IN THE HIGH COURT OF ORISSA AT CUTTACK

WP(C) No. 17627 of 2016

(In the matter of an application under Articles 226 and 227 of the
Constitution of India, 1950).

Tapaswini Panda …. Petitioner (s)

-versus-
Zonal Manager, LIC of India, Patna & …. Opp. Party (s)
Ors.

Advocates appeared in the case:

For Petitioner (s) : Mr. Debaraj Mohanty, Adv.

-versus-

For Opp. Party (s) : Mr. J. R. Deo, Adv.

On behalf of
Mr. G. Misra, Sr. Adv.
(for O.Ps.1 & 2)

CORAM:
DR. JUSTICE S.K. PANIGRAHI
DATE OF HEARING:-17.05.2024
DATE OF JUDGMENT:-24.07.2024

Dr. S.K. Panigrahi, J.

1. 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.

Signature Not Verified
Digitally Signed pg. 1
Signed by: BHABAGRAHI JHANKAR
Reason: Authentication
Location: ORISSA HIGH COURT, CUTTACK
Date: 03-Aug-2024 11:54:52
 I. FACTS OF THE CASE:

2. 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

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Signed by: BHABAGRAHI JHANKAR
Reason: Authentication
Location: ORISSA HIGH COURT, CUTTACK
Date: 03-Aug-2024 11:54:52
 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

Signature Not Verified pg. 3

Digitally Signed
Signed by: BHABAGRAHI JHANKAR
Reason: Authentication
Location: ORISSA HIGH COURT, CUTTACK
Date: 03-Aug-2024 11:54:52
 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

II. SUBMISSIONS ON BEHALF OF THE PETITIONER:

3. The counsel appearing on behalf of the Petitioner urged the following

submissions:

(i) The earlier two policies of the deceased Raghunath Naik, the death

claim amount has already been settled and paid to the petitioner

without any objection with regard to the age of the policy holder but

the Opp. Party No.1 repudiated the death benefit of the policy

holder under the policy no. 593967375 on the ground of age

mentioned in the voter id which is illegal and without any basis.

(ii) The age has been given in the policy no. 593967375 on the basis of

previous policies which has been duly accepted by the Opp. Parties

at the time of acceptance of policy and also taken a premium for the

aforesaid policy.

(iii) In the previous policy i.e. policy No. 593891802, the date of birth has

been mentioned as 18.3.1952 and when the said policy has been

settled and the same reflection in the disputed policy and

repudiation of the same and confirmation by the Opp. Party No. 1 is

otherwise illegal, arbitrary and hence liable to be quashed.

Signature Not Verified

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Signed by: BHABAGRAHI JHANKAR
Reason: Authentication
Location: ORISSA HIGH COURT, CUTTACK
Date: 03-Aug-2024 11:54:52
 (iv) The documents of the Opp. Parties itself show that, at the time of the

death, the age of the deceased was 61 years. The same is reflected in

his death certificate.

(v) The age of a person cannot be determined on the basis of the Voter

ID, as it cannot be a conclusive evidence for determination of the

age. In the instant case the Opp. Parties have accepted, the aforesaid

three policies and admitted that the age of the policy holder was

18.3.195 and on that basis the two policies have been settled in

favour of the petitioner.

III. SUBMISSIONS ON BEHALF OF THE OPPOSITE PARTY NOS.1 & 2 :

4. Per Contra, learned counsel for the Opposite Party Nos.1 and 2 urged the

following submissions:

(i). The first policy bearing Policy No. 593080488 of Life Assured was

accepted on the basis of Voter ID Card. The subsequent policy

bearing Policy No. 593891802 was completed on the basis of school

certificate and policy No.593967375 was completed on the basis of

previous policy showing D.O.B. as 18.03.1952 (i.e. whatever written

in policy No.593891802). However, during investigation it was

found that as per the Voter ID No.OR/15/113/332194, age of the

deceased Life Assured was 67 and it is against the rule of LIC to

accept any policy at this age.

(ii). The claims for the benefits under the third policy bearing Policy No.

593967375 on account of the fact that there was a mismatch of 8

Signature Not Verified pg. 5

Digitally Signed
Signed by: BHABAGRAHI JHANKAR
Reason: Authentication
Location: ORISSA HIGH COURT, CUTTACK
Date: 03-Aug-2024 11:54:52
 years in the age of the deceased father of the petitioner vide letter

dated 25.3.2013.

(iii). The Learned Insurance Ombudsman vide its award dated 34.3.2015

dismissed the case of the petitioner on the ground of suppression of

age (67 years to 59 years) of the policy holder at the time of taking

of the policy, thereby confirming the validity of the repudiation of

the claim of the petitioner.

(iv). Being a non-early claim, Policy No. 593080488 was settled without

any investigation. However, in case of early claims, claimant needs

to submit all the claim papers at a time and should clearly mention

all the policy in Claim Form A. But, in this case, the claimant

(present petitioner) deliberately deposited claim papers of different

branches (Bolangir and Sambalpur- 1) at different times. So, in the

case of Policy No.593891802, though early claim was there but

during investigation suppression of age was not revealed and the

claim was admitted unknowingly by the Opp. Parties. However,

during the investigation against Policy No. 593967375, it was found

that there was suppression of age (67 years to 59 years) of the Life

Assured at the time of taking of the policy. The Opp. Parties, thus,

repudiated the claim as per the mandate of Section 45 of Insurance

Act, 1938.

(v). Further, the Policy No.593891802 would have been repudiated, had

the suppression of age detected at time of inquiry.

Signature Not Verified

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Signed by: BHABAGRAHI JHANKAR
Reason: Authentication
Location: ORISSA HIGH COURT, CUTTACK
Date: 03-Aug-2024 11:54:52
 (vi). Insurance is a contract of uberrima fides i.e utmost good faith. At the

time of proposal stage the Opp. Parties accept proposal and other

documents without any verification. However, LIC investigates the

case, if death occurs within three years after date of commencement

of the policy or within three years after the date of revival of the

policy. In this case, as per LIC Rules policy was issued to Life

Assured and collected premium.

IV. COURT’S ANALYSIS AND REASONS:

5. I have considered the submission of the learned counsels for the parties

and perused the materials on record.

6. 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.

7. 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

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Digitally Signed
Signed by: BHABAGRAHI JHANKAR
Reason: Authentication
Location: ORISSA HIGH COURT, CUTTACK
Date: 03-Aug-2024 11:54:52
 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.

8. 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 non-

standard 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.

9. The Supreme Court in Susil Kumar v. Rakesh Kumar,1 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.

1
2003 (8) SCC 673
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Signed by: BHABAGRAHI JHANKAR
Reason: Authentication
Location: ORISSA HIGH COURT, CUTTACK
Date: 03-Aug-2024 11:54:52
 10. Further, in Babloo Pasi v. State Of Jharkhand,2 the Supreme Court

reiterated its stance and held that, in the absence of evidence indicating

the basis on which the entry in the Voters List bearing the name of the

accused was made, merely presenting a copy of the Voters List, although

it is a public document as per Section 35 of the Evidence Act, is

insufficient to establish the age of the accused.

11. In Ram Kripal alias Chirkut v. Deputy Director of Consolidation &

Others,3 the Allahabad High Court ruled that the informal nature of the

date of birth recorded in the voter list and voter ID card renders it

unreliable for determining the actual date of birth. The relevant excerpt

is mentioned hereinbelow:

“22. The evidence being insignificant would not shift the

burden on shoulders of the petitioners. There appears to be no
reason as to why Smt. Gulabi did not examine any of her
relatives in support of her case. The evidentiary value of voter-
list of the year 1966 and 1973 is also of inconsequential nature.
The voter-list is prepared on the statement and particulars
furnished by such person. It is in the nature of self serving
evidence. It is not safe to place much reliance upon it, in such
matters. However, our legal system has always emphasis on
value, weight and quality rather than quantity, multiplicity or
plurality of witness. Nothing has come on record to connect
Smt. Gulabi with the said birth entry.
23.Therefore, on facts at hand, in the absence of evidence to
show on what material the entry in the Voters List in the name
of the accused was made, a mere production of a copy of the
Voters List, though a public document, in terms of Section 35,
was not sufficient to prove the age of the accused.”

2
2008 (13) SCC 133
3
Civil Misc. Writ Petition No.13286 of 1981, All. HC
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Signed by: BHABAGRAHI JHANKAR
Reason: Authentication
Location: ORISSA HIGH COURT, CUTTACK
Date: 03-Aug-2024 11:54:52
 12. 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.

13. 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.

14. 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.

15. It is further seen that insurance contracts are heavily dependent on

reciprocal obligations and in an ideal situation, if both the parties

understand their rights and responsibilities, and acted accordingly; the

need for repudiating a claim would never arise. It has often been seen

that there is a great deal of asymmetry of information in insurance

contracts; and most of this asymmetry arises because the policyholder

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Signed by: BHABAGRAHI JHANKAR
Reason: Authentication
Location: ORISSA HIGH COURT, CUTTACK
Date: 03-Aug-2024 11:54:52
 does not understand the nuances of the contract – either on account of

the lack of awareness or owing to the fact that the insurer has not

bothered to explain the terms of the contract in their exhaustive detail. In

any case, the controversy arises only when there is a repudiation of a

claim, and by then it is too late.

16. In order to avoid such a scenario, there is need for making the proposal

form more exhaustive, simple and meaningful; and to ensure that the

proposer is explained the terms of interpretation of the queries and the

replies thereto. It is no brainer that in most repudiated cases, one

common argument is that the proposer has simply signed on the dotted

line. The importance of the queries and the declaration has to be clearly

explained to the proposer before obtaining his signature to ensure that

the asymmetry is reduced to a great extent. The insurers should also

highlight the utility of the free-look period in order that the policyholder

takes an informed decision.

17. On the other hand, there have often been attempts to defraud the

insurance companies either by making a claim that does not exist or by

exaggerating a claim. In view of the lack of deterrent punishment, such

incidences do not attract sufficient publicity and tend to get tacit

approval. Taking a cue from the more advanced markets where the

punitive measures for such offences are really strong, there is need to at

least highlight such incidences, if not strictly apply them at this stage

when the awareness levels are still relatively low. It will certainly reduce

the number of attempts at defrauding insurers. Further, the importance

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Reason: Authentication
Location: ORISSA HIGH COURT, CUTTACK
Date: 03-Aug-2024 11:54:52
 of the concept of utmost good faith in insurance has to be clearly

explained to the common public. Interpretation of the clauses very

strictly and in their word – and not in their spirit – should be avoided;

and should there be any occasion for dual interpretation, the benefit of

doubt should always be cast in favour of the policyholder.

18. With the onset of fresh channels like brokers, corporate agents,

bancassurance etc., insurance intermediation has assumed new

challenges. The insurance agent needs to be trained properly to make the

prospective policy holders aware of the implication of giving wrong

information at the time of taking the policies. At the same time, the

insurance agent should also be disciplined in so far as filing wrong

information at the behest of some of the illiterate and semi-illiterate

policy holders in order to grab the policy by any means.

V. CONCLUSION:

19. 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.

20. 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.

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Signed by: BHABAGRAHI JHANKAR
Reason: Authentication
Location: ORISSA HIGH COURT, CUTTACK
Date: 03-Aug-2024 11:54:52
 21. 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.

22. 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.

23. 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.

24. The Writ Petition is, accordingly, allowed.

( Dr. S.K. Panigrahi )

Judge

Orissa High Court, Cuttack,

Dated the 24th July, 2024/

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Digitally Signed
Signed by: BHABAGRAHI JHANKAR
Reason: Authentication
Location: ORISSA HIGH COURT, CUTTACK
Date: 03-Aug-2024 11:54:52