National Insurance Co.Ltd vs PITAMBAR LAL SARAVAGI

THIS appeal is by the National Insurance Company Ltd. against order dated 5 August, 1992 of District Consumer Forum, Gorakhpur in Complaint Case No. 94 of 1992. By this order the District Forum has directed the appellant Company to pay a sum of Rs. 15,301 /- to the complainant-respondent towards a claim in respect of the expenditure made by the complainant in connection with his treatment at Gorakhpur and Delhi for a heart ailment. The appeal was filed on 25.9.1992.

WE have heard Sri A.K. Mittal, Advocate for appellant Company and Sri. M.H. Khan, Advocate for the complainant-respondent. It was pointed out by Sri Khan that the appeal was belated. Alongwith appeal an application was filed seeking condonation of delay, if any. This application was supported by an affidavit in which it has been asserted that the certified copy of the order was received by the Company on 26.8.1992 and the appeal, which was filed on 25.9.1992, was within time. It has been asserted on behalf of the complainant in the reply to it that the decision was made by the District Forum on 5.8.1992 in the presence of the Counsel for the Insurance Company and as such the Company had knowledge of the decision on that very day. The appeal was, therefore, barred by time.

Under the relevant rules a Memorandum of Appeal is to be accompanied by a copy of the order appealed against. Even if the Counsel for , the appellant Company was present when the decision was made but appeal could not be filed without obtaining a copy of that decision. There is nothing before us on the record of this appeal to show that a copy of the order was received by the Company on any date prior to 26 August, 1992 when it is stated to have been received by it in the affidavit filed in support of the delay condonation application. Under these circumstances, it is not possible to hold that the appeal is belated;

ON merits, it has been urged by Sri Mittal that the complainant had concealed the fact that he was suffering from heart disease when he made the proposal on the basis whereof the insurance policy was given to him and since there was non-disclosure of a material fact the Insurance Company cannot be held liable under the policy issued in these circumstances. He has mentioned that this plea was raised before the District Forum and has also pointed out that the facts about it stood established from the copies of the various documents, including the proposal form filed alongwith the Memo of Appeal. A perusal of the order of the District Forum shows that while the aforesaid plea was raised in the Written Statement no cogent evidence was placed on the record of the proceedings before the District Forum to substantiate the plea. In other words, the Insurance Company failed to establish by evidence before the District Forum that the complainant had concealed any material fact while filling in the Proposal Form and thus misled the Insurance Company in entering into the contract of insurance. In view of these facts it is clear that the decision made by the District Forum cannot be faulted in the peculiar circumstances of the case. We, therefore, dismiss the appeal but leave parties to bear their own costs in it.

LET copies of the order be made available to the parties or their learned Counsel as per rules. Appeal dismissed.