It is definitely quite crucial to note that in a very significant step, the Orissa High Court in a most notable judgment titled Tapaswini Panda vs Zonal Manager, LIC of India, Patna & Ors in WP(C) No. 17627 of 2016 that was heard on 17.5.2024 and then pronounced finally on 24.7.2024 and presided over by the Single Judge Bench comprising of Hon'ble Mr Justice SK Panigrahi has directed the Life Insurance Corporation of India (LIC) to reassess and disburse the claim of the petitioner - Tapaswani Panda, within one week thus highlighting the unreliability of voter ID as the proof of date of birth in insurance matters. We must note that the Bench was unequivocal in maintaining that, "The Insurance Company erred in rejecting the petitioner's claim solely on the ground that the deceased insured's date of birth, as recorded in the voter ID/voter list, differed from the date of birth stated in his other documents." We need to note here that this brilliant judgment also highlighted that the deceased's date of birth was consistently listed as 18th March 1952 across all documents except the voter ID, thus questioning the LIC's reliance on the latter. Very rightly so.
At the very outset, this brief, brilliant, bold and balanced judgment authored by the Single Judge Bench comprising of Hon'ble Mr Justice Dr SK Panigrahi sets the ball in motion by first and foremost putting forth precisely in para 1 that, "The Petitioner, in this Writ Petition, seeks to challenge the award dated 31.03.2015 passed by the Insurance Ombudsman, Odisha, Bhubaneswar, wherein the Tribunal has confirmed the repudiation of death Claim under Policy No.593967375, Plan/term:165-11 for an assured sum of Rs.5,00,000/- (Five Lakh) by the Opp. Parties vide its letter dated 25.3.2013, for the aforesaid policy being illegal and arbitrary."
To put things in perspective, the Bench then envisages in para 2 while dwelling briefly on the facts of the case stating that, "Succinctly put, the facts of the case are as follows:
(i) Late Raghunath Nayak, the father of the petitioner, had made three policies of Life Insurance Corporation of India, Sambalpur Division bearing policy No. 593080488, 593891802 and 593967375 respectively. The Opp. Party No. 2 also issued bonds in the respective policies. The father of the petitioner made a policy no.593891802 where in date of birth of late Ragunath Naik was declared to be 18.03.1952 on the basis of previous policy.
(ii) The Opp. Parties accepted the same and issued bond in favour of late Ragunath Naik. Thereafter, the Opp.Parties accepted premium for the aforesaid policy.
(iii) On 18.9.2010, Raghunath Nayak made another policy with the Opp. Party No.1 bearing Policy No.593967375 wherein date of birth has been declared as 18.03.1952 on the basis of previous policies status. The sum assured of the aforesaid policy was Rs.500000/-. The Opp. Party No.1 also accepted the same and issued bond no.8907. Thereafter, the Opp. Parties accepted premium for the aforesaid policy. It is pertinent to mention that in the aforesaid policies the petitioner is the nominee.
(iv) As a matter fact, the policy holder namely Rghunath Nayak died on 15.03.2012. and thereafter the petitioner who is the nominee to the policies of the deceased Raghunath Nayak made claim for the insured amount to the Opp.Party No. 2 under the prescribed format including all required credentials and the same has been duly accepted
(v) After the claim made by the petitioner as the nominee to the policy holder for settlement of death benefit of her late father under the aforesaid three policies. It is pertinent to mention that the Opp. Party No.2 has settled the benefit under the two policies i.e. Policy nos.: 593080488, 593891802, but on 25.3.2013 the Opp. Party No.1 repudiated the benefit/claim under the Policy No.593967375 on account of the fact that there is mismatch in the age of the deceased father of the petitioner. Accordingly, as per Section 45 of the Insurance Act, the policy shall be void and all the claims or any benefit will cease and all the money paid in consequence thereof shall belong to the Corporation.
(vi) Aggrieved by the aforesaid letter of repudiation dated 25.03.2013, the petitioner made a representation to the Opp. Party No. 3 praying therein that in order to settle the claim of death in favour of the nominee.
(vii) Opp. Party No. 1 treated the representation of the petitioner as an appeal and referred the matter to the Insurance Ombudsman, Odisha, Bhubaneswar i.e. Opp. Party No.3 wherein the learned Insurance Ombudsman issued notice to the petitioner to appear and present her case. It is further submitted that after hearing both the parties the learned Insurance Ombudsman vide its order dated 25.3.2015 has been pleased to dismissed the grievance of the petitioner on the ground of suppression of age of the policy holder thereby confirmed the repudiation of claim of the petitioner vide letter dated 25.03.2013, though the latest status of the policy shows that the age proof the deceased policy holder is as per the previous policy."
As we see, the Bench observes in para 6 that, "At the outset, an insurance policy must not be obtained through fraudulent actions by the insured. If fraudulent activity is discovered, the claim may be repudiated. The proposer must demonstrate bona fide intentions, which must be evident from the record. In such cases, it is not required for the insurer to prove that the suppression of information was done fraudulently by the policyholder, or that the policyholder was aware of the falsity of the statement or the material fact that was suppressed. A deliberate false statement that significantly impacts the insurance contract may lead to the policy being invalidated in law if discovered."
Do note, the Bench notes in para 7 that, "In this case, the discrepancy in the date of birth of the insured in the insurance policy would indeed be detrimental to the petitioner's claim. In this case, the discrepancy in the date of birth in the insurance policy would indeed be detrimental to the petitioner's claim. However, there is an important consideration: the date of birth of the insured is consistent across all documents except the voter ID/electoral roll, which is, clearly, the sole basis for the Opp. Party/insurer's argument. Therefore, the resolution of the case hinges on the evidentiary value and credibility of the date of birth as recorded in the voter ID or electoral roll. The court must evaluate whether the voter ID or electoral roll entry is a reliable source of the insured's date of birth."
Be it noted, the Bench then notes in para 8 that, "Now, in the realm of insurance policies, the veracity of one's date of birth is paramount, forming the bedrock upon which risk assessments and premium calculations rest. While a Voter ID card is a widely recognized identification document for civic duties, it is often deemed to be a nonstandard proof of date of birth within the insurance industry. This preference stems from the Voter ID's primary purpose of verifying eligibility to vote rather than establishing a chronological record of one's birth. Consequently, insurers tend to favor more authoritative documents, such as school certificates or certified municipal records, to ensure the accuracy and reliability of the insured's personal information, thereby minimizing potential discrepancies in coverage provisions."
While citing a relevant case law, the Bench then states clearly in para 9 that, "The Supreme Court in Susil Kumar v. Rakesh Kumar, (2003) 8 SCC 673 observed that date of birth contained in the voter list and the Election Identity Card are recorded as per the statement made by the person concerned and as such are not conclusive proof of date of birth."
Viewed thus, we see that the Bench then holds most significantly in para 12 that, "Based on the discussion above, it is evident that the Insurance Company erred in rejecting the petitioner's claim solely on the ground that the deceased insured's date of birth, as recorded in the voter ID/voter list, differed from the date of birth stated in his other documents."
Needless to say, the Bench states in para 13 that, "It is generally accepted by Indian Courts that the date of birth recorded in the voter ID/voter list should not be relied upon to determine a person's age. This view is subscribed to by the Insurance Companies' policies, which categorize the voter ID as a non-standard proof document."
It is worth noting that the Bench notes in para 14 that, "The voter list is compiled based on the statements and particulars provided by the individual, making it self-serving evidence. Therefore, it is unsafe to place significant reliance on it in such matters. Furthermore, the deceased/ insured's voter ID was likely issued during a time when automation, online records, and the internet existed only in a person's fever dream. It is common for dates of birth to be inaccurately recorded in many documents issued during that period. This case also falls in the category of such case."
Most forthrightly, the Bench mandates in para 19 that, "Based on the analysis of both factual and legal aspects of the case, this Court concludes that the Opp. Party/Insurance Company erred in dismissing and rejecting the rightful claim of the Petitioner."
It cannot be lost sight of that the Bench is at pains to point out in para 20 lamenting that, "Unfortunately, it is a well-observed phenomenon that insurance companies, while readily accepting premiums from their clients, often adopt practices that result in significant challenges for policyholders at the time of filing claims. This dichotomy between the ease of premium collection and the rigorous scrutiny applied during the claims process highlights a critical area of concern in the insurance industry."
Frankly speaking, the Bench then rightly concedes in para 21 that, "The process of paying premiums is streamlined, with multiple options available to ensure timely and hassle-free payments. However, when it comes to the moment of truth-filing a claim-policyholders often encounter a starkly different experience. The claims process can be arduous, marked by extensive documentation requirements, prolonged investigations, and meticulous scrutiny of every detail. Clients may find themselves entangled in bureaucratic red tape, facing delays and denials that can exacerbate their distress, particularly during times of personal loss or crisis."
It also cannot be ever glossed over that the Bench then suggests in para 22 underscoring that, "It is, thus, strongly suggested that insurance companies critically evaluate their actions and prioritize working for the benefit of their customers. While the primary goal of any business is profitability, the insurance industry must balance this objective with a commitment to fairness and customer satisfaction."
Resultantly, the Bench then directs in para 23 that, "Based on the foregoing, it is hereby ordered that the Opposite Parties to correct the identified error and reassess the Petitioner's claim. Additionally, the Opposing Parties are directed to disburse the insured amount to the Petitioner within one week from the date of receipt of this judgment/order."
Finally, the Bench then aptly concludes by holding decisively in para 24 that, "The Writ Petition is, accordingly, allowed."
