LIC OF INDIA vs Sarojan Devi

THIS revision petition has been filed by the petitioners against the order dated 1.1.2009 passed by the H.P. State Consumer Disputes Redressal Commission, Shimla (in short, ''the State Commission'') in Appeal No. 166/07 Branch Manager, LIC Vs. Smt. Sarojan Devi by which while dismissing appeal, order of District Forum allowing complaint was upheld.

BRIEF facts of the case are that Complainant/Respondent''s husband Raj Kumar got himself insured from OP/petitioner for a sum of Rs.50,000/ - vide policy dated 28.9.2001. Raj Kumar died on 1.8.2002 and claim was submitted to OP which was repudiated on 30.9.2003 on the ground that insured had withheld material information regarding his health at the time of taking policy. Alleging deficiency on the part of O P, complainant filed complaint before District forum. OP resisted complaint and submitted that claim was rightly repudiated as insured suppressed material information relating to his health and medical leave and prayed for dismissal of complaint. Learned District Forum after hearing both the parties allowed complaint and directed OP to pay Rs.50,000/ - with 9% p.a. interest and further allowed Rs.1000/ - as litigation cost. Appeal filed by OP was dismissed by learned State Commission vide impugned order against which, this revision petition has been filed.

NONE appeared for respondent even after service. She was proceeded ex -parte. Heard learned Counsel for the petitioner and perused record.

LEARNED Counsel for the petitioner submitted that inspite proof of suppression of material facts and wrong information in the proposal form, learned District Forum committed error in allowing complaint and learned State Commission further committed error in dismissing appeal; hence, revision petition be allowed and impugned order be set aside.

IT is not disputed that insured obtained policy on 28.9.2001 for a sum of Rs.50,000/ - from OP and insured died on 1.8.2002. In the proposal form for obtaining policy, he has replied following questions as under: (1) Have you ever been admitted to any hospital or nursing home for general check -up, observation, treatment or operation? : No

(2) Have you remained absent from place of work on grounds of health during the last 5 years? : No

(3) What has been your usual state of health? : Good OP proved by evidence that Raj Kumar availed medical leave for 20 days from 8.12.1996 to 27.12.1996 and 13 days from 15.11.2002 to 27.11.2000. The proposal form was signed by him on 28.9.2001. OP also proved medical certificate given by Dr. Virandra Mohan by his evidence in which it was mentioned that Raj Kumar was admitted in his clinic on 16.11.2000 on Psychiatric disorder and was discharged on 25.11.2000. Thus, it become clear that his reply to aforesaid queries mentioned in the proposal form was wrong.

LEARNED State Commission dismissed appeal on the basis of judgment of this Commission in R.P. No. 2409 of 2000 Smt. Santosh Kanwar Vs. LIC of India in which it was observed that ailments referred by Insurance Co. had no connection with death of insured and allowed revision petition and directed Insurance Co. to make payment of the Insurance policy. In the aforesaid judgment the judgments of three Revision Petitions of this Commission were referred, but it was observed that aforesaid judgments were not applicable.

HON ''ble apex Court in Civil Appeal No. 5322 of 2007 P.C. Chacko and Anr. Vs. Chairman, Life Insurance Corporation of India and Ors. dismissed claim on the ground of false answers/suppression of facts to the questions as under: (a) Did you ever have any operation, accident or injury? The answer was No.

(b) Have your remained absent from place of your work on ground of health during the last 5 years ? To which answer was No.

(c) What has been your state of health? The answer was good.

Hon''ble Apex Court in Satwant Kaur Sandhu Vs. New India Assurance Co. Ltd., 2009 4 CPJ 8Dismissed claim on the ground of wrong answers to the query about his health and as mentioned his health to be sound whereas he was suffering from diabetes and also chronic renal failure.

IN the case in hand, insured remained under treatment for Psychiatric disorder and also remained on medical leave twice and answers to the queries in the proposal form was also wrong. In the light of aforesaid judgments of Hon''ble Apex Court, learned District forum committed error in allowing complaint and learned State Commission further committed error in dismissing appeal and revision petition is to be allowed as claim was rightly repudiated and there was no deficiency on the part of OP in repudiating claim.

CONSEQUENTLY , revision petition filed by the petitioner is allowed and order dated 1.1.2009 passed by the H.P. State Consumer Disputes Redressal Commission, Shimla (in short, ''the State Commission'') in Appeal No. 166/07 Branch Manager, LIC Vs. Smt. Sarojan Devi and order of District Forum dated 13.3.2007 in CC No. 42 of 2005 - Smt. Sarojan Devi Vs. LIC is set aside and complaint stands dismissed with no order as to costs.