- (1.) THIS instant appeal has been filed under Section 15 of the Consumer Protection Act, 1986 , against the order dated 12.9.2002, passed in Complaint No. 106/2001 by the District Consumer Disputes Redressal Forum, Durg (hereinafter called the District Forum for short) whereby the complaint for deficiency in service against the L.I.C. was allowed and the opposite party was directed to pay to the complainant the insured sum of Rs. 25,000/ - together with interest @ 9% per annum besides paying Rs. 700/ - towards cost of proceedings and Rs. 300/ - towards Counsel s fee.
(2.) THE facts not presently in dispute are that the husband of the complainant late Sevak Ram Madhariya had obtained a life insurance policy bearing No. 381594728 on 28.1.1997 for a sum of Rs. 25,000/ - from the appellant/opposite party. The said Sevak Ram Madhariya had appointed his wife i.e., the respondent/complainant as his nominee for purposes of the aforesaid policy. It is also not in dispute that the said Sevak Ram Madhariya died on 30/31.1.1998 and further that the claim filed by the nominee of the deceased i.e., the respondent/complainant was repudiated by the insurer on 31.8.1999 on the ground that while filling proposal form the life assured had suppressed material facts regarding his state of health.
(3.) IN consequence of repudiation of claim, the widow of the life assured had filed complaint before the District Forum and contended that at the time of filling the proposal form her husband was hale and hearty and leading an active life. Before issuance of policy the duly authorised doctor of the LIC had medically examined her husband and as he was found in perfect condition of health, first premium was accepted and policy was issued. It was further contended that subsequent to obtaining the policy, there was sudden deterioration in health of the life assured and consequently he died on the night intervening between 30 and 31 January, 98. It was further averred that the insurer has wrongly repudiated her claim under the garb of suppression of material facts regarding the state of health of her husband at the time of filling proposal form. The complainant had claimed the insured sum of Rs. 25,000/ - together with interest @ 18% per annum and Rs. 10,000/ - as damages together with interest @ 18% per annum and cost of proceedings. The complainant had filed her own affidavit in support of the averments contained in the complaint. The appellant/opposite party insurer had averred in the written version that the policy holder had given wrong information regarding state of health while filling the proposal from and had suppressed the fact that he was suffering from various diseases from the period prior to obtaining insurance policy and had taken leave from his place of work as detailed in the written version. It had also been averred that the fact that a person is examined by the L.I.C. s medical examiner does not absolve the proposer from his responsibility to disclose the material facts. It has also been averred that as the death was within a short period after obtaining the insurance policy, the L.I.C. had conducted thorough investigation and obtained leave record of the policy holder from his employer together with medical certificate submitted by him with the employer. The policy holder had suppressed all these facts at the time of filling proposal form. Further that it is also clear from the post -mortem report that the policy holder suffered from tuberculosis, etc. Hence, the claim was repudiated bona fide and by doing so the company has not committed any deficiency in service.;