Life Insurance Corporation of India vs RAMPATI

LIFE Insurance Corporation has come up in appeal against the order dated 19th August, 1996 passed by learned District Forum, Hisar, whereby complaint of Smt. Rampati widow of Kartar Singh challenging the repudiation of her claim for insurance by the L.I.C. has been allowed and L.I.C. has been directed to pay the amount of the insurance policies alongwith 12% interest.

COMPLAINANT has approached the District Forum, Hisar with the grievance, that her husband Kartar Singh had secured insurance policy bearing No. 170163689 for Rs. 25,000/on 21st February, 1989 and policy No. 170286433 for Rs. 35,000/on 25th August, 1991. After the death of her husband on 31st January, 1993 when the insurance amount under the aforesaid policies was claimed, the L.I.C., repudiated the same on the ground that the deceased was suffering from some illness which fact was not disclosed at the time when the insurance policies were taken. Before the District Forum the same position was reiterated by the parties. The LIC pleaded that Kartar Singh was patient of diabetes and this ailment was not detected or noticed by the Medical Officer of the L.I.C. at the tune of medical check up. It was further pleaded that the deceased was employed in a Bank, where he used to apply for leave on that ground as and when he wanted to avail the leave. It was still further pleaded that the deceased used to take treatment from certain hospital for the diabetes also. After considering the matter in detail and examining the evidence produced by the parties the learned District Forum disagreed with the plea taken by the L.I.C. and allowed the complaint by holding that there was no suppression of any material fact by the deceased at the time of his taking the insurance policies as L.I.C. had failed to prove on record that when the original policy was taken as back as in February, 1989 the deceased was suffering from the diabetes. In the appeal before us, Mr. B.J. Singh, learned Counsel for the appellant LIC has vehemently contended that even though the first insurance policy had been taken out on 21st February, 1989, the second one had commenced w.e.f. 25th August, 1991. Therefore, the date of death being 31st January, 1993 the presumption would be that death being within two years of taking out of the second policy, it was a case of non-disclosure of previous history of diabetes. The learned Counsel proceeds further to contend that with regard to the state of his health wrong answers given by the insured in the proposal forms amounts to mis-statement and nondisclosure of material facts on the basis whereof the repudiation of the insurance claim was justified. On that basis, the learned Counsel contends that there was no deficiency in service on the part of L.I.C.

After hearing the learned Counsel for the appellant and having gone through the record, we do not find any merit in the contentions raised by the learned Counsel as there is no legal infirmity in the detailed and well-reasoned order passed by the learned District Forum. It is evident on record that the first policy was taken out by the insured on 21st February, 1989 whereas the date of death is 31st January, 1993; thereby the death having occurred four years after the date of commencement of the policy, the plea of suppression of material fact relating to the bad health of the complainant looses all significance. The repudiation of the claim on the face of it is without any legal justification. So far as the second policy taken out on 25th August, 1991 is concerned, again there was no mis-statement or suppression of any material fact as the same insured person was before the insurer-LIC, who had been subjected to medical check up and examination by the LIC''s doctor. Even if the medical examination of the deceased conducted by the Doctor of the LIC was not to be treated as authentic as contended by the learned Counsel for LIC, yet diabetes was not such a serious ailment which was necessary for the insured to bring it to the notice of the Insurance Corporation. For these reasons, the repudiation of the claim by the LIC was wholly arbitrary and without any cogent or convincing reason. Consequently, we do not find any merit in the appeal and dismiss the same. Appeal dismissed.