SUNITA AGARWAL Vs. LIFE INSURANCE CORPORATION OF INDIA

JUDGEMENT

(1.) BY this complaint under Section 17 of the Consumer Protection Act, 1986 complainant attributes deficiency to opposite party -the LIC in the matter of repudiation of her claim under three life insurance policies and claims awardment of sum assured i.e., Rs. 11,00,000/ -, damages and cost.

(2.) LATE Shri Pawan Agarwal the husband of complainant had obtained four policies from the opposite party bearing Nos. 350203897 for Rs. 1,50,000/ -, 350223715 for Rs. 3,00,000/ -, 351890631 for Rs. 3,00,000/ - and 351842002 for Rs. 5,00,000/ - w.e.f. 28.12.1991, 28.12.1995, 28.12.2001 and 15.2.2002 respectively. Deceased insured aged about 45 years, was on 12.1.2003 admitted in Chirayu Health and Medicare Centre with complaint of sudden onset of vertigo associated with headache and nausea and was diagnosed to be suffering with hypertension with non -insulin dependent diabetes mellitus. On 15.1.2003 he died of cardio and respiratory failure. Policy dated 28.12.1995 was running in lapsed condition for some time before it was revived on 31.3.2000 by the deceased insured on payment of arrears of premium with interest. While the opposite party -LIC allowed the claim of complainant under Policy No. 350203897 dated 28.12.1991, but repudiated her claim in respect of other three policies mainly on the ground that the deceased was suffering with HT and DM prior to his obtaining these three policies but he suppressed his pre -existing ailment while making proposals for these policies. Feeling aggrieved by this repudiation, the complainant has approached this Commission and it is contended that the deceased -insured was hale and hearty and had no such ailment on the dates when these three policies were obtained or even on the date of revival of Policy No. 350223715. Opposite Party -LIC have resisted the claim reiterating the ground of repudiation as aforesaid.

(3.) BOTH parties have led evidence in the form of affidavits and documents. Opposite party also examined Dr. Ajay Goenka who treated the deceased in Chirayu Hospital before his death.