State Consumer Disputes Redressal Commission
Kiran Pali vs Lic on 25 October, 2017
M. P. STATE CONSUMER DISPUTES REDRESSAL COMMISSION,
PLOT NO. 76, ARERA HILLS, BHOPAL (M.P.)
FIRST APPEAL No.841 /2016.
DECIDED ON : 25 -10-2017.
Smt. Kiran Pali,
w/o Late Shri Rajkumar Pali,
R/o Ganesh Talai, Malipura,
Khandwa (Madhya Pradesh).
.... Appellant.
Versus
Bhartiya Jeewan Beema Nigam,
Khandwa through Manager.
.... Respondent.
BEFORE:
HON'BLE SHRI JUSTICE RAKESH SAKSENA, PRESIDENT
HON'BLE DR. (SMT) MONIKA MALIK, MEMBER
COUNSEL APPEARING FOR THE PARTIES :
SHRI AJAY DUBEY, LEARNED COUNSEL FOR APPELLANT.
ORDER
The following order of the Commission was delivered by Dr. (Smt) Monika Malik, Member :
1. This is an appeal by the complainant against the order dated 14.6.2016 passed by the District Forum, Khandwa in CC No.228/2015, whereby the complaint filed by the complainant was dismissed.
2. In short, the facts of the case are that complainant's husband had obtained an insurance policy from the opposite party, which got lapsed in October 2011 owing to non-payment of premium instalment. Thereafter, the complainant's husband had renewed the insurance
- 2- policy (after payment of requisite premium) which was effective from 13.9.2012 onwards. Subsequently the complainant's husband died on 17.9.2014 (during the policy cover period) regarding which the complainant had filed a claim form with the opposite party, who eventually repudiated the same vide letter dated 8.4.2015 on the ground that the complainant's husband had filled incorrect information regarding his health during the policy renewal.
3. Learned District Forum after taking into consideration the pleadings and the evidence placed on record by both the complainant as well as the opposite party, dismissed the complaint filed by the complainant citing that the complainant's husband had done misrepresentation of facts at the time of policy renewal.
4. Learned counsel of the appellant reiterated that the insured had filled correct information during the policy renewal and therefore the appellant is entitled for the claim amount.
5. On perusal of the impugned order as well as the evidence placed on record we observe that it is clearly mentioned in the Form 3 and Form 4 (Ex. D/1) that the appellant's husband was on leave due to illness (infective hepatitis) from 3.3.2012 to 26.3.2012 (24 days) and again from 17.4.2012 to 24.7.2012 (99 days). On the other hand, when we observe the policy renewal form (Ex.D/7) dated 13.9.2012, (filled by the appellant's husband) we observe that the appellant's husband has answered "no" to the query wherein it is enquired that whether he had suffered from a serious ailment in the past for which he had taken leave for a week or more.
- 3-
6. In the light of the aforesaid discussion it is evident that the appellant's husband had done misrepresentation of material facts at the time of the policy renewal, and therefore we hold that the respondent was not wrong in not awarding the insurance claim of the insured to the appellant.
7. In the above circumstances, we find no infirmity in the order passed by the District Forum and we hold that the appellant does not deserve the claim amount. The appeal is therefore dismissed summarily without issuing notice to the other side.
(Justice Rakesh Saksena) Dr.(Smt) Monika Malik
PRESIDENT MEMBER