State Consumer Disputes Redressal Commission
Life Insurance Corporation Of India vs Vijay Singh Chalal on 24 August, 2011
STATE CONSUMER DISPUTES REDRESSAL COMMISSION UTTARAKHAND
DEHRADUN
FIRST APPEAL NO. 221 / 2006
Life Insurance Corporation of India
having one of its Branch Office at Pithoragarh
and one of its Divisional Office at
Jeevan Prakash Building, Haridwar Road, Dehradun
through its Authorised Signatory
......Appellant / Opposite Party
Versus
Sh. Vijay Singh Chalal H/o late Smt. Shanti Chalal
R/o Village Chal, Post Nagling
Tehsil Dharchula, District Pithoragarh
......Respondent / Complainant
Sh. T.S. Bindra, Learned Counsel for the Appellant
Sh. Ram Singh Negi, Learned Counsel for Respondent
Coram: Hon'ble Mr. Justice B.C. Kandpal, President
Mr. C.C. Pant, Member
Mrs. Kusum Lata Sharma, Member
Dated: 24/08/2011
ORDER
Per: Justice B.C. Kandpal, President (Oral):
This is insurer's appeal under Section 15 of the Consumer Protection Act, 1986 against the order dated 17.08.2006 passed by the District Forum, Pithoragarh, whereby the District Forum has allowed the consumer complaint No. 40 of 2004 and directed the opposite party - appellant to pay to the complainant insured sum of Rs. 50,000/- together with incidental benefits and bonus and also to pay compensation of Rs. 5,000/- towards mental and financial agony and Rs. 5,000/- towards litigation expenses, within a period of one month from the date of the order, failing which the above amount was directed to be paid together with interest @8% p.a. from the date of the order till payment.2
2. In brief, the facts of the case, are that Smt. Shanti Devi, the wife of the complainant, had purchased a life insurance policy No. 240415305 for assured sum of Rs. 50,000/- on 22.12.1997. The complainant was the nominee under the said policy. On 18.11.2002, the life assured died. On the death of the life assured, the complainant lodged the claim with the insurance company, which was repudiated by the insurance company and alleging deficiency in service on the part of the insurance company, the complainant filed a consumer complaint before the District Forum, Pithoragarh.
3. The insurance company filed written statement and pleaded that on account of non-payment of premium due for the month of February, 1999 in time, the policy got lapsed, which was revived on 25.08.1999. The policy was again lapsed for want of payment of premium due for the month of February, 2000 and onwards, which was revived on 27.08.2002. The life assured died on 18.11.2002 after about 2½ months from the date of revival. It was also pleaded that the case was investigated and it was found that the life assured had concealed material facts at the time of revival and she was suffering from Anaemia, Asthma with RTI and she died on account of cardio respiratory arrest. It was also pleaded that the claim was repudiated on valid grounds and no deficiency in service was made.
4. The District Forum, on an appreciation of the material on record, allowed the consumer complaint vide impugned order dated 17.08.2006 in the above terms. Aggrieved by the said order, the insurance company has preferred this appeal.
5. We have heard the learned counsel for the parties and gone through the record.
36. The policy was revived for the second time on 27.08.2002. There is Form No. 300 M.R. (Revised) on record (Paper Nos. 61 to
62). It has been signed by Dr. (Mrs.) Gyansheela. In the said form, no abnormality has been pointed out regarding the health of the life assured. This shows that at the time of revival of the policy, the life assured was medically examined by the doctor of the insurance company and the life assured was not found to have been suffering with any ailment or disease. The insurance company has placed reliance on Certificate of Hospital Treatment issued by Dr. D.S. Nabiyal, Pediatriciast, District Hospital, Pithoragarh (Paper Nos. 70 to
71), wherein he has mentioned that the life assured was suffering with Anaemia, Asthma with RTI. The life assured was admitted in the hospital on 13.11.2002. The duration of illness has been mentioned as 2-3 months. The doctor has also mentioned that he has not treated the life assured prior to admission in the hospital on 13.11.2002.
7. There is no document on record to show that the life assured was treated by any doctor or she was admitted in any hospital in connection with any disease prior to 13.11.2002. The policy was revived on 27.08.2002 and there is no evidence on record as may suggest that the life assured had taken any treatment before the said date or was admitted in any hospital and she suppressed the said fact at the time of revival of the policy. It is true that Dr. D.S. Nabiyal has mentioned the period of illness as 2-3 months, but if the life assured was not herself aware of the fact that she was suffering from any such disease, how she could have disclosed it in the revival form. It is also important to note that at the time of revival, the life assured was medically examined by the doctor of the insurance company and no abnormality was found by the doctor in regard to the health of the life assured. It is an admitted fact that the life assured died on account of 4 cardio respiratory failure. Thus, it is proved that there was no misstatement on the part of the life assured and no material fact was suppressed and the insurance company has made deficiency in service by repudiating the claim of the complainant. The District Forum has considered all the aspects of the case and has passed a reasoned order, which does not warrant any interference on merit. However, the District Forum has awarded interest @8% p.a., which is on the higher side. In our view, interest @6% p.a. shall be proper interest. This apart, the District Forum has awarded sum of Rs. 5,000/- towards compensation for mental and financial agony, which in our view, is on the higher side and in our view, the same should be Rs. 3,000/-. Thus, the appeal succeed partly and is to be allowed accordingly.
8. For the reasons aforesaid, appeal is partly allowed. Order impugned dated 17.08.2006 passed by the District Forum is modified to the extent that the rate of interest is reduced from 8% p.a. to 6% p.a. and the amount of compensation for mental and financial agony is reduced from Rs. 5,000/- to Rs. 3,000/-. Rest of the order of the District Forum is hereby confirmed. Costs of the appeal made easy.
(SMT. KUSUM LATA SHARMA) (C.C. PANT) (JUSTICE B.C. KANDPAL) K