National Consumer Disputes Redressal
Life Insurance Corporation Of India vs Vinod Rani on 19 January, 2007
Equivalent citations: 2(2007)CPJ58A(NC)
ORDER
K.S. Gupta, J. (Presiding Member)
1. Challenge in this revision is to the order dated 4.8.2006 of Consumer Disputes Redressal Commission Punjab, Chandigarh dismissing appeal against the order dated 10.5.2006 of a District Forum whereby petitioner was directed to pay amount of Rs. 50,000 together with amount of Rs. 2,000 towards costs etc. to the respondents.
2. Kuldip Mittar, husband of the respondent had taken a policy of Rs. 50,000 on 28.5.2000 from the petitioner/opposite party. The policy lapsed for non-payment of premium in November, 2001 and on the basis of personal statement and declaration (Form 680) furnished by the life assured on 20.12.2002, it was revived on 23.12.2002. It was further alleged that Kuldip Mittar met with an accident on 17.6.2005 and he ultimately succumbed to injuries on 14.7.2005 after more than 2 years of the revival of policy. Claim made by the respondent under the policy was repudiated by the petitioner through the letter dated 20.12.2005 on the ground that at the time of revival of policy the life assured had not disclosed that he had met with an accident on 202.2001, got a leg fractured in accident and remained hospitalised. Respondent thereafter filed complaint which was contested by the petitioner on the ground similar to that taken in repudiation letter dated 20.12.2005. Complaint was allowed by the District Forum in the manner noticed above and appeal filed by the petitioner against District Forum's order was dismissed by the State Commission.
3. Copy of personal statement and declaration submitted at the time of revival of policy is at pages 20-22 and question at 2(b) and answer thereto given by the life assured which are material, are reproduced below:
Did you ever have any operation, accident or injury? No.
4. Contention advanced by Mr. Uttamchand Mittal for petitioner is that though the life assured had met with accident on 20.2.2001, suffered fracture in leg and remained admitted in a hospital, still he gave inaccurate answer to above question 2(b) and, thus, it being a case of suppression of material fact the petitioner Insurance Company was justified in repudiating the claim. It is not in dispute that policy had run over two years after its revival on 23.12.2002. Section 45 of the Insurance Act, 1938 which has bearing in the case, reads thus:
45. Policy not to be called in question on ground of mis-statement after two years--No policy of life insurance effected before the commencement of this Act shall after the expiry of two years from the date of commencement of this Act and no policy of life insurance effected after the coming into force of this Act shall after the expiry of two years from the date on which it was effected, be called in question by an insurer on the ground that a statement made in the proposal for insurance or in any report of a medical officer, or referee, or friend of the insured, or in any other document leading to the issue of the policy, was inaccurate or false unless the insurer shows that such statement was on a material matter or suppressed facts which it was material to disclose and that it was fraudulently made by the policy holder and that the policy holder knew at the time of making it that the statement was false or that it suppressed facts which it was material to disclose:
Provided that nothing in this section shall prevent the insurer from calling for proof of age at any time, if he is entitled to do so and no policy shall be deemed to be called in question merely because of the policy are adjusted on subsequent proof that the age of the insured was incorrectly stated in one proposal.
5. Burden was on the petitioner Insurance Company, amongst others, to show that the inaccurate statement made in regard to life assured's not having met with accident and suffered fracture was a material matter and was fraudulently made by him. Insurance Company has not pleaded or shown that the said inaccurate statement was made by the assured fraudulently. The life assured had not died of any disease but due to injuries sustained in the accident. We are, therefore, not inclined to interfere with the orders passed by Fora below in revisional jurisdiction under Section 21(b) of Consumer Protection Act, 1986. Accordingly, revision petition is dismissed.