NIRMLA DEVI Vs. SENIOR DIVISIONAL MANAGER LIFE INSURANCE CORPORATION OF INDIA

JUDGEMENT

(1.) Smt. Nirmla Devi complainant has come up in appeal against the order dated 2.2.1996 passed by the learned District Consumer Forum, Karnal, whereby her complaint, challenging the repudiation of her claim by the Life Insurance Corporation for the payment of the insurance amount of Rs.25,000/-, has been dismissed by relegating the complainant to seek her remedy before the Civil Court.

(2.) According to the complainant, her husband late Sh. Megh Nath Sharma got himself insured for a sum of Rs.25,000/- with the L. I. C. on 15.11.1993. She being the nominee of the policy lodged her claim with the L. I. C. after the death of her husband on 23.6.1994. However, the L. I. C. repudiated the claim on the ground that the insured had suppressed the material information at the time of taking the insurance policy regarding an accident suffered by him about seven and a half years prior to the date of the insurance policy. Aggrieved by that, she claimed the insurance amount alongwith 18% interest thereon. In their written reply, the L. I. C. reiterated their stand before the District Consumer Forum by pleading, that on verbal enquiries made by them it transpired that the deceased had suffered a head injury in a motor- cycle accident a couple of years back and on account of that he had some mental derangement. It was further pleaded that since in the application made to the police by the complainant it was mentioned that the deceased had taken weedicide under the influence of liquor, as the bottle of his medicine was also lying in the same Almirah, the L. I. C. was well advised to repudiate the claim. Justifying the dismissal of her complaint by the District Forum on the ground that the death of the deceased was shrouded in mystery, the learned Counsel for the L. I. C. submitted that the matter could not be decided by the learned Forum. Hence, the complainant should seek her remedy before the Civil Court. On the other hand, the learned Counsel for the appellant has vehemently contended that the repudiation was wholly arbitrary as it was not a case of any suppression of facts about the pre-existence of any disease on the part of the deceased, or that it was a case of suicide having been committed by the deceased. Mr. H. N. Mehtani, the learned Counsel for the L. I. C. has reiterated the stand taken by the L. I. C. before the District Forum to plead further, that there was some scar mark on the forehead of the deceased from which it could be gathered that after the accident the deceased was not keeping perfect mental health.

(3.) After having heard the learned Counsel for the parties and having gone through the record, we are of the considered view that the repudiation of the claim by the L. I. C. is wholly arbitrary and the complaint deserved to be allowed. There was hardly any complications or intricacies for deciding any question of fact or law, for which the complainant was asked to seek her remedy before the Civil Court. According to the facts established on the record and based on the admitted position by the parties, there was no disease or ailment from which the insured was suffering either at the time of his death or for a number of years preceding thereto. Therefore, it is not a case of non-disclosure or suppression of any material information relating to the pre-existence of some disease at the time of getting the insurance policy. Further, the death took place by taking some weedicide or pesticide from a bottle placed near the bottle of liquor in the Almirah. Even if one has to disagree with this version, the L. I. C. has not been able to prove on record the cause of death other than the one alleged or reported by the complainant. Finally, the mere fact that the insured had met with an accident about a couple of years back in which he had suffered some head injury, the knowledge of which the L. I. C. claims to have gathered through enquiries made by them, does not lead to the conclusion that the death of the insured had taken place due to that accident or the non-disclosure of that accident was sufficient to repudiate the claim of the complainant. In view of the aforesaid factual position, we accept the appeal filed by the complainant and set aside the order passed by the learned District Consumer Forum. Resultantly, the complaint is allowed by directing the L. I. C. to make the payment of the insurance amount to the complainant within one month from the receipt of this order. In the circumstances of the case, there shall be no order as to costs.