Page 23 - Suri’s - NCDRC ON LIFE INSURANCE 2017 V1.3

Suri’s - NCDRC ON LIFE INSURANCE 2017 23

ORDER
JUSTICE V.K. JAIN (ORAL)

Late Shri Sanwarmal Todi, father of the complainant, submitted a proposal dated
29.3.2012 to the petitioner for obtaining an insurance policy. In the aforesaid pro-
posal, he interalia declared that he was not suffering from Diabetes. However, in the
Questionnaire dated 31.3.212, he interalia admitted that he was suffering from Diabe-
tes for last more than 5 years and he had been on medication. The name of the medi-
cine being taken by him was also disclosed in the answer to the Questionnaire. The
cheque whereby premium of Rs.45,000/- was paid by the deceased was encashed by
the petitioner. The case of the petitioner is that since the deceased was suffering from
Diabetes, the proposal was never accepted by it and the amount received from him
was sent back vide cheque No.482353 sent by Regd. Post on 25.4.2012. The aforesaid
cheque, however, could not be served upon the deceased, he having expired in the on
25.4.2012. After the death of the deceased, the complainant submitted a claim for
payment in terms of the policy for which the proposal had been submitted by the de-
ceased. The claim was rejected vide letter dated 23.5.2013 which to the extent it is
relevant, reads as under:-
―This is with reference to your concern registered with us for the Birla Sun
Life Insurance Plan Policy No. 005515236.
We wish to inform you that we had received the Application No.A46115297
for Policy Number 005515236, however the same rejected by the underwriting in
the initial stage due to medical reasons and the initial premium of Rs.45,000/- was
processed through cheque number 482353 and the same was dispatched to your
registered address on April 25, 2012; but the same was received undelivered to
Head Office.
In order to issue the refund cheque in your name, kindly submit the below
mentioned requirements at the nearest Birla Sun Life Insurance Branch:
Deed of relinquishment DOR – notarized on a Rs.200 stamp paper
Death Certificate
Photograph of the proposed policy owner
Proof of identity of the proposed policy owner
Proof of residence of the proposed policy owner
On receipt of the same needful shall be done.‖
Being aggrieved from the rejection of the claim, the complainant approached the
concerned District Forum by way of a consumer complaint alleging therein that the
policy No.005515236 had been issued to him by the petitioner company.
2. The complaint was resisted by the petitioner interalia on the ground that
since the proposal was never accepted by them, no concluded contract of insurance
came into existence and no policy or document was actually issued to the deceased.
3. The District Forum having ruled in favour of the complainant, the petitioner
approached the concerned State Commission by way of an appeal. The said appeal
also having been dismissed, the petitioner is before this Commission by way of this
revision petition. The learned counsel for the petitioner company has drawn my atten-
tion to clause 5 of the receipt which was issued to the deceased at the time cheque of

INDEX