RAMBADI SAHU vs Life Insurance Corporation of India

THIS appeal, under Section 15 of the Consumer Protection Act, 1986 is directed against the order dated 20.11.2001 in Complaint No. 126/2001 by the District Consumer Disputes Redressal Forum, Raipur (hereinafter called as ''District Forum'' for short), directing the respondents to pay to the complainant/appellant a sum of Rs. 28,000/- with interest thereon being the paid value of the policy obtained by the insured Hariram Sahu the husband of the complainant.

UNDISPUTEDLY, the insured Hariram Sahu had obtained the Life Insurance Policy which was to ensure from 15.9.1993 to 15.9.2013. The half-yearly premium of Rs. 3,420/- was payable on the said policy, on 15th of March and September each year. It is also not in dispute that on account of non-payment of premium, the policy lapsed. It was got revived by the insured by submitting a declaration on 10.7.1998 regarding his health. Premium which had fallen due was paid on 15.9.1998. The insured died on 8.10.1998. The complainant/appellant, the nominee under the policy laid claim with the respondents/insurers. A statement dated 7.2.1989 was submitted by her. The claim was however, repudiated by the respondents insurers by their letter dated 19.2.2001 on the ground that the deceased suppressed the material fact that he as suffering from Mittal Stenosis, C Atrial Fabrillation, C.V.A. Hemiplagea. The complainant lodged a complaint with District Forum claiming the assured amount of Rs. 50,000/- alleging that the repudiation was not justified.

The complaint was resisted by the respondents/insurers inter alia on the ground that the insured suppressed material facts at the time of revival of policy. It was stated that the complainant in his declaration did not disclose that he was suffering from Mittal Stenosis C Atrial Fabrillation, C.V.A. with Right side Hemiplagea and Thromboembolism and that he took treatment in the Modern Medical Institute, Raipur and also remained admitted there from 25.9.1996 to 30.9.1996. It was, therefore, averred that the repudiation of the complainant''s claim was justified and was done bona fide after considering the facts and circumstances of the case.

THE learned District Forum held that in his declaration form, the insured had not disclosed the material facts of his ill-health and treatment. In view of above, the complainant could not get the full benefit under the policy. However, it was directed that paid up value of policy, be refunded to her. Learned Counsel for the appellant/complainant submitted that the assured amount under the policy and not only the paidup value of the policy should have been directed to be paid to her.

IT may be noticed that the respondents/insurers have placed on record the document regarding ailment and the treatment given to the insured immediately prior to the revival of the policy. IT would appear from the discharge certificate issued by M.M.I., Raipur that the insured was a known case of Mittal Stenosis C Atrial Fabrillation C C.V.A. C RT Hemiplagea and Thromboembolism. He remained admitted in the M.M.I. Hospital from 25.9.1996 to 30.9.1996 as is disclosed from discharge certificate and other documents placed on record. However, the insured did not disclose the said facts in his declaration dated 10.7.1998 while making request for revival of policy. Therefore, the finding of the learned District Forum that there was suppression of material fact by the insured appears to be justified and is affirmed. In view of above, there is no reason for interference in the impugned order. This appeal has no substance and is accordingly dismissed. Parties to bear their own costs of this appeal. Appeal dismissed.