MANAGER, LIFE INSURANCE CORPORATION OF INDIA vs LAKHUBEN

AS Miscellaneous Application No. 375 of 2002 has been granted by consent, this appeal is taken up for final disposal today.

THIS appeal arises from order dated 28.8.2002 rendered by learned Consumer Disputes Redressal Forum, Sabarkantha in Complaint No. 119 of 1998 directing the opponent Life Insurance Corporation of India to pay to the complainant Rs. 25,000/-, the policy amount with interest at the rate of 18% p.a. from the date of complaint till payment, compensation in the sum of Rs. 10,000/- on the head of mental agony and harassment and cost in the sum of Rs. 5,000/-. We have gone through the impugned order. We have heard the learned Advocates for the parties. We have also gone through the grounds taken in the memorandum of appeal and various documents which have been placed on the record of this appeal. Complainant''s husband Somabhai Punjabhai had taken life insurance policy in question for Rs. 25,000/- from opponent LIC on or around 26.2.1993. The insured was at work in his agricultural field on 29.12.1994 when he had snake bite resulting into his calling for help. Persons who were working in the field escorted him to his home and doctor was called. He treated the insured with medicine and injection. However, the injured died during the course of treatment. Complainant preferred claim before the opponent LIC, but the opponent LIC repudiated the claim. According to the complainant, there was no legal and valid reason for repudiation of the claim and, therefore, alleging deficiency in service on the part of the opponent LIC, the complainant preferred claim before the learned Forum. The complainant also prayed for compensation and cost. The opponent resisted the complaint inter alia on the same ground, namely that the insured died natural death and that he suppressed material fact at the time of taking of insurance. It was alleged by the opponent LIC of India that insured suffered from bronchial asthma before the date of taking of insurance, namely 26.2.1993. It has been submitted on behalf of the opponent LIC before us that the Investigator S.P. Singh had submitted report inter alia stating that the patient had history of chronic bronchitis and Status Asthamaticus. However, we do not have any evidence to support this finding so as to correlate the fact that the insured was in fact suffering from these ailments prior to the date of insurance and that the insured knew about such ailment prior to the date of taking of the insurance. THIS is apart from the fact that the cause presented by the complainant before the opponent LIC in the first instance and before the learned Forum in the second instance is the snake bite which ultimately resulted in the insured''s death. The complainant had produced necessary evidence before the opponent LIC as well as before the learned Forum. The facts which have been narrated in the complaint would clearly indicate and support the stand of the complainant that at the relevant point of time, the insured was down with snake bite resulting into persons who were working in the field or surrounding fields had to rush the insured to home and call for medical assistance forthwith. THIS is borne out from the documentary evidence which has placed on record. The cause of death has been stated to be snake bite by concerned doctor. THIS can be seen from page 67 also placed on record of this appeal. The evidence which has been discussed by the learned Forum and pointed out before this Commission, therefore, clearly indicates two aspects - the opponent LIC was not able to show before the learned Forum the fact regarding the insured having knowledge of his ailment of bronchial asthma and that he died on account of snake bite. In that view of the matter, the finding of the learned Forum with regard to deficiency in service on the part of opponent LIC of India cannot be faulted. The Investigator appears to have not carried out complete investigation for showing and establishing the inference drawn by it. In our considered opinion it is a clear case where the complainant has established the cause of snake bite resulting into death of the insured and the opponent LIC of India failing to even show the ailment of bronchial asthma from which the insured was alleged to have suffered as also knowledge of such ailment on the part of the insured. Hence, award of insurance amount at the hands of the learned Forum cannot be disturbed. With regard to interest, the learned Advocate appearing for the original complainant concedes for granting interest at the rate of 9% instead of 18% awarded by the learned Forum. With regard to compensation on the head of mental agony and hardship, it might be noted that the complainant preferred claim before the opponent LIC of India who was required to carry out investigation. It is a different matter that the opponent LIC of India was not able to show the fact that the insured was suffering from bronchial asthma prior to the date of insurance as well as show that the insured had knowledge with regard to the said ailment. Under such circumstances, investigation/inquiry conducted by opponent LIC cannot be said to be mala fide. In that view of the matter, bearing in mind the facts and circumstances of the case, grant of compensation on the head of mental agony and hardship is unwarranted.

Insofar as cost of the complaint is concerned, apparently it is on a higher side bearing in mind the amount of insurance involved in the present case. We propose to award cost in the sum of Rs. 2,000/- . We, therefore, pass following order. ORDER Impugned order dated 28.8.2002 rendered by learned Consumer Disputes Redressal Forum, Sabarkantha in Complaint No. 119 of 1998 is hereby maintained except with regard to rate of interest which is reduced from 18% to 9%. With regard to amount of compensation of Rs. 10,000/- the same is hereby set aside. With regard to cost of Rs. 5,000/-, the same is altered to Rs. 2,000/-. This appeal is accordingly partly allowed with no further order as to costs. The amount as directed by this order shall be paid by the opponent LIC of India within six weeks from today. Appeal partly allowed.