Gurinder Kaur vs Life Insurance Corporation of India

BRIEFLY stated the facts are that Sh. Karaj Singh son of Sh. Assa Singh had got himself insured to the tune of Rs. 5 lakh from the branch office, Taran Tarn of opposite party on 5.11.99 vide Policy No. 470619681. The copy of the policy is Annexure C-1. After issuance of policy, he had been paying instalments regularly till his death which took place on 20.2.2001 at his house. He was hale and hearty and was not suffering any kind of disease at the time of death. The copy of the death certificate is Annexure C-2.

IT was next averred that the complainant is widow of Karaj Singh and she lodged claim with OP with respect to the amount under the policy but OP after long delay repudiated the claim vide letter dated 30.3.2002 on the ground that at the time of filling the proposal form, Karaj Singh had not given correct information with regard to his health. Alleging deficiency in service, the complaint was filed and claimed Rs. 7 lakh as compensation including Rs. 2 lakh as compensation for harassment and mental agony, etc.

Opposite party contested the complaint and filed written reply. It denied the allegations and stated that the death of Karaj Singh was not natural but he died on 20.2.2001 due to brain haemorrhage. It further stated that before submission of proposal form, he was suffering from hypertension and heart ailment. It next stated that after submission of proposal form dated 16.11.1999, Karaj Singh did not appear before the medical officer for examination and ECG test but some other person was produced on his behalf, thus, he did not give proper information about his health and the medical report had been obtained by impersonation and forgery and as such the complaint should be dismissed.

THE complaint was initially instituted in the State Commission, Punjab on 4.2.2003 which was later on transferred to this Commission by the order of Hon''ble National Commission. None appeared on behalf of complainant, although Counsel for respondent had informed the Counsel for complainant Mr. Deepak Nayyar.

WE have heard Counsel for opposite party Mr. B.J. Singh and carefully gone through the file. It is an admitted fact that Sh. Karaj Singh had obtained insurance policy bearing No. 470619681 from opposite party for Rs. 5.00 lacs on 5.11.1999 and he died on 20.2.2001. The death certificate Annexure C-2 proves this fact. Annexure C-1 is proposal form which was filled by Karaj Singh at the time of getting insurance policy dated 16.11.1999. The policy was issued starting from 5.11.1999 and date of maturity was 5.11.2015. The premium payable was Rs. 17,197 annually. The date of birth is mentioned to be 5.11.1955. Annexure OP-3 is certificate issued by the doctor of Insurance Company Dr. Gurdesh Kumar Mehta after examining Karaj Singh. It is also signed by Karaj Singh. Annexure OP-4 is another medical certificate dated 16.11.1999. It is also signed by Karaj Singh. When signatures on Annexure OP-3 and Annexure OP-4 of Karaj Singh are compared with signatures on the proposal form annexure OP-2, then it cannot be said with certainty that Karaj Singh had not signed on the medical examiner''s confidential reports i.e. Annexures OP-3 and OP-4. Of course, Jassy Anand, Finger Prints and Handwriting Expert had stated that signatures on the proposal form OP-2 and medical examiner''s confidential reports OP-3 and OP-4 are of different persons but we have compared signatures in view of powers vested under Section 73 of Indian Evidence Act and hold that report of Finger Prints and Handwriting Expert is not reliable and in fact signatures of Karaj Singh on proposal form OP-2 tally with signatures of Karaj Singh on OP-3 and OP-4. There is another peculiar fact to discard the report of documents'' expert because the proposal form OP-2 and medical examiner''s confidential reports OP-3 and OP-4 are signed by Dr. Gurdesh Kumar Mehta and these documents are further signed by Karaj Singh, insured. It is not the case that medical examiner''s confidential reports OP-3 and OP-4 are by different doctors but Gurdesh Kumar Mehta had also signed the proposal form as well as the medical examiner''s confidential reports. If Karaj Singh had not appeared before Dr. Gurdesh Kumar Mehta at the time of issuance of medical examiner''s confidential reports on 16.11.1999, then he would not have given the certificates. Proposal form as well as medical examiner''s confidential reports are of the same date i.e. 16.11.1999. Either the medical examiner had colluded with Karaj Singh or all the three documents were signed by one person i.e. Karaj Singh. If we minutely compare signatures, then we find that there are many similarities in the words of writing Karaj Singh because words ''K'', ''r'', ''a'' , ''s'' and ''h'' are similar. The matter went up to the insurance ombudsman, whose copy of award is Annexure OP-11. The main plea of OP was that Karaj Singh deceased (life assured) was suffering from hypertension and blood pressure and he had paralytic attack three years back. The burden to prove this fact was on OP but OP had not produced any satisfactory/acceptable evidence to prove this fact. Of course, certificate from one doctor namely Dr. Lakhbir Singh Sandhu OP-8 has been produced to prove that Karaj Singh was under his treatment for hypertension and heart disease but this certificate cannot be relied upon because the said certificate is neither dated, nor, on the printed letterhead and did not even mention the registration number of the doctor. The certificate does not disclose the specific period during which life assured was suffering from hypertension and heart disease. There is no mention of paralytic attack suffered by the life assured. The other plea of OP is that he had taken treatment from Kakkar Hospital but no document of Kakkar Hospital has been placed on file to prove that he was suffering from some disease. Thus, it has not been substantiated that he was suffering from hypertension and heart disease and had attack of paralysis. Therefore, we hold that he was hale and hearty when he got insurance policy and had died a natural death due to bursting of vein of brain on 20.2.2001 and the opposite party is liable to pay the death claim.

CONSEQUENTLY the complaint is accepted with costs of Rs. 10,000 and opposite party is directed to pay assured sum of Rs. 5 lakh to the complainant with interest @ 9% p.a. from the date of repudiation of claim vide letter dated 30.3.2002 till payment. The interest will also take care of compensation claim on account of mental agony and harassment, etc.

COPIES of this order be communicated to the parties, free of charge. Complaint allowed.