Decided on March 12,2003

L.I.C.OF INDIA Respondents


P.RAMAKRISHNAM RAJU,PRESIDENT - (1.) THE complainants husband late Seemakurthi Penduranga Rao took out 20 years ˜Jeevan Surbhi policy bearing No. 681321132 with accident benefit for a sum of Rs. 5 lakhs from the second opposite party branch which commenced on 1.5.1995 with annual premium of Rs. 48,834/ - and the complainant was appointed as his nominee under the said policy. While so the insured died on 14.2.1997 due to ˜Poems Syndrome and weakness of limbs. When the complainant submitted a claim for payment of the policy amount the first opposite party repudiated the claim on 15.2.1996 stating that her husband made incorrect statements at the time of proposal. Hence she filed the complaint claiming the sum assured together with compensation of Rs. 50,000/ - and costs of Rs. 10,000/ -.
(2.) IN the written version filed by the opposite parties, it is admitted that the complainants husband made a proposal on 23.6.1995 for Rs. 5 lakhs under ˜Jeevan Surabhi Plan. As per the procedure of the Corporation if the proposal is not accepted within six months the Corporation would call for a fresh proposal along with fresh medical report. In this case same thing happened. Accordingly her husbandsubmitted a fresh proposal dated 15.2.1996 requesting to date back the policy from 1.5.1995 collecting the balance of the consideration amount on 25.3.1996 vide SOC No. 014967 for Rs. 11,832/ -, total premium being Rs. 48,340/ - and first premium receipt was issued on 25.3.1996. The insured was having another policy for Rs. 50,000/ - and on his death the said policy was settled but it investigated into the matter in respect of the policy in question as it was an early claim. During the course of investigation it came to light that the policy holder was suffering from pain in limbs and took treatment at Nizam Institute of Medical Sciences, Hyderabad on 28.12.1995. He also underwent treatment at National Institute of Mental Health and Neuro Sciences, Bangalore where he died. The material gathered by the opposite parties clearly discloses that the policy holder was suffering with weakness and problem with both lower limbs before making the proposal. As the insured suppressed his health condition that he was suffering from pain in limbs and he was not able to get up from the sitting position nor could he climb steps, the Corporation rightly repudiated the claim of the complainant.
(3.) THE complainant filed Exs. A -1 to A -5 besides filing her affidavit. The opposite parties also filed Exs. B -1 to B -18 besides filing the affidavit of Assistant Secretary, Legal Cell of the Zonal Office of the opposite party Corporation. The point that arises for consideration therefore is whether there is any deficiency in service on the part of the opposite parties, if so to what relief?;

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