National Consumer Disputes Redressal
Dilraj Singh vs Life Insurance Corporation Of India & ... on 9 September, 2015
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION NEW DELHI REVISION PETITION NO. 1863 OF 2014 (Against the Order dated 20/01/2014 in Appeal No. 510/2013 of the State Commission Chandigarh) 1. DILRAJ SINGH WD/O LATE SHRI MANDEEP SINGH, R/O 320 SECTOR-9 CHANDIGARH ...........Petitioner(s) Versus 1. LIFE INSURANCE CORPORATION OF INDIA & ANR. UNIT-II,JEEWAN PRAKASH BUILING SECTOR-17-B, THROUGH ITS BRANCH MANAGER CHANDIGARH 2. SHRI KISHORE CHANDER PANDA, AGENT CODE NO-760180 UNIT NO-II, JEEWAN PRAKASH BUILDING,SECTOR-17 B, CHANDIGARH ...........Respondent(s)
BEFORE: HON'BLE MR. JUSTICE K.S. CHAUDHARI, PRESIDING MEMBER
For the Petitioner : Mr. Shrey Mehta, advocate For the Respondent : For Respondent No. 1: Mr. Arunav Patnaik & Ms. Kanika
Singh, advocates
For Respondent No. 2: N E M O
Dated : 09 Sep 2015 ORDER
PER JUSTICE K.S. CHAUDHARI, PRESIDING MEMBER
This revision petition has been filed by the petitioner against the order dated 20-01-2014 passed by the State Consumer Disputes Redressal Commission, UT Chandigarh (in short, 'the State Commission') in Appeal No. 510/2013 - Mrs. Dilraj Singh Vs. Life Insurance Corporation of India & Anr. by which while dismissing appeal order of District Forum dismissing complaint was upheld.
2. Brief facts of the case are that complainant/petitioner's husband took a life Insurance Policy from Opposite Party No.1, valid for the period from 14.01.2010 to 14.01.2035, for the sum of Rs.3 lakhs. The premium of Rs.17,902/-, was paid to Opposite Party No.2, an agent of Opposite Party No.1, on 14.01.2010. The life assured/husband of the complainant, who was working as Software Engineer, in U.S.A., died on 26.06.2011 at The Johns Hopkins Hospital, Baltimore City, U.S.A., while he was under treatment there. Thereafter, the complainant being the nominee of her husband, in the said Policy, lodged the claim, with Opposite Party No.1, on 15.12.2011, along with all requisite documents through Opposite Party No.2. Opposite party repudiated claim. Alleging deficiency on the part of opposite party complainant filed complaint before District Forum. Opposite party No. 1 resisting complaint, admitted issuance of policy and further stated that the life assured had been getting treatment, for the same since 2009. It was further stated that, the said disease was in the knowledge of the life assured, at the time of filling in the proposal form and signing the same. However, he did not mention the same, in the proposal form, and, as such, concealed the material information, relating to his health, at the time of submitting the same, for getting the Insurance Policy. It was further stated that since the life assured concealed the material information, relating to his ill health, the claim under the Policy was legally and validly, repudiated, as per the terms the conditions of the same and prayed for dismissal of complaint. Opposite party no. 2 resisted complaint and submitted that he being agent of opposite party no. 1 got insured Mandeep Singh. It was further stated that Opposite Party No. 2, had explained the terms, conditions and benefits of the Policy to the life assured. It was further stated that the proposal form was completed after getting the information from the life insured, who after reading and understanding the same, signed it at different places. It was further stated that the Policy was issued by Opposite Party No.1, and the claim was also repudiated by it (Opposite Party No.1). It was further stated that Opposite Party No.1, being only an Agent and facilitator, for getting the Insurance Policy, was not at all liable. It was denied that the husband of the complainant signed the blank proposal form. Denying any deficiency on his part, prayed for dismissal of complaint. Learned District Forum after hearing both the parties dismissed complaint. Appeal filed by the complainant was dismissed by learned State Commission vide impugned order against which this revision petition has been filed.
3. Heard learned counsel for the parties finally at admission stage and perused record.
4. Learned counsel for the petitioner submitted that inspite of no suppression of disease in proposal form, learned District Forum committed error in dismissing complaint and learned State Commission further committed error in dismissing appeal, hence revision petition be allowed and impugned order be set aside and complaint be allowed. On the other hand, learned counsel for the respondents submitted that order passed by learned State Commission is in accordance with law, hence revision petition be dismissed.
5. Perusal of proposal form submitted by the deceased reveals that he has shown his state of health as good on 14-01-2010. It is not disputed that deceased was treated in Johns Hopkins Hospital, USA from 05-03-2011 till he expired on 26-06-2011. In the certificate of hospital treatment, deceased previous history was shown as "(i) Wegner's granulomatosis diagnosed in 2009. Followed by Dr. Levine in rheumatology. History given by patient.
(ii) IgA nephropathy, diagnosed 2009. Do not know of nephrologist who was treating him."
which makes it clear that Wegner's granulomatosis was diagnosed in the deceased in 2009 on account of which he died but in the proposal form he has not shown this disease and has shown himself to be of good health. Learned counsel for the petitioner has submitted that in discharge summary issued by Johns Hopkins Hospital, reference of disease since 2009 has not been mentioned and in such circumstances previous history shown in certificate of hospital treatment cannot be believed. I do not agree with the submission of learned counsel for the petitioner because merely not mentioning past history in discharge summary, this certificate signed by treating doctor of Johns Hopkins Hospital narrating history given by the deceased himself, cannot be disbelieved. Learned counsel for the petitioner has also drawn my attention towards certificate issued by doctor Mubarik Khan of Advanced Internal Medicine, USA in which it was submitted that deceased was under his treatment at Fairfax Hospital from 21.05.2011 to 25.05.2011 and he was diagnosed with viral syndrome, abnormal liver enzymes and fever. With the certificate he has not annexed treatment record maintained by Fairfax Hospital and in such circumstances this certificate cannot be believed.
6. Learned State Commission after detailed discussion rightly dismissed appeal.
7. Learned counsel for the petitioner placed reliance on judgment of Hon'ble Apex Court in AIR (2001) Supreme Court 549 - Life Insurance Corporation of India & Ors. Vs. Smt. Asha Goel & Anr., in which it was observed that claim should not be repudiated in a mechanical and routine manner. This judgment was considered by Hon'ble Apex Court in (2008) 1 Supreme Court Cases 321 - P.C. Chacko & Anr. Vs. Chairman, Life Insurance Corporation of India & Ors., in which it was observed that deliberate wrong answer given by insured having a great bearing on contract of insurance may lead to policy being vitiated in law and policy can be repudiated if obtained with a fraudulent act. As I observed earlier deceased while suppressing his previous disease showing him to be of good health for obtaining policy was fraudulent act on his part and respondent has not committed any deficiency in repudiating claim. Learned District Forum rightly dismissed complaint and I do not find any illegality, irregularity or jurisdictional error in the impugned order and revision petition is liable to be dismissed.
8. Consequently, revision petition filed by the petitioner is dismissed at admission stage with no order as to costs.
......................J K.S. CHAUDHARI PRESIDING MEMBER