A Delhi district consumer forum has directed Aviva Life Insurance Company Pvt Ltd to pay Rs 13.5 lakh to a late policy holder's sister for rejecting her claim for the sum assured on her brother's death.
The insurance company had rejected the claim on the ground that the policy holder had given a wrong date of birth.
Holding the rejection of the claim as "arbitrary," the New Delhi District Consumer Disputes Redressal Forum said the wrong date of birth was mentioned in the proposal form due to a "lapse" by the insurance firm.
"It's lapse on their (Aviva's) part that the wrong date of birth was mentioned in the proposal form. It is a clear case of deficiency on the part of the opposite party (Aviva)
and hence repudiation of claim is totally arbitrary. The intention of the opposite party since beginning is malafide and is liable for statutory action under the Insurance Act.
"Opposite party is directed to pay Rs 12 lakh (insured amount)... We also award Rs 1,50,000 (as damages) for mental agony, harassment and litigation charges," the bench presided by C K Chaturvedi said.
Renu, resident of Noida in Uttar Pradesh, had said in her complaint that her brother Praveen Kumar, 54, had purchased a life insurance policy from Aviva in which she was made the nominee and on his death she was to receive Rs 12 lakh.
Her brother had died on January 31, 2006 and she had filed the claim for the assured amount but it was rejected by the insurance company on the ground that the date of birth was wrongly mentioned in proposal form, she had said.
She had said a senior Aviva executives had filled up the proposal form and all required documents were supplied to them, but they had wrongly mentioned the date of birth as November 18, 1954 instead of November 18, 1952.
The insurance company had taken the plea, in its reply to the complaint, that the claim was rejected as the policy holder had wrongly mentioned his date of birth in the proposal form.
The forum, however, rejected the contention saying the insurance company has "falsely implicated" the policy holder by disputing that he had wrongly mentioned his date of birth in the proposal form "whereas the facts of this case is that proposal form was filed up by the opposite party's senior executives"