Life Insurance Corporation of India vs Balwinder Kaur

LIFE Insurance Corporation challenges order of District Forum, Jalandhar dated April 23, 1998 whereby direction was given to pay the insured amount of Rs. 3 lacs with 18% interest after four months from submission of the claim to the complainant Smt. Balwinder Kaur alongwith Rs. 1,000/- cost of litigation.

CHAIN Singh, husband of Balwinder Kaur, complainant had taken life insurance policy from Life Insurance Corporation in the sum of Rs. 3 lacs on September 28,1994. On June 18,1995 he died. Claim was lodged with the Corporation which repudiated the claim on June 1,1996 on the ground that CHAIN Singh had concealed material facts regarding his health at the time of taking the insurance policy. He was a chronic alcoholic, a patient of T.B. Meningitis and these facts were not disclosed. Balwinder Kaur approached the District Forum with the complaint alleging deficiency in rendering service on the part of the Corporation and in reply Corporation, took up the stand that the repudiation was bona fide made on material collected that the insured had concealed material facts relating to his health and habits as stated above. The District Forum did not accept the plea of the Corporation and held that repudiation was arbitrary and allowed the complaint. The short question involved in this appeal is about illegality or otherwise of the repudiation of the claim made by the Corporation. Two fold stand of the Corporation is required to be considered in this respect. Ex. 0-2 is the Proposal Form submitted by Chain Singh at the time of taking the insurance policy. To all the relevant questions, he replied in the negative which related to his previous health, illness of different types suffered prior thereto. Ex. 0-3 is Form No. 3816 obtained by the Corporation from Dr. Rupinder Singh Sidhu of Dayanand Medical College and Hospital indicating that on June 4, 1995 Chain Singh was admitted in the hospital aforesaid and died on June 18,1995. The history was reported to have been given by Balwinder Kaur, his wife. He was stated to be a patient of Hypertension for one year, T.B. (Tuberculous Meningitis)for six months, chronic alcoholic for 10 years. Ex. 0-4 is the Form No. 3816 obtained by the Corporation from Dr. Shangara Singh, a Surgical Specialist of Jalandhar. It is this doctor who had referred Chain Singh to D.M.C. Ludhiana on January 18, 1995. When he examined Chain Singh on January 10, 1995 he found the symptoms of Fever, Vomiting, Diarrhea 2 weeks. History was reported by the patient and the diagnosis made was Meningitis. Ex. 0-5 is another Form No. 3816 obtained by the Corporation from Dr. K.L. Trihan of Dayanand Medical College and Hospital. Date of admission is January 18,1995 and date of discharge is February 3, 1995. The diagnosis made was T.B. Meningitis. It is on the basis of the aforesaid material that the Corporation repudiated the claim. We find such material to be insufficient to record a finding that at the time of submission of Proposal Form Chain Singh was suffering from T.B. Meningitis. The policy was taken, as already stated above, in September, 1994 and it was in January, 1995 and thereafter that he took treatment from doctors referred to above. From such material as collected, no finding can be arrived at that Chain Singh was suffering from T.B. Meningitis in September, 1994.

The other question which requires consideration is the effect of history being recorded at Chain Singh was a chronic alcoholic. To one of the questions in the Proposal Form, he had replied in the negative which related to taking liquor. It is argued that it was a material fact regarding the habitual behaviour of the insured in the matter of his way of living that he used to take excessive liquor daily. He concealed such a fact to obtain the insurance policy as taking excessive liquor daily affects the life span. If pointed out at the relevant time, the Corporation would have taken into consideration such a factor in taking the decision as to whether policy is to be issued or not. We have given due consideration, but we do not find any merit in this contention. No doubt, one of the questions exist in the Proposal Form which the insured was required to answer as to whether he was used to take liquor or not. It can be considered a material factor only if ultimately the cause of death had any co-relation therewith. In the present case, no such evidence has been produced that cause of death had any connection with the taking of liquor. Respiratory failure is the cause of death as recorded. There is no material produced by the Corporation that such Cardiac Rest was on account of insured taking excessive liquor during his life time. Reference be made to the observations of Haryana State Commission in Life Insurance Corporation of India v. Smt. Chander Kanta, 1998 (2) CON.LT 193. In para 3 of the judgment, it was observed as under in the case of the insured who was described as alcoholic : "Finally, the LIC has not been able to prove that the insured died being an alcoholic or due to his daily consumption of liquor being excessive. In the aforesaid circumstances, we do not find any legal infirmity in the order passed by the learned District Consumer Forum which is a detailed and well-reasoned one."

APART from the fact that in the history sheet of the hospital it was recorded that the patient was chronic alcoholic, no other material was produced that infact the insured was taking liquor daily or his dose of liquor was excessive. Chronic alcoholic at the most can be a person who daily takes liquor but it cannot be said that such a person daily takes liquor excessively that ultimately his health was bound to deteriorate or that such dose of liquor would shorten his life span. Much more material was required to be collected by the Corporation in such like cass to co-relate the factum of liquor (quantity of liquor) and the cause of death. For the reasons recorded above, we find no merit in this appeal. The same is dismissed with costs of Rs. 500/-. The order of the District Forum is affirmed. The amount awarded be paid within one month from receipt of copy of this order. Vide interim order passed on June 11,1998 on payment of 50% of the amount, execution of the remaining amount was stayed. That order stands vacated. Appeal dismissed.