State Consumer Disputes Redressal Commission
Rameshwari Devi Soni vs Lic Of India & Ors on 20 October, 2010
BEFORE
STATE CONSUMER DISPUTES REDRESSAL COMMISSION, CIRCUIT BENCH,
RAJASTHAN, JAIPUR
Appeal No. 1173/2003
Smt.
Rameshwari Devi Soni W/o Shri Banshi Lal Soni, R/o Behind Bhaskar
Hotel, Nagaur (Raj.)
..Appellant-Complainant
VS
LIC
of India, North-Regional Office, Jeevan Bharti, Connaught Circus,
New Delhi.
Sr.
Divisional Manager, LIC of India, Divisional Office, Jaipur
Road,Bikaner.
Branch
Manager, LIC of India, Bikaner Road, Nagaur (Raj.)
..Respondents-Non-applicants
Before:
Mr.
G.S. Hora, Presiding Member
Mr. Sikandar Punjabi, Member Present:
Mr.Paras Jain, counsel for the Appellant Mr. Sandip Saxena, counsel for the Respondents ORDER Dated: 20.10.2010 PER Mr. G.S. HORA, PRESIDING MEMBER This appeal arises out of order dated 24.5.2003 passed by the District Consumer Forum (DCF), Nagaur whereby the complaint of the Complainant was dismissed.
Late Shri Ajay Soni, the Life Assured (LA) obtained a life policy of Rs. 5,00,000/- by submitting a proposal form on 26.1.2001 wherein he claimed himself to be healthy and gave answsers in negative to all the questions pertainting to certain diseases. He died on 9.4.2001 and the Complainant being the nominee under the policy lodged a claim with the Insurance Corporation but the claim was repudiated vide letter dated 12.10.2002 on the ground that the insured had been suffering from Jaundice etc. for which he had taken the treatment but he did not disclose this material fact in the proposal form rather gave false answers therein. The learned DCF on the basis of certificate issued by Govind Ballabh Pant (GBP) Hospital, New Delhi came to the conclusion that the LA had suffered from Jaundice before taking the policy and taking it to be a case of suppression of 2 material fact, dismissed the complaint.
We have considered the arguments advanced by both the counsels and gone through the file.
The policy was taken on the basis of proposal form dated 26.1.2001 and nearly about 2 & half months, the insured died. Since it was a case of early death, the Insurance Corporation went into details to find out whether there was any suppression of material fact. Certificate Exhibit-2 has been obtained from the Medical Superintendent, GBP Hospital, New Delhi. Exhibit 2 goes to show that Shri Ajay Soni was admitted in the Hospital on 16.3.2001 after he was diagnosed as suffering from Jaundice for the last ten days. There was abdominal distension for the last 10 days. In para 5, it has been mentioned that the patient had history of Jaundice five years before, who responded to steroids. There was recurrence of the disease about eight months before the admission. At that time also he had history of abdominal distension and responded to some strong medicines. It has also been mentioned that he was admitted for admission for the first time in October, 2000 and was discharged from the Hospital as the condition had improved. That time the patient was diagnosed for auto-ammune hepatitis. This certificate further goes to show that finally he was discharged from the Hospital on 7.4.2001 i.e. 2 days before the death and at that time his general condition was very poor. All these facts go to show that the LA died because of lever problem. He had the same problem five years before and thereafter also there was recurrence of the disease and he had to take steroids. There is direct nexus between the cause of death and the disease, the LA had been suffering from before taking the policy. The LA who was 22 years of age, going for a policy of Rs. 5,00,000/- who died within a period of two & half months go to show that the LA was knowing about the consequences of his disease before taking the policy but he did not disclose these material facts in the proposal form and therefore we hold that the Insurance Corporation was justified in repudiating the claim of the Complainant.
Consequently, we find no force in this appeal and the same is dismissed with cost on parties.
Member Presiding Member Hira Lal