AJAY PRAKASH MITTAL vs LIFE INSURANCE CORPORATION OF INDIA

THIS Revision Petition is directed against the Order dated 24th July, 1996 passed by the Consumer Disputes Redressal Commission, Rajasthan at Jaipur. The facts which are necessary for the disposal of the case may be briefly summarised as under.

SHRI Ajay Prakash Mittal, the Complainant (Revision Petitioner herein) and his deceased wife had taken a Jeevan Sathi Policy for the period commencing from 28.10.1990 to 28.10.2010 for Rs. 50,000/-. The Complainant''s wife expired on 4.4.1991. The Complainant had paid the premium of Rs. 2,697/- on 26.6.1990 at the time of taking insurance. According to the Complainant the Development Officer of the Corporation got blank forms signed from the Complainant''s wife on 26th June, 1990. The authorised Doctor of the Corporation issued good health certificate to the Complainant''s wife. The Complainant''s wife expired on 9.4.1991 due to jaundice. The Complainant in June 1991, preferred claim alongwith all the benefits under the policy on the death of his wife to the Opposite Party. The Opposite Party repudiated the claim on the ground that the insured gave false answers to question No. 26(c) and (d) in the proposal form. 26(c) was regarding the last date of menstruation which was mentioned as 2.6.1990 and 26(d) pertained to the question whether she was pregnant to which she replied in the negative. As the claim had been repudiated by the Life Insurance Corporation, the Complainant approached the District Forum Sriganga Nangar seeking relief under the provisions of the Consumer Protection Act. The complaint was contested by the Opposite Party. The Opposite Party admitted in its reply that the Complainant and his wife had taken Jeevan Sathi Policy and the same was issued to them. The Complainant was not covered by the definition of consumer. It was denied that the signatures of the insured were obtained on the blank forms. Rather the insured signed the forms after fully understanding the questions contained in the proposal form. The Complainant''s wife, at the time of signing the proposal form, had not given correct answers regarding her health and gave false statement knowingly and with ulterior motives. She concealed a material fact from the Opposite Party that she was pregnant on the date the proposal form was signed. The Complainant was not entitled to claim any compensation for the reason that his wife had concealed a material fact at the time of getting the life cover.

AFTER considering the relevant material on record the, District Forum allowed the claim and directed the Opposite Party to pay a sum of Rs. 50,000/-.

THE Life Insurance Corporation, being aggrieved of the Order of the District Forum, approached the State Commission, Rajasthan at Jaipur by way of an appeal. By order dated 24th July, 1996, the State Commission allowed the appeal of the LIC and dismissed the complaint. The Complainant has approached this Commission by filing this Revision Petition by assailing the Order of the State Commission. We have heard the learned counsel for the parties. On behalf of the Revision Petitioner it was contended that the State Commission failed to appreciate that the death was due to jaundice and was not due to pregnancy or delivery of the child. The case of death and pregnancy were not even remotely connected. Death occurred four months after the normal delivery. The deceased did not indulge in any suppression of facts as the proposal was signed by her with an assurance from the Development Officer, LIC that he would fill up the same in due course. The deceased did not try to suppress the fact that she was pregnant at the time of submission of the proposal form. The deceased was an illiterate woman having no knowledge of English language.

ON the other hand, counsel for the Corporation canvassed that the findings of the State Commission were based on appreciation of evidence and called for no interference.

WE have given our thoughtful consideration to the entire matter. Against question No. 26(c) and 26(d) in the proposal form regarding the date of last menstruation and about pregnancy, the deceased gave the answer that the date of last menstruation was 22.6.1990 and that she was not pregnant on 24th June, 1990. She delivered the male child on 2nd December, 1990. From this, it can safely be inferred that on 22nd June, 1990 she was pregnant. The case set up by the Complainant was that Bhagwan Das Ahuja, who was an employee of the LIC, had not explained the contents of the proposal form to the deceased. The State Commission had not accepted this explanation for the reason that it was for the deceased to understand what she was signing in the proposal form and it was borne out that the deceased had given wrong answer about her being not pregnant and about the date of her last menstruation. We see no reason to differ with the finding of the State Commission on this aspect. Reliance was placed by the Corporation on the Manual of Instructions given to their agent wherein it is provided that the proposal for assurance on the life of a lady after the child birth would be considered only six months after delivery. If the deceased had disclosed correctly regarding her pregnancy on 24th June, 1990 when she signed the proposal form, the LIC could waive off the conditions of six months or abide by the instructions in the Manual not to insure the pregnant lady until six months had expired after delivery. According to us, if the deceased had not suppressed the material facts, it would have influenced the LIC whether to insure or not to insure the deceased. It may be pertinent to mention that the deceased had died within the period of two years from the date of taking of the life insurance policy. We are of the firm opinion that the LIC was able to establish that the deceased suppressed facts which it was material to disclose. The State Commission was right in holding likewise. In the result we find no merit in this Revision Petition and we dismiss it. However, we leave the parties to bear their own costs.