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2020 Supreme(Online)(NCDRC) 878

NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION
MR. PREM NARAIN, Presiding Member
MEGHARAM BIDIASAR – Appellant
Versus
BRANCH MANAGER, LIFE INSURANCE CORPORATION OF INDIA & ANR. – Respondent
REVISION PETITION NO. 3605 OF 2017 | Appeal No. 539/2017



Advocates:
For the Appellant: Mr. Ankit Acharya
For the Respondent: Mr. Santosh Kumar

The court emphasized the necessity of utmost good faith in insurance contracts, ruling that claims based on forged documents are invalid, reinforcing the principle of accountability for signed proposal forms.

Headnote:(A) Consumer Protection Act, 1986 - Sections relevant to repudiation of insurance claims based on forged documents - Claim denied due to counterfeit documentation - Upholding of the preliminary inquiry and reaffirmation of the exclusion of claims based on fraudulent misrepresentation is established. (Paras 3, 9)

(B) Insurance - Good faith principle breached - The court emphasized that signing a proposal form includes liability for its accuracy and content, irrespective of who filled it, stressing the importance of truthful representation in insurance agreements. (Paras 7, 8)

Facts of the case:
The petition arises from an insurance claim repudiation after the insured's death, citing fraud in date of birth verification. The District Forum initially awarded the claim, but the State Commission reversed this ruling, deeming the claim based on a forged school certificate.

Findings of Court:
The court noted the strong reliance on forged documents, highlighting the insured’s breach of duty to provide accurate information in the proposal form, which nullified the insurance claim.

Issues: The court addressed the legitimacy of documentation proving the insured's identity and birth date, evaluating the responsibilities of the insured in verifying information. The court also analyzed the evidentiary weight of the school certificate against other available identity documents.

Ratio Decidendi: The court maintained that the presence of forged documentation severely compromises the validity of the insurance claim, requiring utmost good faith from the insured to uphold the integrity of the insurance contract.

Result: Revision petition dismissed; State Commission’s order upheld.

Table of Content
1. revision petition filed challenging order of state commission. (Para 1 , 2)
2. claim denied based on forged documents established during investigation. (Para 3 , 4)
3. discrepancies in birth verification questioned; reliance on forged certificate ruled unacceptable. (Para 5 , 6)
4. violation of utmost good faith justifies claim rejection. (Para 7 , 8)
5. revision petition dismissed; inquiry under 340 cr.p.c. set aside. (Para 9)

This revision petition has been filed by the petitioner Megharam Bidiasar against the order dated 12.10.2017 of the State Consumer Disputes Redressal Commission, Rajasthan (in short ‘the State Commission’) passed in First Appeal No.539/2017.

2. Brief facts of the case are that wife of the petitioner/complainant took an insurance policy from the respondent Life Insurance Corporation for sum insured of Rs.2,00,000/- and policy period was 30 years from 28.12.2013 till 28.12.2043 and the insured expired on 29.08.2015. The complainant filed a complaint before the Insurance Company. The Insurance Company appointed an investigator. It was found that the date of birth mentioned in the proposal form was mentioned on the basis of a certificate given by school. However, the certificate was found to be forged and therefore, the claim was not payable. The claim was thus repudiated and the petitioner/complainant filed consumer complaint bearing no.246/2017 before the District Forum challenging the repudiation. The complaint was resisted by the respondents/opposite parties by filing the written statement. It was stated that the certificate on which the date of birth was mentioned in the proposal form was found to be forged and therefore, the information given by the insured in the proposal form was not correct. Hence, the claim was not payable. The District Forum, however, allowed the claim and directed the respondents to pay Rs.2,00,000/- along with interest of 9% p.a. from the date of presentation of the complaint i.e. 07.10.2016. The District Forum also awarded Rs.10,000/- as compensation for mental agony and Rs.5,000/- as litigation cost. The respondent Insurance Company preferred appeal bearing no.539 of 2017 before the State Commission and State Commission allowed the appeal and quashed the order of the District Forum. The State Commission also ordered to hold an inquiry under Section 340 Cr.P.C. for offence under Sections 193, 196, 197 and 198 of IPC against the petitioner and the concerned officers who issued the Aadhar Card and Bhamashah Card.

3. Hence, the present revision petition.

4. Heard the learned counsel for both the parties and perused the record. The learned counsel for the petitioners stated that the date of birth given in the proposal form is 10.07.1992. The same date is also mentioned in the Aadhar Card and Bhamashah Card issued by the Government. It was argued by the learned counsel for the petitioner that point no.5 of the claim inquiry report by the investigating officer of the Company clearly stated that the school certificate was forged by CLIA (the agent of the company). It was argued that the proposal form was filed by the agent as the insured could only make her signature as she was not literate. The learned counsel further stated that it was true that the Aadhar Card and Bhamashah Card were of the subsequent date to the death of the insured, but the insured had applied for Aadhar Card and Bhamashah Card before her death. As per the acknowledgment slip, the insured applied for Bhamashah Card on 28.08.2015 and she applied for her Aadhar Card on 20.7.2015. It was argued that these cards were received after her death though she had applied for these cards much earlier. These cards also mention the date of birth as 10.07.1992. It was further argued by the learned counsel for the petitioner that as per her Voter Identity Card which was issued to her on 07.06.2013, her date of birth was also 10.7.1992. It was argued by the learned counsel that the proposal form was filled on 30.12.20

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