National Consumer Disputes Redressal
Lic Of India vs Gurubalappa Malikarjun Umrani on 16 August, 2012
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION NEW DELHI REVISION PETITION No. 2065 OF 2009 (From the order dated 16.02.2009 of Maharashtra State Consumer Disputes Redressal Commission, Circuit Bench, Aurangabad in First Appeal No. 107 of 2008) Life Insurance Corporation of India Jeevan Bharati Building Petitioner Connaught Place, New Delhi 110 001 Through Mr. K. L. Virmani, Assistant Secretary versus Gurubalappa Mallikarjun Umrani 104, Akshay Apartments, Near Labour Court Respondent Savedi Road, Ahmednagar BEFORE: HON'BLE MR. ANUPAM DASGUPTA PRESIDING MEMBER HONBLE MR. SURESH CHANDRA MEMBER For the Petitioner Mr. U. C. Mittal, Advocate with Mr. Aditya Mishra, Advocate For the Respondents In person R 2 & Auth. Rep. of R 1, 3, 4 and 5 Pronounced on 16th August 2012 ORDER
Anupam Dasgupta This revision petition is directed against the order dated 16.02.2009 of the Maharashtra State Consumer Disputes Redressal Commission, Circuit Bench, Aurangabad (in short, the State Commission) in First Appeal no. 107 of 2008. By this order, the State Commission dismissed the appeal of the respondent/complainant but directed the petitioner to refund the amount of premium deposited by him after deducting the necessary official charges.
2. The facts of the case are undisputed. The respondent had obtained a life insurance policy for Rs.1 lakh on 21.08.2000. The policy also permitted reimbursement of medical expenses for certain ailments. In November 2005, the insured underwent a surgery of the urinary tract and during March 2006 February 2007 another for removal of his right kidney. He preferred claim for reimbursement of the expense of Rs.67,000/- incurred on his medical treatment. The petitioner repudiated the claim on the ground that the insured suppressed material facts regarding the status of his health in the proposal for insurance.
3. Aggrieved, the insured filed a consumer complaint before the District Consumer Disputes Redressal Forum, Ahmednagar (in short, the District Forum). The petitioner (opposite party - OP - before the District Forum) contested the complaint mainly on the ground that the insured did not disclose certain material facts relating to his health at the time of filling up the proposal for the insurance policy in 2000. In particular, the insured did not disclose that he had undergone pyelolithotomy operation in 1998 and that he was suffering from some kidney-related disease since 1985. The petitioner further claimed that the insured had admitted in his letter dated 30.08.2006 that he had the above-mentioned disease prior to obtaining the insurance policy.
4. On appraisal of the pleadings and evidence, the District Forum dismissed the complaint. In appeal by the complainant/insured, the State Commission also upheld the findings of the District Forum but proceeded to direct the petitioner/insured to refund the premium paid by the insured. It is this order that has been challenged in this revision petition.
5. During the pendency of this revision petition, the insured (respondent/complainant) expired and was replaced by his legal representatives by our order dated 29.11.2011. We have heard Mr. U. C. Mittal, learned counsel for the petitioner and Mr. Sagar G. Umrani, son of the deceased insured (also representing the other legal representatives of the deceased, namely, his mother, wife, another son and a daughter) and considered the documents on record.
6. Both the Fora below have returned the finding that the deceased respondent/insured suppressed facts relating to his health/ailments in the proposal form that he filled in for the insurance policy in the year 2000. This being the position, repudiation of the claim of Rs.67,000/- by the petitioner was fully justified. Further, in view of the settled legal position, direction to the petitioner to refund the premium deposited from time to time by the deceased insured cannot be sustained. This was not even a prayer in the complaint filed by the deceased insured.
7. As a result, the revision petition is allowed and the impugned order is set aside. Parties are left to bear their own cost.
Sd/-
[Anupam Dasgupta] Sd/-
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[Suresh Chandra] Satish