- (1.) THIS appeal, under Section 15 of the Consumer Protection Act, 1986 , is directed against the order dated 13.9.2002 in complaint No. 146/2001, by District Consumer Disputes Redressal Forum, Ambikapur (hereinafter called District Forum for short ) whereby the complaint of the complainant/respondent herein was allowed and the opposite party/appellant Life Insurance Corporation, was directed to pay to the complainant/respondent the assured sum of Rs. 2 lacs with interest and cost of the complaint.
(2.) THE relevant facts which are no longer in dispute stated in brief are, that the deceased insured Ku. Seema Anwari Fatima who was the daughter of the complainant/respondent obtained a life insurance policy from the appellant effective from 13.9.1999 to 13.6.2019. The proposal form was filled up by the deceased insured on 6.9.1999. The deceased insured died on 17.4.2000. The cause of death, as reported in the medical attendant s certificate obtained by the appellant insurer was Sickle Cell disease -Haemolytic crisis C ARF C Septicemia. It was also reported by Dr. Suresh Sethi issuing the said certificate that the deceased was suffering from the disease for the period of 6 to 8 years prior to her death. The claim of the complainant was accordingly repudiated by the appellant insurer by their letter dated 26.12.2001 on the ground that she died of Sickle Cell disease and had obtained treatment therefor, for the last 6 years, but she did not disclose the disease in her proposal form and had furnished false replies to the questions in the above regard.
(3.) COMPLAINANT /respondent in his complaint averred that the deceased insured was his daughter. It was also averred that when she fell ill, the complainant got her treated. Her ailment was diagnosed as jaundice. It was further averred by the complainant that despite treatment his daughter died on 17.4.2000. After her death the complainant lodged claim under the policy with the appellant/insurer. However, they have repudiated the same. The complainant, therefore, preferred complaint before the Distt. Forum. The complaint was resisted by the insurer/appellant. In their reply -cum -affidavit, the Manager of the appellant/insurer averred that the deceased was suffering from Sickle Cell disease and received treatment for the said disease for the last 6 to 8 years before her death. However, the deceased did not disclose about her ailment and was thus guilty of suppression of material facts.;