National Consumer Disputes Redressal
Life Insurance Corporation Of India vs Sajida Begum on 5 June, 2007
Equivalent citations: III(2007)CPJ319(NC)
ORDER
Rajyalakshmi Rao, Member
1. The revision petitioner aggrieved by the order passed by the Andhra Pradesh State Commission, Hyderabad in first appeal No. 81/2004 dated 15.12.2006, wherein the appeal of the complaint was allowed.
Brief facts of the case:
2. The respondent Smt. Sajida Begum is the wife of late Yousufuddin who died on 287,1998, Her husband had obtained during his life-time Jeevan Sanehay Plan Insurance Policy of 12 years for the assured sum of Rs. 60,000 on 1.1.1998 by paying monthly premium amount. The complainant's claim was repudiated on the ground that the complainant's husband has suppressed about his pre-existing diseases such as diabetes millites, hypertension, diabetic nephropathy, that he was also facing difficulty even in walking and further that he was getting giddiness and had to take medical leave.
3. Learned Counsel for the petitioner relied on the certificate of hospital treatment wherein it was mentioned that the deceased was suffering from hypertension for 15 years, diabetes for 10 years and was in ICCU. It has not been shown that what was the condition of the patient at the time of admission in the hospital before his death except that he was brought in with shortage of breath, chest pain, guiddiness, etc. The noting made during the stay of ICCU the assured showing various diseases cannot be relied upon as they were not known to the insured. Further, various medical certificates given by one Dr. C.N. Vijay Kumar show hypertension, guiddiness, back pain, high B.P., cough sneezing, asthama, diabetes, general weakness, etc. A person trying to take medical leave and giving different medical reasons over the years by the same doctor who is an M.B.B.S. which have been collected and shown on record by the petitioner. There is no evidence as to what was the treatment taken by the assured for these various diseases he was suffering from during his life-time. None of the details as to the treatment were shown anywhere, Further, Panel Doctor of the petitioner-Insurance Company examined and certified that he is keeping good health at the date of issuance of the policy. If the assured was suffering from so many problems and is facing difficulty even in walking and having guiddiness for the same, it is most surprising how Panel Doctors could not detect any of these conditions. The Panel Doctor did not even think that assured needs further investigations and tests. The assured died 011 account of cardio respiratory arrest and secondly with acute renal failure.
4. The State Commission returned the finding that Dr. Vijay Kumar's medical certificates given for getting leave from the employer, as an unreliable evidence. On the very face of it this repeated stereotype medical certificates are being given by the same doctor in similar fashion for number of years without any record of treatment for the same do not inspire us to believe in the same. There is no affidavit of Dr. Vijay Kumar and no other evidence is produced by the petitioner in order to reaffirm their contention.
5. In view of the above discussion we find no reason to interfere in revisional jurisdiction under Section 21(b) of the Consumer Protection Act.?