Life Insurance Corporation of India vs Asha Singh

PETITIONER was the opposite party before the District Forum, where the respondent/complainant had filed a complaint alleging deficiency in service on the part of the respondent.

VERY briefly the facts of the case are that the deceased Rajesh Pratap Singh had obtained a Life Insurance Policy from the petitioner on 21.8.1997 which was lying in a lapsed condition after 28.1.1999, which was got revived on 18.11.1999 and the insured died on 21.5.2002. When the nominee filed a claim before the petitioner Insurance Company, it was repudiated on the ground that the deceased had suppressed the fact of existing heart ailment at the time of seeking revival of the policy on 18.11.1999. In these conditions a complaint was filed before the District Forum, which was dismissed. On an appeal filed before the State Commission, it was allowed and the petitioner was directed to pay Rs. 3 lakh together with other benefits along with interest @ 6% p.a. and cost of Rs. 1,500. Aggrieved by this order this revision petition has been filed before us. We heard the learned Counsel for the petitioner and perused the material on record. We have very carefully gone through the Section 45 of Insurance Act, which clearly stipulates that no policy of life insurance after the expiry of two years from the date on which it was effected will be called in question by Insurers on the ground that a statement made in the proposal for insurance or in any report of a medical officer, or referee, or friend of the insured, or in any other document leading to the issue of the policy, was inaccurrate or false, unless the insurer shows that such statement was on a material matter or suppressed facts which it was material to disclose and that it was fraudulently made by the policy-holder and that the policy-holder knew at the time of making it that the statement was false or that it suppressed facts which it was material to disclose.

We are afraid that the Section 45 of the Insurance Act is against the petitioner. There are two parts of Section 45. One relates to suppression of facts/make disclosure fraudulently and more importantly the Policy-holder knew at the time of making it, that the statement was false. The only material brought before us by the petitioner in support of this is the certificate issued by ''Escorts Heart Institute & Research Centre, New Delhi'', which states that echo done in 1999. Like State Commission, we reject this particular entry with the contempt it deserves. There is a very heavy over-writing on this and we are not sure as to what was the actual figure. Learned Counsel for the petitioner has worked hard and has procured the originals from the hospital and also a report of the hospital on this point. Over-writing is apparent with regard to the year in the original report as well. The report from the hospital is that the person who wrote, is no longer working with the hospital hence the actual date of entry could not be verified, in view of which we have no difficulty in holding like the State Commission that this report does not help the petitioner. The year 1999 when the Echo was ordered to be done has not been corroborated by any evidence, on account of which the very foundation of the case of the petitioner falls like nine-pins. The judgment of the Hon''ble Supreme Court in the case, P. Sarojam v. LIC of India, AIR 1986 Kerala 201, also does not help the petitioner as the petitioner has not been able to prove that any false answer was given by the insured. There is no other material or evidence of any person, to state that the deceased was suffering from any cardiac problem or any ailment, and that was within his knowledge, hence relying upon the evidence on record as also the provisions of Section 45 of the Insurance Act, the repudiation of the claim was rightly held by the State Commission to be not in order. The order passed by the State Commission is as per law and does not call for any interference.

THIS revision petition is devoid of merit, hence dismissed. Revision Petition dismissed.