Gulab Singh vs HDFC Standard Life Insurance Co. Ltd. & Anr

V.K. Jain, J

Late Shri Balbir Singh, uncle of the petitioner obtained an insurance policy from the respondent HDFC Standard Life Insurance Co. Ltd. on 10.8.2013 for a sum assured of Rs.11.00 lacs. He having died just after one month of purchasing the policy, a claim for payment of the benefit available under the insurance policy was lodged by the complainant / petitioner. The claim however, was repudiated vide letter dated 16.9.2014, which to the extent it is relevant reads as under:

"The proposal was accepted based on the information provided in the proposal form and the policy was issued on the August 10, 2013.

In this connection we refer to the section B in the said application, with deals with "PERSONAL DETAILS OF LIFE TO BE SURED" under this section the life assured had declared his date of birth as August 01, 1965 and had produced PAN card as proof of the same. On the basis of aforesaid date of birth, the life assured was aged 48 years at the time of his death.

However, through the investigations we had established that the correct age of life assured is 68 years at the time of death and that the date of birth declared by him in the application for insurance was false. We are satisfied that the company has been led to issue the above policy on the basis of false document which renders the contract of insurance under the policy to the void abinitio."

Being aggrieved from the repudiation of the claim, the petitioner / complainant approached the concerned District Forum by way of a consumer complaint.

The complaint was resisted by the insurer, which alleged that the insured had suppressed material facts, while obtaining the insurance policy. He claimed to be 48 years old at the time of taking the policy, whereas his correct age at that time was 68 years. It was further alleged that the deceased was suffering from cancer of neck and the said ailment was concealed by him while taking the insurance policy.

The District Forum having dismissed the consumer complaint, the petitioner approached the concerned State Commission by way of an appeal. The said appeal also having been dismissed, he is before this Commission by way of this revision petition.

The learned counsel for the petitioner submits that the insurer cannot be allowed to travel beyond the ground in the repudiation letter and since concealment of cancer was not one of the grounds for repudiating the claim, the fora below were not justified in dismissing the consumer complaint on the aforesaid ground. In view of the decision of the Hon'ble Supreme Court in Galada Power and Telecommunication Ltd. Vs. United India Insurance Company Limited & Anr. (2016) 14 SCC 161, it can hardly be disputed that the insurer cannot be allowed to go beyond the grounds on which the claim is repudiated. Therefore the only question which requires to be considered is that as to whether the deceased had concealed his correct age at the time of obtaining the insurance policy or not.

A perusal of the proposal submitted by the deceased insured to the insurer would show that he claim, at the time of taking policy, that his date of birth was 01.8.1965, meaning thereby that he was about 48 years old at that time. The petitioner himself has placed on record a copy of the identity card issued to the deceased Balbir by Election Commission of India. As per the said identity card, he was 36 years old as on 01.1.1994. Therefore, going by the aforesaid identity card, he was born in the year 1958. Therefore, it can hardly be disputed by the petitioner that the correct age of the deceased insured was not given at the time of taking the insurance policy.

The date of birth of the insured is a material fact which needs to be correctly shared with the insurer, since, while considering the proposal, the insurer has to consider inter-alia the age of the proposer in order to decide whether it should accept the proposal or not. Based upon the age of the proposer, the insurer may either reject the proposal, it may ask him to undergo medical examination or it may charge a higher premium considering the risk commensurate with his age.

The contract of insurance being based upon utmost good faith, the insured must correctly share all material facts, including his age with the insurer. That having not been done in this case, the orders passed by the fora below does not call for any interference by this Commission in exercise of its revisional jurisdiction. The revision petition is accordingly dismissed.