SUNITA SOOD Vs. LIFE INSURANCE OF CORPORATION OF INDIA
HIMACHAL PRADESH STATE CONSUMER DISPUTES REDRESSAL COMMISSION
Life Insurance Of Corporation Of India
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(1.) ONLY question involved in this complaint for determination is, whether deceased -life assured was guilty of having intentionally misstated material matters, or had suppressed such facts disclosure of which was material at the time of getting himself insured under the policies which is subject matter of this complaint. If this question is answered in affirmative, then whether such suppression was fraudulent. In case both these points are held against the complainant, her complaint has to be dismissed. Otherwise we shall have to determine the complaint further on merit regarding her entitlement or otherwise to any relief.
(2.) FACTS giving rise to this complaint are within narrow compass, as such those are being briefly noted. These are, that Dr. Vivan Sood was holding a number of insurance polices. Claim in respect of all other polices, except other than following was settled and paid by the OPs to the complainant: -
During the currency of these policies, life assured died on 03.10.2007 at Fortis Hospital, Mohali on 12.10 p.m.
(3.) AT the time of his death, deceased was working as a Medical Officer in Mahatma Gandhi Medical Services Complex, Khaneri (Tehsil Rampur). While on duty on 02.10.2007 he was suddenly taken ill and was put under treatment. From Khaneri he was referred to IGMC, Shimla/PGI, Chandigarh. Dr. B.D. Negi, Medical Officer at Khaneri Hospital, accompanied him to Chandigarh. Instead of PGI, he was taken to Fortis Hospital, where he breathed his last on 03.10.2007 in the afternoon at 12.10 p.m. There is ample evidence on record to suggest that the parents of deceased were not in a position to accompany him, because his mother was attending upon her ailing and bedridden husband at Khaneri. As already noted, claim was lodged in respect of all insurance policies held by deceased, and except for the above four policies, amount of all other insurance policies was paid to the complainant by the OPs.
Claim in respect of these four policies was disputed by the OPs on the ground that deceased had wrongly answered the questions in proposal forms while obtaining each one of these policies, particularly while replying Column No.11 as envisaged in the said proposal form. After repudiation of claim, complainant approached the OPs vide representations Annexures C -14 to C -17. All the policies were separately repudiated by the OPs. Copies of repudiation letters are Annexures C -8 to C -11.;
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