JANKI DEVI vs LIC OF INDIA

THIS judgment of ours shall dispose of above mentioned four appeals as they have arisen out of the common order dated 19.1.2000 passed by District Forum, Ambala, whereby all the four complaints have been dismissed.

GOBIND Ram Chawla had taken six life insurance policies on 10.8.1993. He died on 6.9.1994. The complainants, who are widow and sons of the deceased, put claim before the opposite party but their claim was repudiated on the ground that the insured had suppressed the material information regarding his state of health and ailment at the time he took the insurance policies. It is thereafter the complainants invoked the jurisdiction of the District Forum by filing four complaints and the same were dismissed vide its first order dated 5.11.1998. The complainants preferred appeals against the said order before the State Commission and the Commission vide its order dated 25.5.1999 quashed the order under appeals and the appeals were remanded to the District Forum for a fresh decision on merits in accordance with law after affording two opportunities each of the parties to substantiate their case. In compliance thereof, necessary opportunities were given to the parties but they did not adduce any fresh evidence as is recorded in the impugned order. After hearing the learned Counsel for the parties, the District Forum dismissed all the four complaints vide order dated 19.1.2000. Aggrieved by the said orders, the present appeals have been filed. We have heard the learned Counsel for the parties and have gone through the record minutely.

AT the outset, notice has to be taken to the submissions made by the Counsel representing the parties with regard to the procedure adopted by the District Forum in deciding the complaints. In support of the stand taken before us, our attention was drawn to one of the submissions made before the District Forum by the complainants was that even after the opposite party got medically examined the insured from two doctors prior to the issuance of the insurance policies, still no major ailment of the insured was detected by them and for that reason there was no justification for repudiation of the claim. In answer to the contention made, it was urged from the side of the respondent that those two doctors could not know about the illness of the insured. During the medical check up of the insured, they had given their opinion on the basis of reply furnished by the insured in the form filled and signed by him to the various questions with regard to his previous state of health and illness. It is clear from the impugned order that the above issues raised before the District Forum, have not been independently dealt with on the basis of evidence adduced on record as is borne out from the following observations recorded in the order : ''We had discussed the aforesaid issues in Paras 10 to 16 of the earlier order dated 5.11.1998 at length and had not accepted the contention raised on behalf of the complainants. We have given our anxious thought to the matter again but are unable to persuade ourselves to record different findings. So the plea taken by the complainants is rejected.''

FROM the above noted observations, we find that the decision was given against the complainants on the basis of findings recorded by the District Forum in Paras 10 to 16 of its earlier order dated 5.11.1998 which order had been set aside by the State Commission vide order dated 25.5.1999 as stated earlier. Merely it has been recorded in the order that anxious thoughts have been given by the Members of the District Forum to the matter again is of no consequence as evidence led on record was not adverted to and no finding was recorded in the order in the light of the submissions made before it. The procedure adopted is wholly illegal and unwarranted under the law. It was further contended by the learned Counsel for the complainants that the complainants have also raised a plea that onus to prove the material concealment, was upon the opposite party and the opposite party has not filed any evidence of the doctor to prove that the insured was suffering from major ailment which fact was fatal to the defence of the opposite party. It was pointed out from the side of the complainants that even no expert doctor was examined by the respondent to prove the concealment as alleged by them and for that reason there was no justification for repudiation of the claim and it should be accepted tha there has been deficiency in service on the part of the opposite parties. We find from the judgment that no effort was made by the District Forum to deal with this plea on the basis of the available material on record.

THE other illegality committed is that the complainants had maintained before the District Forum that the investigation conducted by the Investigating Officer is vitiated because he had made no efforts to contact the near and dear of the insured before submitting the report. This submission was rejected for the reasons and findings given in para Nos. 17 and 18 of the earlier order dated 5.11.1998. It means that the plea raised from the side of the complainants in the light of facts and requirement of law was not examined and was rejected on the basis of reasons given in paras 17 and 18 of the first order dated 5.11.1998. Such an approach cannot be accepted as a valid basis for deciding the issue raised for decision before the District Forum.

ADDITIONALLY , it was pointed out from the side of the opposite parties that it was brought to the notice of the District Forum that an application dated 10.10.1998 seeking permission to summon two doctors namely Dr. D.S. Goel of Ambala Cantt and Dr. Kapil Bhargava of PGI as witnesses to prove their defence, was made, but the same was declined, but, at the same time, it was observed in the impugned order that no adverse inference can be drawn against the opposite parties on this count. This finding, according to the learned Counsel, is self contradictory. The fact remains that the opposite parties have been denied the due opportunity to examine the witnesses for which specific prayer was made before the District Forum and the same was rejected without any basis. From the position explained above, it is clearly spelled out from the record that the District Forum has not given reasons as required under the law in support of the conclusion drawn in the impugned order. Needless to say that the absence of reasons would in fact render the impugned order unsustainable. It would be apt to notice the observations made by Honble Supreme Court in case of Charan Singh v. Heeling Touch Hospital, III (2000) CPJ 1 (SC)=AIR 2000 SC 3138, in para 11 of the judgment, which read as under : ''The authorities under the Act exercise quasi judicial powers for redressal of the consumer disputes and it is one of the postulates of such a body that it should arrive at its conclusion based on reason. The necessity to provide reasons, however, brief, in support of its conclusion by such a Forum, is too obvious to be reiterated and needs no emphasizing. Obligation to given reasons not only introduces clarity but it also excludes or at any rate minimizing, the chances of arbitariness and the higher Forum can test the correctness of those reasons.''

The ratio of the above case fully applies to the facts of the present case.

IN fairness to the Counsel for the parties, the submissions on merits as well were made but as the cases have to be remanded to the District Forum, Ambala to decide their approach, no decision is required to be given regarding other issues in the appeal so as to avoid any prejudice being caused to either of the parties.

FOR the aforesaid reasons, while setting the impugned order dated 19.1.2000, the appeals are accepted and the cases are remanded to District Forum, Ambala for a fresh decision on merits in accordance with law. The District Forum, Ambala shall afford one opportunity to the respondent to summon the doctors as prayed by them in the application dated 10.10.1998 and thereafter decide the case after giving reasons in support of the order. Compliance be done within three months from the date of receipt of copy of the order. Appeals allowed.