called for certain documents vide letters dated 02.12.05, 26.12.05 and 18.04.06. The sole motive of OPs was to deprive the complainant from receiving its legitimate dues. The complainant vide letter dated 05.06.06 clearly stated that she has already submitted all the relevant documents. Complainant was shocked to receive another letter dated 19.06.06 from OP-2 whereby she was asked to submit further documents pertaining to treatment of her husband The complainant has already clarified