Decided on December 18,2009

JAMNA DEVI Respondents


- (1.) THIS appeal was heard at Hamipur on 27.11.2009. Mr. Jagdish Sharma, Advocate appeared for the appellant and Mr. Balwant Singh, appeared for the respondent. It was adjourned for orders on 11.12.2009 at Shimla, however order was not ready, and the case was ordered to be listed on 18.12.2009.
(2.) FACTS as they emerge from the complaint file are, that husband of the respondent late Shri Prem Chand had obtained an Insurance policy in the sum of Rs.50,000/ - and according to her he was regularly paying premium of Rs.1553/ -. At the time of hearing it was not disputed on behalf of the parties that the premiums payable was half yearly on 28th of June and 28th December every year. Date of commencement of the policy was from 28.12.2000. Because of non payment of the insurance premiums due on 28.12.2002 and 28.6.2003, policy was in a lapsed condition. It was got revived on 31.10.2003. Declaration in this behalf while getting the policy revived was signed by the deceased on 29.10.2003. In original, it has been placed on record by the appellant as Annexure R.III.
(3.) AFTER revival of the policy, Prem Chand died. In the aforesaid background, respondent approached the appellant for payment of the sum insured alongwith other admissible benefits in terms of the policy bond, Annexure R.II. Instead of needful being done, her claim was repudiated on 21.9.2006 on the plea that when the policy was got revived on 29.10.2003, prior to it and even during the period when it was lying in a lapsed condition due to non payment of premium, Prem Chand was registered for treatment on 23.9.2003 in the Department of ENT of Indira Gandhi Medical College and Associated Hospitals (IGMC), for swelling right side neck and pain throat - 2 months. It is further case of the appellant that in addition to swelling right side neck for two months, there was pain throat during swallowing for 2 months, hoarseness voice plus cough for 22 days. He was registered as a patient of Carcinoma Larynx T3N1M0 registered in RT.OPD on 23.9.03 with complaints of swelling rt. Side neck since 2 months and pain during swallowing food. Radiating to rt. Ear. H/O hoarseness of voice and cough since 22 days no H/O haemoptysis. Patient was treated c.2 cycles neoadjacent chemotherapy based on cisplatin and 5 flourouroal, and Radiation therapy - 45 cy/Ltwll/20 Fx + 20hy/2wk/10fx, completed in Jan"04. Discharge slip of the deceased is also there on the record which indicates that he was admitted on 23.9.2003 and was discharged on 1.10.2003. Its copies are at pages 25 and 26 of the complaint file. We may notice in this behalf that in the discharge slip, name of the patient is shown as that of the father of the deceased Shri Prem Chand. However the particulars of the disease are same as given in Forum No.3816 Annexure R.IV. A perusal of this form clearly indicates that his biopsy was done and thereafter treatment was given to him at IGMC, Shimla. Deceased having remained as indoor patient could not be disputed on behalf of the respondent by her learned Counsel.;

Click here to view full judgement.
Copyright © Regent Computronics Pvt.Ltd.