Decided on May 26,2009

Manager Claims Life Insurance And Ors Appellant
Amara Vati Devi And Ors Respondents


- (1.) THIS appeal is directed against the order passed by Distict Forum, Bilaspur, camp at Ghumarwin, in Consumer Complaint No. 83/2006, decided on 13.11.2007. In the operative part of the judgement the Distict Forum below had directed the respondents to pay assured sum of Rs. 50,000/ - alongwith vested bonus to Master Pankaj respondent No. 2 with interest @ 9% per annum from the date of complaint till realistion and besides this cost Rs. 1000/ - had also been awarded.
(2.) THE facts of the case that emerges from the complaint are that respondents Smt. Amara Vati Devi, W/o late Sh. Bal Mukund and Pankaj, Son had filed complaint u/s 12 of the Consumer Protection Act, 1986 against the respondents wherein it had been alleged that Bal Mukund had got himself insured vide policy No. 151356437 by the appellants on 24.8.2003 and insured Bal Mukund had died on 3.10. 2003 due to heart failure at Tapri, District Kinnaur and it had been also alleged in the complaint that death claim under the policy was submitted to the appellant for assured sum of Rs. 50,000/ -. The appellants vide letter dated 30.3.2005 had refused to make the payment on the pretext that the insured had undergone by pass surgery and this fact was concealed at the time of insurance contract. Since the payment was not made to the respondents on account of policy despite request as such this act on the part of the appellants amounts to deficiency in service, hence present complaint had been filed with a prayer for direction to the respondents to made payment of Rs. 50,000/ - with interest @ 9% per annum from the date of death of Mal Mukund and Rs. 10,000/ - had been claimed for mental and physical harassment besides Rs. 1000/ - as litigation cost.
(3.) THE respondent have contested the claim submitted by the appellants and the main plea which was taken in the reply was that there is a breach of terms and conditions of the policy and policy holder had suppressed the true and material facts and as such the present case is hit by Section 45 of the Insurance Act, 1938. It had further been averred in the reply that the life assured had obtained the said policy by suppressing material facts with fraudulent intention, since policy holder did not disclose about the medical leave availed by him and the fact about undergoing by pass surgery in Batra Hospital. The rejoinder to the reply was also filed wherein the respondent have completely denied the averments and re -asserted stand taken in the complaint.;

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