Life Insurance Corporation of India and Ors. vs SHAMIM

THIS appeal by the appellant/opposite party - Insurance Co. is directed against the order dated 5.2.2002 of Consumer Disputes Redressal Comission U.P., Lucknow whereby it was directed to pay a sum of Rs. 5.00 lakh alongwith interest @ 18% p.a. and cost to the respondent/complainant.

FACTS giving rise to this appeal lie in a narrow compass. Rais Haider obtained policy No. 220144325 dated 6.6.1992 for a sum of Rs. 5.00 lakh from the appellant -Insurance Co. Respondent is the nominee under the policy. Rais Haider died on 29.5.1996. Respondent intimated the Insurance Co. of his death on 16.9.1996 and supplied the information asked for by the Insurance Co. on 24.9.1996 and 21.11.1996. On repudiation of claim, the respondent alleging deficiency in service filed complaint seeking payment of the policy amount with interest and Rs. 5.00 lakh as compensation for mental agony. Insurance Co. contested the complaint by filing written version. It was alleged that Rais Haider made a proposal for purchase of a Whole Life (without profit) policy of Rs. 5.00 lakh on 28.5.1992. In the proposal form, it was stated that his date of birth was 5.7.1972 and his occupation was agriculture''. In support of the date of birth and educational qualification, a certificate dated 29.5.1992 from Ram Prasad Bismil Higher Secondary School, Bareilly was filed. Relying on the statements made, replies given to various questions and declaration at the foot of the proposal form, the policy in question commencing from 6.6.1992 was issued. Letter dated 30.11.1992 was received with request to transfer the policy from Bareilly to New Delhi. Signature on this letter did not tally with those on the record of the Insurance Co. Therefore, by the letter dated 25.5.1993, Rais Haider was asked to send application for transfer with his correct signature. However, no response was received from him. It was alleged that in the intimation dated 16.9.1996 received from the respondent the date and place of death of Rais Haider were not mentioned. He was, thus, asked to furnish them. While processing the claim everything did not appear above board and, therefore, investigation was made which revealed that late Mohd. Asgar had three sons viz. Mohd. Naseem, Mohd. Shamim (respondent ) and Rais Haider. In Electoral Roll of 1995 against house No. 14/6, Rajender Nagar, Bareilly only the names of the respondent, his wife and two daughters were shown. Name of Rais Haider who in the proposal form gave his address as 14/6, Rajender Nagar, Bareilly, did not appear against the said house. In proposal form, the educational qualification was shown as High School. On inquiry, Ram Prasad Bismil Higher Secondary School, Bareilly denied of having issued the certificate dated 29.5.1992 filed along with the proposal form. The certificate is fake. It was stated that during investigation, certificate of Junior High School (Class VIII) and mark sheet dated 20.5.1992 issued by Indira English Junior High School, Kanghi Tola, Bareilly were submitted by the respondent. On verification, principal of the school stated that both the certificate and mark sheet, rubber stamp and signature thereon are forged. It was stated that Rais Haider was a non -existent person. It was denied that life assured died on 29.5.1996 and was buried in the burial ground at Rajender Nagar, Bareilly as alleged. By the letter dated 3.5.1997, claim was repudiated for sufficient reasons.

WE have heard Mr. Mohinder Singh for the appellant -Insurance Co., the respondent and have been taken through the record. Repudiation letter dated 3.5.1987 (copy at pages 83 and 84) would show that the claim was repudiated by the appellant on the grounds of Rais Haider not owning any agricultural land and having income from agriculture, certificate of Ram Prasad Bismil Higher Secondary School filed in support of date of birth, etc. being fabricated, Rais Haider not having been buried in the burial ground of Rajender Nagar, Bareilly on 29.5.1996, making mis -statement in the affidavit dated 12.9.1996 by the respondent on the basis whereof death certificate was issued by Municipal Corporation, Bareilly, Rais Haider not being the brother of respondent and he being a non -existent person. Grounds of repudiation primarily pertain to the period of making proposal and post -death period. We are deciding this appeal on the assumption that Rais Haider did exist. It is not in dispute that in the proposal form the date of birth of Rais Haider was mentioned as 5.7.1992, he was shown having passed High School and his income was Rs. 1.00 lakh p.a. from agriculture. Copies of the certificate dated 29.5.1992 and writing dated 18.11.1996 from Ram Prasad Bismil Higher Secondary School are placed on the file. It is in para No. 9 of the affidavit of R.P. Bhardwaj, Sr. Branch Manager filed by way of evidence before the State Commission that the certificate dated 29.5.1992 was submitted along with the proposal by Rais Haider. In the grounds of appeal on the affidavit of respondent, it is averred that the said certificate was not submitted while making the proposal. Rais Haider was a student of Samaj Kalyan Inter -College, Saidpur Kani, Bareilly and copy of the Scholar''s register and transfer certificate obtained from the college is being filed as Annexure''B'' to the affidavit. There was no occasion of having filed the certificate of any other college in support of the date of birth. To be noted that such a case is not pleaded in the complaint nor copy of Annexure -B seems to have been filed before the State Commission. In this annexure, Rais Haider is shown to have passed VIIIth class. Obviously, this did not support that he was High School as mentioned in the proposal form. In this backdrop, there seems to be no reason to dis -believe said Shri Bhardwaj that the certificate dated 29.5.1992 was submitted while making the proposal. In aforesaid para 9 of the affidavit, it is further averred that the certificate dated 29.5.1992 was confirmed by the principal of the said Higher Secondary School vide letter dated 18.11.1986 to be forged one. In para No. 18 of this affidavit, it is also averred that during investigation by the letter dated 28.1.1997, the respondent was asked to inform the name of the school from where Rais Haider had passed the High School and what was his Roll number. Respondent submitted certificate along with marksheet purported to have been issued by Indira Junior English High School certifying that Rais Haider passed VIIIth class in 1992. On 20.12.1996, he sent a letter to the principal of the said school and in response thereto the principal vide letter dated 26.2.1997 confirmed that the said certificate and mark sheet were not issued by them and the same were forged. Copies of the certificate and mark sheet are at pages 42 and 43 while that of the letter dated 26.2.1997 at page 81. It may be mentioned that in the reply to the grounds of appeal, the respondent has denied of having submitted the said certificate and mark sheet to the Insurance Co. It is alleged that those appear to have been concocted by the Insurance Co. There was least possibility of said Shri Bhardwaj, a senior officer who did not have any personal interest in the matter, to have fabricated said certificate and mark sheet. In support of the annual income of Rais Haider to be Rs. 1.00 lakh from agriculture, the respondent heavily relied upon on the affidavit of Majid Ali dated 9.2.1999 who claimed to be owning along with his family approximately 60 Bigas of land in village Ladpur and Senthal in para No. 1 of the affidavit. In para No. 2 of the affidavit, it is averred that Rais Haider took on contract basis the said land in the years 1990, 1991 and 1992. Said R.P. Bhardwaj made an application dated 25.4.1997 to the Tehsildar Nawabganj, Distt. Bareilly (copy at page 82) seeking certification if the respondent, his two brothers, father and Rais Haider owned any agricultural land and the extent thereof. Endorsement is made at the foot of this application that none of them owned any agricultural land. Respondent also does not dispute that no land was owned by Rais Haider. In said para No. 2 of the affidavit Majid Ali has not disclosed the contract value for any of the three years nor was any agreement evidencing such transaction between Rais Haider and Majid Ali was filed before the State Commission. That apart, if Rais Haider was taking land on contract basis for agriculture, the occupation in proposal form should have been mentioned as contractor or Thekedar instead of agriculturist. Convincing evidence of Rais Haider earning Rs. 1.00 lakh p.a. from agriculture at the time of making proposal has not been filed by the respondent. In a contract of insurance, there is requirement of Uberrimae fide on the part of the insured and insured has a duty to disclose accurately all the facts which would influence a reasonable insurer in accepting the risk. From the said discussion, it must follow that mis -statement was in the proposal form, documents were forged to support the date of birth and educational qualification and income which were material facts. Having returned this finding, we need not examine the grounds of repudiation relating to post death period. There was sufficient justification for the appellant -Insurance Co. to have repudiated the claim on aforesaid grounds pertaining to the period of making proposal. State Commission fell in grave error in discarding the aforesaid documentary evidence which is by and large connected in the affidavit of R.P. Bhardwaj and genuineness whereof cannot be doubted on ground of originals thereof not having been filed by the Insurance Co. Order under appeal being legally erroneous can not be legally sustained.

ACCORDINGL Y , while allowing appeal the order dated 5.2.2002 is set aside and complaint dismissed. Respondent will pay Rs. 3,500 as cost to the appellant. Appeal allowed.