National Consumer Disputes Redressal
Lic Of India vs Mandava Geetha on 23 August, 2012
This revision petition challenges the order dated 12 NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION NEW DELHI REVISION PETITION No. 37 OF 2010 [From the order dated 12.10.2009 in First Appeal No.388 of 2007 of the Andhra Pradesh State Consumer Disputes Redressal Commission, Hyderabad] Life Insurance Corporation of India YOGAKSHEMA Jeevan Bima Marg, Mumbai Through CO, Legal Cell, Northern Zonal Office Petitioner H 39, New Asiatic Building, 2nd Floor Connaught Place, New Delhi 110 001 versus Smt. Mandava Geetha Wife of Mandava Prakash Resident of Revenue Colony Respondent Bhadrachalam 507 111 Khammam District, Andhra Pradesh BEFORE: HON'BLE MR.ANUPAM DASGUPTA PRESIDING MEMBER For the Petitioner Mr. Anoop K. Kaushal, Advocate For the Respondent Mr. K. Maruthi Rao, Advocate Pronounced on 23rd August, 2012 ORDER
ANUPAM DASGUPTA This revision petition challenges the order dated 12.10.2009 of the Andhra Pradesh State Consumer Disputes Redressal Commission, Hyderabad (in short, the State Commission) in first appeal number 388 of 2007. By this order, the State Commission dismissed the appeal filed by the Life insurance Corporation of India Limited (LIC) and confirmed the order dated 29 September 2006 of the District Consumer Disputes Redressal Forum, Khammam (in short, the District Forum).
2(i) The respondent in this petition was the complainant before the District Forum. She alleged deficiency in service on the part of the LIC in that the latter repudiated her claim for payment of the amount assured under the life insurance policies obtained by her late husband for Rs. 5 lakh each, on the ground that the life assured had given contradictory/fraudulent information about himself at the time of submitting the proposals for insurance. She claimed that her late husband had given correct information and that he was medically examined and found fit before acceptance of the proposals for insurance. Unfortunately, he died of heart attack all of a sudden. As the nominee of the policies obtained by her husband, she was entitled to receive the sum assured under each policy.
(ii) The LIC contested the complainant by pointing out the discrepancies in the proposals submitted by the life assured at two different Branches of the LIC almost simultaneously.
(iii) However, on appraisal of the pleadings and evidence produced by the parties, the District Forum allowed the complaint and directed the LIC to pay to the complainant the assured sum of Rs. 5 lakh due under one policy with interest at the rate of 7.5% per annum from the date of repudiation, i.e., 27 November 2002 till the date of realisation.
(iv) Aggrieved by this order, the LIC filed an appeal to the State Commission, which, as stated earlier, dismissed it by its impugned order dated 12.10.2009.
3. I have heard Mr. Anoop K. Kaushal, learned counsel for the petitioner and Mr. K. Maruti Rao, learned counsel for the respondent and considered the documents brought on record.
4(i) Learned counsel for the petitioner has stated that the husband of the respondent M. Prakash had submitted two proposals under Jeevan Shree Plan, both dated 31.01.2002 for Rs.5 lakh each simultaneously, suppressing the fact of his submission of one proposal at Rajahmundry Main Branch under the Rajahmundry Division and the other proposal at the Bhadrachalam Branch under the Warangal Division of the petitioner. The information furnished in these two proposals was as under:
Details given in proposal Bhadrachalam Branch Rajahmundry Branch Date of Proposal 31.01.2002 31.01.2002 Place of Submission Bhadrachalam Rajahmundry Division Warangal Rajahmundry Fathers Name M. Mussaiah M. Thomas Educational Qualification SSC Intermediate Place of Birth Bhadrachalam Nizamabad Date, Time and Place of Medical Examination 31.01.2002 at 06.00 pm at Bhadrachalam 31.01.2002 at 09.00 pm at Rajahmundry Date of Completion of Policy 05.02.2002 05.02.2002 Policy Number 686562808 802503655 [Emphasis supplied]
(ii) As the proposals were submitted at two different Branches under two different Divisions of the LIC, each Branch Office accepted the information furnished in the respective proposal as correct and issued the policy. The Rajahmundry Main Branch Office and Bhadrachalam Branch Office issued the policies on 06.02.2002 and 19.02.2002 respectively.
(iii) The respondent informed the petitioner that the life assured had died on 11.05.2002 due to heart attack. Since it was an early death claim arising within four months of issuing of the policy, the petitioner made enquiries into the matter to ascertain the bona fides of the claim. It was during the investigations that it was found that the deceased life assured had submitted two proposals for Rs. 5 lakh each at two different Branches without disclosing the fact of his submission of another proposal to another Branch of the petitioner. Had he disclosed this information correctly in reply to paragraph 8 of the proposal form (s), the Branch Office would have called for and required him to be subjected to special medical investigation reports like ECG, Blood Sugar, etc. But in view of the deliberate suppression of this vital material fact about submission of the other proposal for Rs. 5 lakh, each the Branch Office of the petitioner accepted the proposal submitted without calling for any special reports resulting in the petitioner covering risk on the life assured for a high sum of Rs. 10 lakh.
(iv) Further, the routine medical examination of the life assured was conducted in respect of the proposal at Rajahmundry on 31.01.2002 at 06 p.m. which resulted in policy no. 802503655 while the other routine medical examination of the life assured was conducted in respect of the proposal at Bhadrachalam also on 31.01.2002 at 09 p.m. which resulted in policy no. 686562808. The distance between the two Branch locations is about 300 kms and not less than six hours of travel by road is necessary to travel form one place to the other. The short gap of 3 hours between the recorded times of the two medical examinations clearly established manipulation by the deceased life assured in collusion with the medical examiners of the LIC.
(v) Besides, the deceased life assured also gave different details in respect of his fathers name, place of birth and educational qualifications in the two proposals to avoid detection of similarity of identity.
(vi) This showed the mala fides and fraud by the deceased life assured in obtaining two policies of Rs.5 lakh each from the LIC Branch offices. The fact that he also died within a short period of three months and six days further proves this point.
(vii) On the other hand, while not denying the facts brought out by the learned counsel for the LIC, learned counsel for the respondent/complainant stated that the claim under at least one of the two policies should be allowed, as had been done by the Fora below.
5. We find that the petitioner had brought out these facts in the written version filed before the District Forum in respect of policy no. 802503655 obtained at the LICs office at Warangal. It is thus evident the Fora below failed to notice that the deceased life assured had committed blatant fraud on the LIC in obtaining these two policies, which of course could not have been possible without the active assistance of the medical examiners. It is settled law that insurance contracts are contracts of uberrima fide and such fraud as committed by the deceased life assured cannot but be dealt with summary repudiation of the claim. Given the undisputable facts of the case, there is absolutely no merit in the submission that the amount of at least one policy should be paid to the nominee.
6. Therefore, the revision petition is allowed, the orders of the State Commission as well as the District Forum are set aside and the complaint is also dismissed, leaving the parties to bear their own costs.
Sd/-
.
[Anupam Dasgupta] Satish