National Consumer Disputes Redressal
Lic Of India vs .Smt. Ranjana Anilrao Dhandole on 1 August, 2012
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION NEW DELHI REVISION PETITION NO. 1961 OF 2012 (From the order dated 27.07.2011 in First Appeal No. A/08/60 of State Consumer Disputes Redressal Commission, Maharashtra, CIRCUIT BENCH AT NAGPUR) WITH IA/1/2012 IA/2/2012 (STAY & DELAY) Life Insurance Corporation of India Petitioner H-39, Connaught Place New Delhi Versus 1.Smt. Ranjana Anilrao Dhandole Respondent 2.Vivek Anilrao Dhandole 3. Rashmi Anilrao Dhandole All at Abhay Nagar, Plot No. 13 Infront of Hari Kirana Store Manewada Road Nagpur, Taq & Dist. Nagpur BEFORE: HON'BLE MR. JUSTICE J.M. MALIK, PRESIDING MEMBER HONBLE MR. VINAY KUMAR, MEMBER For the Petitioner : Mr. Neeraj Gupta, Advocate with Mr. Kamal Gupta, Advocate Pronounced on_1st August, 2012 ORDER
JUSTICE J.M. MALIK
1. In this revision petition the State Commission while dismissing the appeal, rejected the contention of the petitioner, LIC of India that the insured had suppressed the disease of cancer. The Foras below found that the insured suffered from cancer at a later period, after the policy was obtained. The facts of this case are these.
Sh. Anilrao Dhandole, husband of complainant/respondent Smt. Ranjana Anilrao Dhandole obtained insurance policy from the LIC of India, for a sum of Rs.1,00,000/-, commencing from 26.08.2003. Husband of the petitioner expired on 03.04.2005, i.e. after 1 year 8 months of the policy.
2. On 18.10.2005, the petitioner Corporation repudiated the claim of the complainant on the ground that the insured in his proposal form answered No, in the Questionnaire at point No. 11, whereas, upon investigation, being the early claim, the Corporation found that the insured was operated upon in March, 2003 for a serious illness Carcinoma of penis. It also transpired that he had consulted Dr. Ravi Deshmukh on 27.09.2004 and the preliminary cause of death was Ca Penis (operated) and secondary cause was pleural effusion, septicemia, multi-organ failure and as such the petitioner had repudiated the claim. It is alleged that all these facts were suppressed.
He remained in the hospital for 5 days, as per the admission by the complainant. She also produced an Autopsy report of the deceased assured dated 02.06.2003.
3. Both the Foras below have recorded concurrent findings and decided the case against the petitioner.
4. We have heard counsel for the petitioner. It is noteworthy that the petitioner failed to file the original proposal form before the Fora below. The copy filed by him goes to show that the deceased, to the Question 11 (b) at Questionnaire, Have you ever been admitted to any hospital or nursing home for General check-up, observation, treatment or operation?, the deceased replied No.
5. The learned counsel for the petitioner also invited our attention to the Report on Histopathology, dated 02.06.2003, issued by Dr. Deshmukh. The relevant portion runs as follows:-
Histopathology Report The section shows marked hyperkeratosis, acanthosis parakeratosis. There is elongation of rete ridges with club like lower ends. Deeper tissue shows marked inflammatory cell infiltrates. No evidence of invasion in the deeper issue. Mild dysplastic change is seen in lower layers.
Impression The features are suggestive of pscudoepitheliomatus hyperplasia. No evidence of malignancy in the present biopsy.
However, advice follow up.
It clearly reveals that he was not suffering from cancer till 02.06.2003, immediately before the policy which was obtained on 26.08.2003.
6. Learned counsel for the petitioner places reliance on the report submitted by the Insurance Ombudsman. Counsel for the petitioner laid emphasis on the following extract :-
After perusal of all the records submitted to this Forum parties to the dispute were called for hearing on 21.02.2007 at Ombudsmans camp at Amravati. Smt. Ranjana Anilrao Dhandole appeared and submitted that LIC has charged that about two months before the date of proposal, the life assured had a history of growth of Cancer which is not correct. She produced a biopsy report dated 02.06.2003 in support of her argument. She wanted to know why the claim was not settled by LIC. She admitted that he was operated for growth in penis in March, 2003 at Kawalkar Hospital and was discharged in the evening. Again he was operated in October, 2004 by Dr. Ravi Deshmukh, Kidney Centre, Jasleen Hospital, Nagpur and remained in the hospital for five days. She mentioned that the replies to the questions in the proposal form were not correctly recorded because the proposal form was filled in by some one else and not by her husband, he only signed the proposal form.
7. Except this report, no other evidence saw the light of the day. No medical report was filed. No admission of any fact made by the complainant in writing, signed by her, was placed on the record. The report reveals that operation was done during the day time and the husband of the complainant was discharged in the evening. His five days stay in the hospital occurred after obtaining the policy. There is not even an iota of evidence that the deceased was suffering from cancer. The said disease cropped up subsequently, after the insurance policy was obtained. The impugned judgment clearly goes to show that at the time of taking the policy, the insured was fully examined by the Panel Doctor of the Life Insurance Corporation of India, the petitioner. They could not find even a shred of proof in support of their case. The evidence collected by the LIC of India is exiguous. It has failed to back up the charge with concrete evidence. The LIC of India failed to prove that the repudiation of claim was correct.
8. The Revision petition has been preferred with a delay of 7 days, as reported by the Registry, for which an application for condonation of delay has been filed by the petitioner. For the reasons stated in the application for condonation of delay, the said delay is condoned.
9. However, the instant revision petition does not go to scotch the doubt about its case and therefore, the same is hereby dismissed.
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(J.M. MALIK, J.) PRESIDING MEMBER .
(VINAY KUMAR) MEMBER md/11