State Consumer Disputes Redressal Commission
Smt. Chanda Goyal vs Life Insurance Corporation Of India on 10 October, 2011
CHHATTISGARH STATE
CONSUMER DISPUTES REDRESSAL COMMISSION
PANDRI, RAIPUR (C.G.)
(A/11/2731)
Appeal No.450/2011
Instituted on : 12.08.2011
Smt. Chanda Goyal,
W/o Late Shri Vinod Kumar Goyal,
Address - Lipik Shakha, Nagarjuna Vigyan
Mahavidyalaya,
Raipur (C.G.) ... Appellant
Vs.
Life Insurance Corporation of India,
Divisional Office, Raipur (C.G.)
Through - Manager, Life Insurance Corporation
of India, Raipur Division, Pandri,
Tehsil & District Raipur (C.G.) ... Respondent.
PRESENT: -
HON'BLE JUSTICE SHRI S.C. VYAS, PRESIDENT
HON'BLE SMT. VEENA MISRA, MEMBER
HON'BLE SHRI V.K. PATIL, MEMBER
COUNSEL FOR THE PARTIES:-
Shri Ashok Mazumdar, for appellant.
Shri N.K. Shrivastava, for respondent.
ORDER (ORAL)
Dated : 10/10/2011 PER: - HON'BLE JUSTICE SHRI S. C. VYAS, PRESIDENT This appeal is directed against the order dated 13.07.2011 of District Consumer Disputes Redressal Forum, Raipur (C.G.) (hereinafter called "District Forum" for short) in Complaint Case No.500/2010, whereby the complaint of the appellant herein, containing allegation of deficiency in service against the respondent/Life Insurance Corporation of India (hereinafter called as // 2 // "Insurance Corporation" for short) in not paying the sum assured of the insurance policy on life of Shri Vinod Kumar Goyal valuing Rs.1,00,000/-, has been dismissed.
2. Undisputedly, Shri Vinod Kumar Goyal, was Professor in a College and happened to be husband of the appellant/complainant, purchased an insurance policy on his life from the respondent/ Insurance Corporation on 14.12.2009 having sum assured Rs.1,00,000/-. The said person Shri Vinod Kumar Goyal died on 06.08.2009 on account of heart failure. The appellant/complainant preferred a claim before the insurer for payment of the sum assured. The respondent/Insurance Corporation repudiated the claim on the ground that deceased insured was guilty of suppression of material fact in the proposal form of insurance policy and has given wrong information in respect of his state of health and also regarding leave taken by him from his employer. Thus, on account of this suppression of material fact, he is not entitled of any payment under the insurance policy, which had become voidable on account of this conduct of the insured. Then complainant filed consumer complaint before the District Forum, in reply of which also, the same defence was taken by the Insurance Corporation.
// 3 //
3. Learned District Forum, agreed with the defence taken by the Insurance Corporation and dismissed the complaint by the impugned order.
4. We have heard arguments advanced by both parties and perused record of the District Forum.
5. From the record, it appears that the deceased was taking treatment for Hypertension and Hyperacidity from one Dr. V.K. Agrawal, who issued Certificate document Annexure NA-12 in this regard on 10.07.2006. Dr. D.K. Chandrakar of Chandrakar‟s Clinic Bagbahra has also treated the deceased insured for diseases of Amoebiasis & Hyperacidity on 12.09.2006 (document Annexure NA-
13). In the record Pathological Investigation Report dated 12.04.2008 (Annexure NA-15) is also available in respect of deceased Shri Vinod Kumar Goyal, who was referred to pathology by Dr. Nitin Malik, for Haematological Investigation (CBC-ESR) for conducting biochemical test and immunological test. His liver function test as well as renal function test was also examined in the year 2008 by the same laboratory though nothing abnormal was detected. The Certificate issued by the employer shows that the deceased was on medical leave from 05.03.2006 to 13.03.2006, and thereafter from 13.07.2006 to 31.07.2006, then again from 07.08.2006 to 15.08.2006, then from 22.08.2006 to 31.08.2006, from 01.09.2006 to 08.09.2006 and from // 4 // 14.09.2006 to 30.09.2006. Prior to that till 10.05.2006 he was on medical leave. This record shows that he was on medical leave for a long period and even for 63 days, medical leave was granted to him without salary.
6. All these facts were material and were required to be mentioned by the deceased insured in the proposal form for the insurance policy, copy of which is available in the record of the District Forum as Annexure NA-1. In reply to the detailed question, the deceased simply denied of having suffered from any disease or from taking any leave on medical ground. Apparently, the answers given by the deceased insured in the proposal form, were not true. In reply to the question No.11(a) whether during the last five years, he ever consulted a Medical Practitioner for any ailment requiring treatment for more than a week, the reply was in „No‟. In reply to the question No.11(c) whether he remained absent from place of working on grounds of health during the last 5 years, also the reply was „No‟. In reply to the question No.11(d) as to whether he ever suffered from any ailments pertaining to Liver, Stomach, Heart, Lungs, Kidney, Brain or Nervous system, , it was stated as he never suffered from any such diseases. These replies were apparently false.
7. The complainant/appellant Smt. Chanda Goyal, in her affidavit had not stated even a single word as to whether the deceased insured was ever suffering from any disease or had remained on leave for a // 5 // long period on medical ground. Thus, the affidavit of the complainant/appellant is also of no assistance for determining as to whether the documents filed by the respondent/Insurance Corporation is true or not. Shri Mahendra Kumar Gupta, Manager (L & HPF) of the Insurance Corporation, in his affidavit has supported these documents and has specifically stated that the deceased was suffering from Hypertension and Hyperacidity, Acute Gastroenteritis and Dehydration, enteric fever etc. and different tests were conducted. He was examined by different doctors and remained on leave for a long period. Thus, there is statement on oath by officer of the Insurance Corporation and there is nothing to controvert that statement. The documents filed by the respondent/Insurance Corporation are fully corroborated by the affidavit of the officer of the Insurance Corporation and therefore, the District Forum has not committed any mistake in relying upon those documents and in dismissing the complaint of the appellant herein.
8. In view of the aforesaid discussion, we do not find any reason on the basis of which, the order recorded by the District Forum can be interfered with, therefore, the appeal fails and is dismissed. No order as to the cost of this appeal.
(Justice S.C. Vyas) (Smt. Veena Misra) (V.K. Patil)
President Member Member
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