LIFE INSURANCE CORPORATION OF INDIA vs GIAN SINGH

This revision petition is directed against the order of the State Commission dated 22.4.2016 whereby the appeal filed by the petitioner corporation against the order for the District Forum dated 19.2.2015 came to be dismissed. This matter had earlier travelled to this Commission by way of Revision Petition No.2423 of 2010 - LIC of India Vs. Gian Singh decided on 17.10.2014. The facts of the case is outlined in the aforesaid order are as under:

"1. Late Rakesh Kumar, son of the complainant, purchased an insurance policy from the petitioner-corporation on 05-06-2003 for an amount of Rs.10,00,000/-. Rakesh Kumar died during currency of the aforesaid policy and a claim was duly lodged with the petitioner-corporation. The claim was, however, repudiated by the corporation primarily on the ground that instead of appearing himself, the insured had produced some other person, for medical examination and thereby a fraud was played upon the corporation.

The repudiation letter dated 25-03-2006, to the extent it is relevant for our purpose reads as under:

"In this connection we have to further state that the life assured has submitted the proposal dated 05-06-2003 along with medical report dated 10-06-2003 in our branch office which resulted in policy No.173447447. We hold in disputable proof to show that the life assured did not present himself before the medical examiner at the time of medical examination himself before the medical examiner at the time of medical examination on 10-06-2003 and presented someone else on his behalf. Hence, this is a case of impersonation to defraud the corporation. The signatures of the person who was medically examined do not tally with the signatures of Sri Rakesh Kumar on the proposal form.

It is therefore evident that it is a case of impersonation. The life assured perpetuated a fraud on LIC of India by presenting someone else on his behalf for medical examination on 10-06-2003 as he was not keeping good health as such we have repudiated the above claim and accordingly we are not liable for any payment under the above policy and all moneys that have been paid in consequence thereof belong to us.

It is an admitted case that despite the claim having been rejected on the ground that the insured himself did not appear before the doctor for the purpose of medical examination, no evidence was led by the complainant to prove that the signature on the medical report dated 10-06-2003 were of the deceased-insured. The petitioner-corporation obtained the opinion of the handwriting expert from the Forensic Science Laboratory, Madhuban, Karnal and the said expert after comparing the signatures of the insured on the proposal form (marked A1 to A3) with the signatures on the medical report (marked Q1) opined that the person who wrote the signatures marked A1 to A3 did not write the signatures marked Q1. However, the aforesaid expert was not produced by the petitioner-corporation as a witness before the District Forum. In these circumstances, the District Forum did not have the benefit of an expert opinion as regards the author of the signature appearing at Q1 on the medical report dated 10-06-2003.

In these circumstances we are of the considered view that the matter needs to be remanded back to the District Forum with a liberty to both the parties to examine their respective handwriting experts, on the question as to whether the signature at Q1 on the medical report dated 10-06-2003 tally with the signature marked A1 to A3 on the proposal form submitted by the insured or not. The District Forum shall give only one opportunity each to both the parties to examine their respective handwriting experts. Opportunity for cross-examination by way of interrogatories shall also be given to the opposite party. The District Forum shall decide the complaint afresh after considering the depositions of the handwriting experts produced before it and the report of the aforesaid experts."

Pursuant to the order of this Commission dated 17.10.2014, the petitioner corporation examined a handwriting expert before the District Forum to prove that the signatures on the proposal dated 5.6.2003 differed from the signatures on the medical report dated 10.6.2003, meaning thereby that the proposer himself had not appeared before the doctor who medically examined him vide report dated 10.6.2003. In the absence of any handwriting expert from the complainant, the expert opinion produced by the petitioner corporation needs to be accepted and, therefore, it stands established that a person other than the insured himself impersonated the insured before the doctor at the time of the medical examination. The aforesaid impersonation obviously could not have been possible without the insured himself being a party to it. The insurance policy, therefore, was obtained by playing a fraud upon the petitioner corporation, by making some person other than insured appear before the doctor at the time of medical examination. The purpose of such impersonation obviously would be to rule out the possibility of the doctor detecting the illness/disease from which the insured might be suffering, during the course of the medical check-up. The insurance policy having been obtained by playing a fraud upon the insurer, the contract of insurance was voidable at the option of the insurer. The complainant, therefore, was not entitled to the benefit of the insurance policy taken in the aforesaid fraudulent manner.

The learned counsel for the petitioner states that the amount which the insured had paid to the petitioner corporation shall be refunded to the complainant along with interest on that amount @ 9% p.a. The impugned orders are, therefore, set aside and the complaint is consequently dismissed subject to the petitioner refunding the amount paid to it by the insured along with interest on that amount @ 9% p.a. from the date on which the payment was made till the date on which the said amount is refunded.

On the petitioner making payment to the complainant in terms of this order, the amount which it has deposited with the District Forum, shall be refunded to it along with interest which may have accrued on that amount.