State Consumer Disputes Redressal Commission
L I C vs Smt Rabia Athar on 9 November, 2022
Cause Title/Judgement-Entry STATE CONSUMER DISPUTES REDRESSAL COMMISSION, UP C-1 Vikrant Khand 1 (Near Shaheed Path), Gomti Nagar Lucknow-226010 First Appeal No. A/2002/305 ( Date of Filing : 07 Dec 2002 ) (Arisen out of Order Dated in Case No. of District State Commission) 1. L I C Aligarh ...........Appellant(s) Versus 1. Smt Rabia Athar Aligarh ...........Respondent(s) First Appeal No. A/2002/306 ( Date of Filing : 07 Feb 2002 ) (Arisen out of Order Dated in Case No. of District State Commission) 1. L I C a ...........Appellant(s) Versus 1. Smt Rabia Athar a ...........Respondent(s) BEFORE: HON'BLE MR. SUSHIL KUMAR PRESIDING MEMBER HON'BLE MR. Vikas Saxena JUDICIAL MEMBER PRESENT: Dated : 09 Nov 2022 Final Order / Judgement Oral State Consumer Disputes Redressal Commission U.P. Lucknow. 1- Appeal No. 305 of 2002 Life Insurance Corporation of India, Regional Office, 573, Laxmi Bhawan, Ramghat Road, Aligarh. ...Appellant. Versus Smt. Rabia Athar w/o Late Athar Ali Khan, R/o Pahasoo House, Civil Lines, Aligarh. ....Respondent. 2- Appeal No. 306 of 2002 Life Insurance Corporation of India, Regional Office, 573, Laxmi Bhawan, Ramghat Road, Aligarh. ...Appellant. Versus Smt. Rabia Athar w/o Late Athar Ali Khan, R/o Pahasoo House, Civil Lines, Aligarh. ....Respondent. Present:- 1- Hon'ble Sri Sushil Kumar, Member. 2- Hon'ble Sri Vikas Saxena, Member. Sri V.S. Bisaria, Advocate for appellant. None for the respondent. Date 9.11.2022 JUDGMENT
Per Sri Sushil Kumar, Member- Both these appeals have been filed against the judgment and order dated 3.1.2002 passed by the Ld. District Forum, Aligarh in complaints case no.245 of 1999 and 246 of 1999, Smt. Rabia Athar vs. Life Insurance Corporation of India, whereby the ld. District Forum by allowing the complaint directed the opposite party/ LIC to pay insurance amount to the complainant alongwith interest @10%.
As per the case of the complainant, her husband Late Athar Ali Khan got two insurance policies from the opposite party/appellant numbering 260545430 and 260439424 on 15.1.1992 and 17.1.1991 respectively. The policy holder died on 16.7.1996 during treatment in SGPGI, Lucknow. The complainant submitted insurance claim but the appellant/ (2) opposite party refused the insurance claim on the ground that the policy holder concealed the fact of pre existing illness.
The insurance company contended that complaint on the ground that both policies were lapsed between the period July, 1994 to January, 1996. These policies were revived on 28.2.1996. On the date of revival of these policies insured person was suffering from high blood pressure since 4-5 years back. He concealed the fact of existing illness, therefore, his nominee is not entitled to get any insurance claim.
Upon consideration the rival evidence of the parties, the ld. District Forum allowed the complaint and directed the insurance company as mentioned above.
This judgment is challenged on the ground that the ld. District Forum has no jurisdiction to decide the consumer case. There was no deficiency in service by the appellant/ LIC. Policies were obtained by fraud by concealing the illness, therefore, repudiation is valid. The Ld. District Forum failed to consider the certificate issued by SGPGI, Lucknow according to which insured patient was admitted in the hospital on 14.7.1996 and died on 16.7.1996. Earlier he was admitted on 15.3.1996 and discharged on 21.3.1996 with complaint of CRF accompanied with Nausea, Vomitting and hyper tension since 4-4 years. The patient was put on dialysis on 13.3.1996 and had a nasovagol collapse, so Haemodialysis was deferred. In the said case history sheet, it was also mentioned that the patient is of known hypertensive for 4-5 years with vomiting and decreased urine output and Herpes Zoster.
We have heard the ld. Counsel for the appellant and perused the impugned judgment and order.
Ld. Counsel for the appellant argued that the patient was put on dialysis on 13.3.1996 and diagnosed as a case of CRF. Both policies were lapsed on the date of revival, he suffered the above mentioned disease but concealed the existence of disease. He further argued that revival of insurance policy is a fresh contract and must be considered that this contract is entered into on 28.2.1996. This Commission agreed with this argument that after revival of a (3) lapsed insurance policy the revival date is the date of fresh contract of insurance and the insured person must disclose all the material fact regarding his health on the date of revival of the lapsed policy.
Now we have to consider, whether the insured person concealed the fact of illness on the date of revival of the insurance policies i.e. on 28.2.1996. There is no document/ certificate available on the record of these appeals that the insured person got admitted in the SGPGI before the date of revival as mentioned in the memorandum of appeals. Burden of proof of this facts lies on the appellant insurance company but the ld. Counsel for the appellant also argued this fact that the policy holder concealed the fact of illness on the date of revival of the insurance policies but he never submitted the medical documents. Therefore, this bench finds no occasion to interfere in the findings of the ld. District Forum. Appeal deserve to be dismissed.
ORDER Both appeals are dismissed.
A certified copy of this order be placed on the record of appeal no.306 of 2002.
The stenographer is requested to upload this order on the Website of this Commission today itself.
Certified copy of this judgment be provided to the parties as per rules.
(Vikas Saxena) (Sushil Kumar) Member Presiding Member
Judgment dated/typed signed by us and pronounced in the open court. Consign to record.
(Vikas Saxena) (Sushil Kumar) Member Presiding Member Jafri, PA I Court 3 [HON'BLE MR. SUSHIL KUMAR] PRESIDING MEMBER [HON'BLE MR. Vikas Saxena] JUDICIAL MEMBER