Godavari Bai vs Life Insurance Corporation of India

THIS appeal, under Section 15 of the Consumer Protection Act, 1986, is directed against the order dated 17.8.2003 in Complaint No. 258/2000 by District Consumer Disputes Redressal Forum, Durg (hereinafter called the ''District Forum'' for short), dismissing appellant''s complaint with the liberty to him, to avail remedy in the Civil Court.

THE complainant is the wife of deceased insured Numan Singh Sahu who undisputedly obtained 2 policies. As per details given in para 3(1) of the complaint, the policies were for assured sum of Rs. 40,000/- and Rs. 10,000/- obtained on 28.2.1995 and 28.3.1997 respectively. It is also not in dispute that the complainant/appellant is the wife and nominee of the deceased insured. THE deceased insured died on 6.12.1997 on account of heart failure. Complainant/appellant averred that she laid claim before the respondent Life Insurance Corporation of India for payment of the assured sum under the above policy. However, her claim was repudiated by the respondent/insurer by their letter dated 5.2.1999 on the ground that there was material suppression of facts. Aggrieved of the repudiation as above, the present complaint was filed.

The respondent/insurer resisted the complaint. According to them the deceased was suffering from Diabetes Mellitus and T.B. from before submitting the proposal form for obtaining the policies. However, he did not disclose the above disease in his declaration form, submitted for obtaining the policies. It was, therefore, averred that in view of the material suppression as above, the claim under the policy could not be accepted.

DISTRICT Forum in the impugned order held that insured Numan Singh Sahu was suffering from Diabetes Mellitus and T.B. since 1994. However, he had suppressed the above fact in the proposal form while obtaining the policies in the years 1995 and 1997. In view of the above the complainant could not get any benefit under the policy. The complaint was accordingly dismissed. Learned Counsel for complainant/appellant submitted that there was no material suppression by the insured and, therefore, the complainant/appellant is entitled to get her claim under the policies obtained by her husband deceased Numan Singh Sahu. Respondent''s learned Counsel submitted that there is unimpeachable evidence that the deceased was suffering from Diabetes Mellitus and T.B. from before obtaining the policy. In view of the material suppression as above the claim of the complainant was rightly repudiated.

THE main question that arises for consideration is: as to whether there was suppression of material facts by the deceased insured Numan Singh Sahu? It is noted that in the proposal form the complainant had stated that he did not suffer from any disease which required treatment for a week or more and that he had no disease of lungs, heart, nervow system etc. However, the certificate of T.B. specialist of District Hospital, Durg clearly indicate that the deceased was suffering from T.B. and was given treatment, for the said disease. It also appears that the deceased Numan Singh Sahu remained admitted in the hospital for the treatment of Diabetes Mellitus etc. from 14.1.1994 to 11.2.1994 i.e., for about 28 days. It also appears from the letter of Executive Engineer, M.P. Housing Board where the deceased Numan Singh Sahu remained on medical leave from 10.1.1994 to 11.3.1994 and that he had submitted a certificate from Durg Hospital about his recovery on 14.3.1994. Copy of the said certificate of T.B. Specialist is placed on record. From the above material on record, it is abudantly clear that the deceased insured Numan Singh Sahu was suffering from Diabetes Mellitus and T.B. prior to obtaining the insurance policies. In the proposal form he did not disclose the diseases as above. It is, therefore, clear that there was suppression of material facts regarding the state of his health and his ailment by the deceased. His claim was, therefore, rightly repudiated.

THE findings of the District Forum as above are justified and are affirmed. THEre is no substance in this appeal. Accordingly this appeal is dismissed. Appeal dismissed.