RACHNA,MEMBER - (1.) THIS is an appeal against the judgment and order dated 23.4.2001 passed by District Consumer Forum, Bulandshahar in Complaint Case No. 494/1998.
(2.) THE facts of the case stated in brief are that the complainant's husband took a life insurance policy of Rs. 50,000/ - on 27.4.1995. At the time when insurance was done the complainant's husband was in good health and after medical examination which was done by the doctor appointed by the opposite party, Life Insurance Corporation of India, the policy was issued.
(3.) AFTER four months of the policy being taken, the complainant's husband was admitted in G.T.B. Hospital, Shahdara, Delhi due to stomach pain. The complainant's husband was diagnosed for intestinal cancer and a minor operation was performed and was discharged on 6.9.1995. After one year two months he was again admitted in same hospital on 29.11.1996 and was discharged on 25.12.1996 and died on 4.1.1997 at his village Thora. The complainant, the wife and nominee of the policy holder submitted a claim on 14.1.1997 but same has been repudiated by the Insurance Company vide letter dated 7.11.1997 on the ground that the policy holder did not disclose true facts about his health. Hence complainant filed a complaint before the District Forum for getting insured amount, compensation and expenses etc. .(as per her complaint). The opposite party in its written version has taken following pleas : (1) The opposite party admitted that the complainant is nominee of the policy holder. (2) The policy holder has concealed the facts of his illness at the time of policy taken by him. (3) The Medical Officer of the Insurance Company had made general checkup of the policy holder and if the policy holder could disclose the true facts about his ailment then the Insurance Company's doctor could have made a thorough check -up of the policy holder. (4) According to the Insurance Company, policy holder was already suffering from illness according to the admission on 25.8.1995 in Guru Teg Bahadur Hospital, Shahdara, Delhi. He had already complained of the pain in his stomach since the last eight months. Therefore, the Insurance Company rejected his claim on the ground of concealment of his ailment.;