State Consumer Disputes Redressal Commission
Branch Manager, Life Insurance ... vs Kartik Chandra Das, Aged About 30 Years, ... on 23 June, 2009
STATE CONSUMER DISPUTES REDRESSAL COMMISSION:ORISSA:CUTTACK STATE CONSUMER DISPUTES REDRESSAL COMMISSION:ORISSA: CUTTACK FIRST APPEAL NO.530 OF 2008 From an order dated 21.04.2008 passed by the District Consumer Disputes Redressal Forum, Balasore in C.D. Case No.184 of 2006. 1. Branch Manager, Life Insurance Corporation of India, Jeevan Jyoti, Zilla School Road, P.S. Town, P.O./Dist. Balasore 2. Divisional Manager, LIC of India, Jeevan Prakash, PO Box No.36, Cuttack-753001 3. Zonal Manager, LIC of India, Eastern Zonal Office, Hindustan Building, 4-Chittaranjan Avenue Kolkata-72 . Appellants -Versus- Kartik Chandra Das, aged about 30 years, son of Baidhar Das, Husband of latlle Banashree Das, At-Kudia, P.O. Nagram, P.S. Sadar, Dist. Balasore . Respondent For the Appellants - Mr. P.R. Barik & Associates For Respondent - Mr. S.B. Mohanty & Associates P R E S E N T : THE HONBLE SHRI JUSTICE A.K. SAMANTARAY, PRESIDENT AND SHRIMATI SMARITA M0HANTY, MEMBER O R D E R
DATE:- The June, 2010.
Justice A.K. Samantaray, President.
This is an appeal by the Life Insurance Corporation of India assailing the order of the District Forum, Balasore dated 21.04.2008 passed in C.D. Case No.184 of 2006.
2. The complainant-respondent Kartik Chandra Das filed the complaint against the appellants-opposite parties alleging deficiency in service on the ground that the complainants wife Banashree Das was a joint policy holder with the complainant vide Policy No.585076335 for an assured sum of Rs.1,00,000/- and the said policy commenced on 04.09.2003. The policy was to mature on 04.09.2020. The said Banashree Das, the wife of the complainant, died on 10.10.2003. Death claim was filed by the complainant-respondent-husband of the deceased, but the claim was repudiated by the appellant-Corporation on the ground that the policy holder had not disclosed at the time of submission of the proposal that she was suffering from chronic gynecological problems. That apart, she committed suicide within a period of one year from the date of commencement of the policy. The complainant, therefore, approached the District Forum with a prayer for direction to the appellant-Corporation to pay the sum assured along with interest.
3. The Insurance Corporation after notice appeared and filed written version wherein it was specifically stated that the life assured Banashree Das was being treated by Dr. G.C. Nandi and Dr. B.K. Behera for her gynic problem prior to commencement of the policy, but she had not disclosed this fact while taking the policy. As regards commission of suicide by the life assured Banashree Das, it has been specifically stated that U.D. Case No.25 of 2003 was registered by the police on the basis of an F.I.R. lodged by a relation of the deceaseds family stating therein that the deceased had consumed poison and was brought to the hospital where she died.
4. The District Forum, after hearing the parties, allowed the complaint and directed the appellant-Corporation to pay Rs.1,00,000/- along with interest at the rate of 6% per annum from 29.06.2006. The District Forum also directed the appellants to pay a sum of Rs.5,000/- towards of litigation, mental agony and harassment.
5. Mr. Barik, learned counsel appearing for the appellants took us through the impugned judgment of the District Forum. The District Forum, assuming that the Agent of the LIC might have convinced the dceased-life assured for opening of the policy and that it was the prime duty to examine the policy holder thoroughly and to certify about her held, has held that the repudiation was not proper. Apart from that, the District Forum has also gone wrong, as we find, inasmuch as without discussing the statement of the father of the deceased life assured recorded by the police during inquiry into the U.D. Case, it has observed that it was the duty of the Doctor of the Insurance Corporation to examine and certify about her health. Mr. Barik took us through the statement of the father of the deceased wherein he has stated that his daughter was suffering from gynic problem even before marriage and also continued to suffer after the marriage and the said problem had disrupted the marital relationship. He further argued that such chronic suffering was the reason for which the life assured committed suicide either by consuming extra doze of medicine or by consuming poison, as has been mentioned in the F.I.R. lodged by a relation of the in-laws family of the deceased. In the said F.I.R. lodged by one Sushant Kumar Jena, it has been mentioned that due to family problem, the deceased had consumed poison on the very same day, i.e., 17.10.2003; she was brought to Sadar Hospital for treatment; and during treatment she expired in the Hospital. In the statement of the father of the deceased, there is clear mention that the deceased was suffering from chronic head reeling and had also gynic problem, for which he had taken her to Cuttack Medical and she was under treatment even before her marriage. This statement fortifies the fact that by the time she took the insurance policy, she had full knowledge of her ailments and deliberately she had suppressed this fact and in each and every column where she was required to make statement as to her health condition, she has answered no. Apart from that, the circumstance under which her death occurred and the F.I.R. was lodged by a close family relation, apparently stands as a truth of the fact that either she had consumed poison or had taken extra doze of medicine, for which she was required to be shifted to the Sadar Hospital, Balasore for treatment, where she died. In support of his contenti9ons, Mr. Barik took us through the materials available in the L.C.R. including the police papers of the U.D. Case. It was argued by Mr. Barik, learned counsel appearing for the appellants that the settled position of law is that a deliberate wrong answer, which has a bearing on the contract of insurance, if discovered during the process of settlement, may lead to the policy being declared void. In the instant case, the deceased-policy holder had deliberately suppressed the fact that she was suffering from chronic gynic problem for which she was being treated even before her marriage. It was only after her marriage that she had taken the policy;; and filled in the proposal form. Within less than two months from taking the policy, she died. The policy commenced on 04.09.2003 and the life assured died on 17.10.2003. Mr. Barik also referred to the conditions and privileges of the policy where, in case of suicide, it is stated that the policy shall be void if either of the life assured commits suicide (whether sane or insane at the time) at any time on or after the date on which the risk under the policy has commenced, but before the expiry of one year from the date of the policy and the Corporation will not entertain any claim by virtue of the policy except to the extent of a third partys bona fide beneficial interest acquired in the policy for valuable consideration of which notice has been given in writing to the office to which premiums under the policy were paid last at least one calendar month prior to death.
6. In the instant matter, there is not only suppression of material fact pertaining to the health condition of the deceased-policy holder, but also there is material to show that she had committed suicide either by consuming poison or by taking extra doze of medicine. Besides, the aforementioned clause in the conditions stands as a bar for the Corporation to make payment of the assured amount as the death of the life assured took place just after one month of commencement of the policy. Insurance policy being a contract between the life assured and the Insurance Corporation and the same being based on purely good faith, suppression of material facts relating to the health condition of the life assured makes the policy void. In the instant case, the fact that the life assured had suppressed material facts relating to her health condition at the time of taking the policy gets amply proved, as we have already discussed and as has been submitted by the learned counsel for the appellant-Corporation. In addition to it, in the F.I.R., the cause of death of the life assured has been mentioned to be suicide. In any view of the matter, repudiation of the claim by the Corporation cannot be faulted with. In our considered view, the appellant-Corporation has rightly repudiated the claim advanced by the complainant-husband of the life assured.
7. The learned District Forum in its judgment has not dealt with these aspects and ignoring the material facts; it has arrived at the conclusion that there was deficiency on the part of the appellants-opposite parties in repudiating the claim. Such a conclusion is totally indefensible and cannot be sustained in the eye of law.
8. In the result, therefore, we allow the appeal, set aside the impugned judgment dated 21.04.2008 passed by the District Forum, Balasore in C.D. Case No.184 of 2006 and direct dismissal of the said consumer complaint.
Records received from the District Forum may be sent back forthwith.
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(Justice A.K. Samantaray) President ........
(Smarita Mohanty) Member SCDRC Orissa, Cuttack June ,2010/Nayak