LIFE INSURANCE CORPORATION OF INDIA Vs. RAMSWAROOP MEENA
LAWS(RAJCDRC)-2006-2-4
RAJASTHAN STATE CONSUMER DISPUTES REDRESSAL COMMISSION
Decided on February 07,2006

LIFE INSURANCE CORPORATION OF INDIA Appellant
VERSUS
Ramswaroop Meena Respondents




JUDGEMENT

- (1.)THIS appeal under Section 15 of the Consumer Protection Act, 1986 has been filed against the order dated 28.5.2004 passed by the District Forum, Dausa by which the complaint of the respondents was allowed in the manner that the appellants were directed to pay to the complainant respondents a sum of Rs. 25,000 in respect of the life insurance policy and a sum of Rs. 6,575 as amount of bonus along with interest @ 9% p.a. w.e.f. the date of filing of the complaint i.e., 2.9.2003 and further Rs. 500 as amount of compensation and Rs. 1,000 as costs.
(2.)THE necessary facts giving rise to this appeal are as follows :
That the wife of respondent No. 1 and mother of respondent Nos. 2 to 5 (hereinafter referred to as deceased ) had taken an insurance policy for Rs. 25,000 from the appellants on 28.8.1997 upto 28.7.2017 bearing policy No. 191387242. It was further stated in the complaint that due to some reason payment for the premium was not paid for the months of August 2001, February, 2002 and August 2002. The policy had lapsed but on 26.2.2003 the policy was again revived by the appellants and for that fresh declaration form was also got filled in by the deceased on 24.2.2003. It was further stated in the complaint that the deceased had died on 1.5.2003 because of biting by poisonous animal and information to this effect was given by the respondents on 21.5.2003 to the appellants. Thereafter the claim was preferred by the respondents before the appellants and that claim was repudiated by the appellants through letter dated 29.7.2003 inter alia stating that the deceased was suffering from the diseases TBM and Hemiparesis and for that she had taken treatment in the hospital during the period 2003 but that fact was not disclosed while filling in up the declaration form thus she had made deliberate misstatements and withheld material information from the appellants regarding her health at the time of getting the policy revived, therefore, the claim of the respondents was repudiated. Thereafter the present complaint was filed.

A reply was filed by the appellants before the District Forum and the same plea which was taken by them in their repudiation letter dated 29.7.2003 was taken by the appellants and apart from that it was further stated by the appellants that the deceased had taken treatment for the diseases mentioned above in the SMS Hospital, Jaipur where she had been admitted for the period from 17.2.2002 to 2.3.2002 for getting the treatment. Thus it was a case of misstatement on the part of the deceased and the claim was rightly repudiated. Hence complaint be dismissed.

After hearing both the parties the learned District Forum through impugned order allowed the complaint of the complainant -respondents in the manner as indicated above inter alia holding

(1) that it was not a case of suppression of material facts,

(2) that since the cause of death of the deceased had no nexus with the diseases as alleged by the appellants, therefore, from the point of view also the claim was wrongly repudiated by the appellants.

Aggrieved from that order passed by the District Forum, Dausa this appeal has been filed by the appellants.

(3.)IN this appeal the main contention of the learned Counsel for the appellants is that since before filling in up the declaration form on 24.2.2003 there is ample evidence to show the fact that the deceased had remained as indoor patient in the SMS Hospital, Jaipur for the period from 17.2.2002 to 2.3.2002 for the treatment of the diseases TBM and Hemiparesis and when this fact was not disclosed by her in the declaration form, therefore, it was a case of misstatement on the part of the deceased and thus findings of the District Forum to the effect that there was no suppression of material facts on the part of the deceased are wholly erroneous, perverse and illegal and thus the same cannot be sustained and liable to be quashed and set aside and this appeal deserves to be allowed.
On the other hand the learned Counsel appearing for the respondent -complainants has supported the impugned order of the learned District Forum.



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