State Consumer Disputes Redressal Commission
Smt. Sumitra Bai , Korba vs Lic Of India, Kosabadi on 1 January, 2011
CHHATTISGARH STATE
CONSUMER DISPUTES REDRESSAL COMMISSION,
PANDRI, RAIPUR (C.G)
Appeal No.357/2010
Instituted on : 29/05/2010
Smt. Sumitra Bai Chauhan,
W/o Hemlal Chauhan,
R/o : Quarter No.OE/71, C.S.E.B. Colony,
East Korba, Hal Mukam Mudapar,
Korba, District Korba (C.G) .... Appellant
Vs.
L.I.C. of India,
Through : Branch Manager,
Branch No.1, Kosabadi,
Tahsil & District Korba (C.G) ... Respondent
PRESENT :
HON'BLE JUSTICE SHRI S.C. VYAS, PRESIDENT
HON'BLE SHRI V.K. PATIL, MEMBER
COUNSEL FOR THE PARTIES :
Ms. Savita Panjabi, for appellant.
Shri Devesh Dixit, for respondent.
ORDER
DATED : 01/01/2011 PER :- HON'BLE SHRI V.K. PATIL, MEMBER.
This appeal is directed against order dated 30.04.2010 passed by District Consumer Disputes Redressal Forum, Korba (hereinafter called "District Forum" for short) in Complaint Case No.09/07, whereby the complaint of the appellant herein has been dismissed on the ground that the deceased life assured had concealed material facts knowingly in the proposal form of insurance policies.
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2. Facts of the case, in brief, are that husband of the appellant herein namely Hemlal Chauhan was insured by the respondent Life Insurance Corporation (herein after called for short as LIC) by way of policies numbering 382556448, 382550019, 382540872,382144816, 382544470 for sum assured Rs.40,000/-, Rs.32,000/-, Rs.33,000/-, Rs.25,000/-, Rs.25,000/- respectively. He died on 10.09.04, so claim was filed by the complainant being the nominee before LIC under the policies and when no amount was paid in spite of notice through advocate, then complaint before District Forum was filed, which was contested by LIC on the ground that the deceased insured was suffering from certain ailments prior to the date of purchase of insurance policies and he had suppressed voluntarily those material facts while making proposal for the insurance, so no amount was payable under the insurance policies.
3. District Forum had earlier dismissed the said complaint by its order dated 04.07.2009 mainly on the ground that it was filed after the period of limitation and thereafter on appeal by the complainant before this commission , the case was remanded to the District Forum vide order dated 23.01.2010 with the direction to reconsider the matter afresh on merit. District Forum accordingly in compliance reconsidered the case having provided opportunity to both the parties and after having heard their arguments and perused record, dismissed // 3 // the complaint. Complainant having been aggrieved by the aforesaid order filed this appeal.
4. We have perused the documents on record and heard arguments advanced by parties.
5. In the written version, in paragraph No.4, it has been submitted by respondent LIC that the claim filed in respect of insurance policies, was such a claim which came under the category of early claim and so as per rules it was duly investigated and ultimately after due consideration it was repudiated, intimation of which was sent to the claimant by registered letter dated 23.02.06. Either of the parties has not filed the said letter of repudiation and was not disputed also.
6. Learned counsel for the appellant argued that LIC has committed deficiency in service by repudiating the bonafide insurance claim of the complainant when the deceased life assured had furnished all information correctly while Learned counsel for respondent LIC argued that the deceased life assured had concealed material information knowingly about health in the proposal form to the effect that he had been suffering from ailment of high blood pressure prior to the submission of proposal forms. He drew our attention towards replies to questions no.11(e) of proposal forms whereby the deceased life assured was asked "Are you suffering from or have you ever suffered // 4 // from diabetes,Tuberculosis,High Blood Pressure,low blood pressure, pressure-
----. against which he replied „No'. Learned counsel for LIC argued that had the deceased assured mentioned the fact about his suffering of ailment of blood pressure in the proposal then the complainant would have been asked to undergo some special medical examination and after its findings only the proposal would have been considered with certain terms or even it could have been declined as per rules but the deceased life assured who was an employee of reputed organization had proposed for insurance on non-medical basis and had deliberately concealed the information knowingly about his ailment of high blood pressure which was material to the risk. He further argued that insurance proposals of the questioned policies were signed concealing the material information of high blood pressure which he had been suffering whereas according to the copy of Hospital Treatment Book issued to the deceased insured by his employer M.P.E.B., he was found to have taken medical treatment for high blood pressure on 25.01.2001, 25.03.2001, 17.04.2003, 29.05.2003 which was prior to the date of said proposal forms. When the proposer of insurance had been suffering from the ailment of blood pressure and taking regular medical treatment for over two years then obviously it was expected of him to disclose the same in the proposal form on the principle of utmost good faith. Nondisclosure of such vital information, which was well within his knowledge, certainly amounts to deliberate concealment of // 5 // material fact thereby misleading LIC to accept insurance proposals in the absence of vital information and without required special medical tests of the proposer. The questioned printed proposal forms are either bilingual in English and Hindi or in Hindi only and the deceased life assured was having qualification 8th pass so he cannot be assumed to have signed the same without understanding. Insurance policy is a contract based on principle of utmost good faith and if the proposer conceals material information deliberately then the insurance policy is voidable at the option of the insurer. LIC has established its contentions with cogent evidence and thus has not committed deficiency in service by repudiating the insurance claim.
7. Under the facts of the case and foregoing discussion we do not find infirmity in the impugned order of learned District Forum so the same is affirmed. The appeal has no force to succeed and therefore it is dismissed. No order as to cost.
(Justice S.C. Vyas) (V.K. Patil)
President Member
/01/2011 /01/2011