S.LEELA KUMARI Vs. L.I.C.OF INDIA
ANDHRA PRADESH STATE CONSUMER DISPUTES REDRESSAL COMMISSION
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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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