National Consumer Disputes Redressal
Life Insurance Corporation Of India vs Mansa Devi on 3 September, 2002
Equivalent citations: II(2003)CPJ135(NC)
ORDER
Mrs. Rajyalakshmi Rao, Member
1. This revision petition is against the order dated 11.11.1997 passed by the State Commission, Himachal Pradesh whereby petitioners, Life Insurance Corporation of India were directed to pay the policy amount, a sum of Rs. 50,000/- to the respondent Mansa Devi along with interest @ 18% p.a. from 6.8.1996, i.e. from the date of filing of the complaint till the amount is paid.
2. The brief facts are as follows :
The respondent is the wife of late Shri Pratap Singh and he had taken a life insurance policy for Rs. 50,000/- commencing from 28.4.1993. Persuant to his death on 28.6.1995, the respondent made a claim in respect of the said policy. The petitioner after enquiries in relation to the claim came to conclusion that the life assured had intentionally and fraudulently suppressed material facts concerning his health such as diabetes mellitus of which he was aware for eight years. In view of the above enquiries, the petitioner repudiated the said claim on the grounds of suppression of material facts while filing the proposal form wherein he gave false answers intentionally and the said decision was communicated to the respondent vide letter dated 26.2.1996.
3. The respondent being aggrieved by the repudiation preferred a complaint before the District Forum, Mandi and the said complaint was dismissed by order dated 1.1.1997 after placing reliance on the documents produced by the petitioner. On the respondent's appeal, the State Commission set aside the order of the District Forum and directed the petitioner to pay the claim as per the terms of the policy with interest @ 18% p.a. with effect from 6.8.1996 i.e. the date of filing the complaint till the amount is paid.
The learned Counsel for the petitioner argued on the following grounds :
(a) It was incumbent upon the life assured to give correct particulars in the proposal form and suppression of material facts and non-disclosure of the facts that he remained ill and that he was admitted to hospital and was treated for diabetes would give the petitioners a reason to repudiate the claim under Section 45 of the Insurance Act. In the proposal form, the life assured answered the following questions before the policy was given.
4. According to the petitioners, the respondent's answers were false to the questions 1, a, b, c, d, e and i and on enquiry found that he was on medical leave for 150 days from 26.3.1992 to 22.8.1992 and remained in the hospital due to a thorn prick i.e. his foot for which his left leg was amputated. It is further contended that the cause of death of the life assured was renal failure which had resulted due to diabetic problems. The certificate of treatment at BBMB Hospital, Sunder Nagar shows that the life assured had been getting treatment from P.G. Hospital for the last eight years.
5. We have carefully perused all the documents and after hearing the arguments from both the parties, we find there is sufficient reason to believe that the life assured suppressed the material facts of existence of diabetes and the treatment he had undergone for eight years, to the petitioner. The learned State Commission disbelieved all the documents produced by the petitioner that they were copies of the originals and that they were not properly attested and that the Insurance Company did not file an affidavit in support of the said documents. It further observed that the opinion of the doctor cannot be authentic unless he is subjected to the examination and cross-examination. They have not considered the fact of suppression in the proposal for the policy and disbelieved the documents placed before them.
6. We find the State Commission has erred in their view that the petitioner has failed to substantiate that the respondent's husband had suppressed material facts at the time of proposing for insurance. It is very clear from the statement of the employer of the respondent Executive Engineer, Township Division B.B.M.B., Sunder Nagar wherein he certified that the life assured was diabetes patient and that he was under treatment of doctors in P.G.I. He further certified that the life assured was on leave for illness from 17.3.1992 to 25.3.1992, 26.3.1992 to 22.8.1992 and 22.3.1995 to 15.4.1995. Further, it is also likely that the leg amputating after a thorn prick and renal failure of the life assured to cause his death are all clear indications of long suffering of diabetes.
7. The State Commission has failed to appreciate that the contracts of insurance are of utmost good faith i.e. Ubremma Fidae and the life assured is bound to disclose honestly, truthfully and correctly all the answers in the proposal form concerning the state of his health and any suppression renders the contract of insurance illegal, invalid, void ab initio and unenforceable.
8. The State Commission has failed to appreciate that in the proposal form the deceased had given an undertaking that all information and answers therein are true and correct and the same constitute the basis of the contract. If it is discovered to the contrary, the contract will be absolutely null and void and all moneys will stand forfeited in favour of the petitioner.
9. The District Forum went into all the facts and returned a clear finding that the life assured had suppressed the material facts. We agree with the view taken by the District Forum that there is no deficiency in service by the petitioner and accordingly set aside the order of State Commission. The Revision Petition is allowed. No order as to costs.