National Consumer Disputes Redressal
Smt. Satyavati Sharma vs Life Insurance Corporation on 10 July, 2013
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION NEW DELHI REVISION PETITION NO. 1322 OF 2012 (From the order dated 01-12-2011 in First Appeal No. 190 of 2010 of the State Consumer Disputes Redressal Commission, Madhya Pradesh) Smt. Satyavati Sharma R/o Village-Lohadwar, Post Office Padra Police Station, Tehsil Raipur Karvelyun, District Rewa (M.P.) Petitioner/Complainant Versus Life Insurance Corporation Through Branch Manager, Krishna Complex, Krishna Nagar District, Satna (M.P.) Respondent /Opposite Party BEFORE: HONBLE MR. JUSTICE K.S. CHAUDHARI, PRESIDING MEMBER HONBLE DR. B.C. GUPTA, MEMBER For the Petitioner : Mr. Vikas Upadhyay, Advocate For the Respondent : Mr. Kamal Gupta, Proxy Counsel for Mr. Neeraj Gupta, Advocate PRONOUNCED ON 10th JULY, 2013 O R D E R
PER JUSTICE K.S. CHAUDHARI, PRESIDING MEMBER This revision petition has been filed by the petitioner against impugned order dated 01-12-2011 passed by the learned State Consumer Disputes Redressal Commission, Madhya Pradesh (in short, the State Commission) in Appeal No. 190 of 2010 Smt. Satyavati Sharma Vs. Life Insurance Corporation, by which while allowing the appeal, order of the District Forum allowing the complaint was set aside.
2. Brief facts of the case are that deceased Shyamlal Sharma, husband of the complainant/petitioner obtained policy for Rs. 1 lakh from opposite party/respondent on 30-03-2007 and suddenly insured Shyamlal died on 13-06-2008. Complainant filed claim for payment of sum assured to the opposite party but claim was repudiated. Alleging deficiency on the part of opposite party, complainant filed complaint before District Forum. Opposite party resisted claim and submitted that after investigation it was noticed that insured was suffering from heart ailment and prior to filling proposal form he had taken leave for 289 days on the ground of said illness. Deceased had suppressed all these facts in proposal form and therefore prayed for dismissal of complaint. Learned District Forum, after hearing both the parties, allowed complaint and directed opposite party to pay Rs. 1 lakh with 8% p.a. interest and Rs.5,000/- as compensation and Rs.1,000/- as cost of the complaint. Appeal filed by the respondent was allowed by learned State Commission vide impugned order, against which this revision petition has been filed.
3. Heard learned Counsel for the parties at admission stage and perused record.
4. Learned Counsel for the petitioner submitted that as there was no nexus between the cause of death and alleged illness, learned District Forum rightly allowed the complaint but learned State Commission has committed error in dismissing the complaint, hence revision petition be allowed and impugned order be set aside. On the other hand, learned counsel for respondent submitted that order passed by learned State Commission is in accordance with law, which does not call for any interference, hence revision petition be dismissed.
5. Perusal of record clearly reveals that in the proposal form, insured replied in negative to Clause 11 (a) & (c) as under:--
Did you ever consult a Medical Practitioner for any Ailment requiring treatment for more than a week?
No Ever remained absent from place of work on grounds Of health during the last 5 years? No
6. On the other hand, record clearly reveals that insured took 289 days leave from the office and he was suffering from various diseases of the nature and kind which he ought to have disclosed before issuance of policy. Learned State Commission rightly observed as under:-
We are of the view that in none of these cases the deceased had proceeded on long leave of 289 days for his treatment and the documents Ex.P/6 to P/18 clearly certify that he was suffering from hyper tension and diabetes. Thus, there is sufficient evidence on record to show that the deceased was suffering from the diseases and he had suppressed it, indeed he had not disclosed that he had taken leave on medical ground. All these circumstances lead to irresistible conclusion that the deceased had deliberately suppressed the pre-existing disease thus, relieving the Insurance Company of its obligation to pay amount of the insurance.
The counsel for the Insurance Company has relied upon the decision of the Supreme Court of India in Satwant Kaur Sandhu vs. New India Assurance Co. Ltd., Civil Appeal No. 2776 of 2002 in support of his contention that the IRDA regulation 2(1) (d) (Protection of Policyholders interest) defines material to mean and include all important, essential and relevant information to decide whether to undertake the risk or not. If the deceased had disclosed the multiple diseases from which he was suffering, the Insurance Company would have taken decision whether to undertake the risk or not.
7. The contract of insurance is a contract of trust and it was obligatory on the part of the insured to disclose previous disease, treatment, etc. but as deceased not only suppressed all these material facts, but also answered in negative and in such circumstances, respondent has not committed deficiency in repudiating the claim. We 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.
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( K.S. CHAUDHARI, J) PRESIDING MEMBER ..
( DR. B.C. GUPTA) MEMBER aj