STATE CONSUMER DISPUTES REDRESSAL COMMISSION

BIHAR, PATNA

(Appeal  No. 23 of 2016)

Branch Manager Life

Insurance Corporation of India,

Sony Alankar Complex, Gudari

 Bajar Road, Hazipur.                                                                                 Appellant. 

VERSUS

Brij Kishore Singh,

S/O- Late Rajdeo Singh

R/O- Mohalla- Hathsarganj ( Near Naka-3)

Deep Narayan Singh Colony,

P.O.- Hazipur,

District- Vaishali  and others                                                                      Respondent.            

BEFORE,

                                Hon’ble Mr. Justice S.K.Sinha, President,

                                Hon’ble Sri Upendra Jha, ADM(Rtd), Member and

                                 Hon’ble Smt. Renu Sinha, member (F)

ORDER

 15.05.2017

Smt. Renu Sinha, Member (F).

                                     The present appeal is directed against the order dt.18-12-15, passed by the District Forum- Hajipur, in complaint case no.61/2008, wherein it was directed to ops -LIC to pay the assured amount of Rs.1lac with interest @12%p.a. from the date of death of assured Neera Sinha to the complainant through chque,  within one month of receipt of the order , failing which the rate of interest shall be payable @15%p.a. on aforesaid amount from 25-6-05 till date of payment.

2.                 The complaint case filed by the complainant the husband of the deceased assured in the District Forum against the ops LIC alleging deficiency in service for repudiation of the death claim made under the  Jeevan  Anand Policy of LIC , issued in the name of policy holder Neera Sinha   for sum of Rs.1lac and after death of assured Neera Sinha  on25-06-05 and the claim repudiated wrongly by Insurance co. on the grounds of suppression  material information regarding  health and suffering  from cancer, was not disclose at the time of revival of the policy by the assured, filed complaint seeking relief of payment of assured death claim amount under the policy with interest and compensation. The stand taken by ops LIC that the said policy  lapsed and was revived  on 02-05-05 after completing formalities  and the assured died on 25-6-05 just after one month23 days of revival and after getting request of  claim during investigation it was found the assured suffering from cancer at the time of revival of the policy  and this information was  not disclosed to insurance co. by the assured supported  by filing of several medical prescriptions as Annexures- A, B, C, D with respect to treatment of cancer by the LIC and the District Forum on consideration of the entire documents/materials produced by the parties in the case and having found no evidence as to show  the assured suffering from cancer to any part and was treated for the same and the medical prescriptions of Dr.B.R.A Institute  Rotary Cancer Hospital  issued in name of one Meera Sinha whereas the assured name is Neera Sinha and in view of the facts that  the policy revived  after getting complete medical checkup and found the assured healthy and fit by the Insurance co., the District Forum held the repudiation of the claim  of the complainant by the Insurance co. on aforesaid grounds as not justified and accordingly allowed the complaint  as mentioned in para one of this order.

3.                  Being aggrieved with the order of the District Forum, the appellants LIC have come in appeal stating that the District Forum failed to appreciate the facts that at the time of revival of the policy the deceased  assured was suffering from many other disease  including breast  cancer which is clear from the supporting  documents adduced by the LIC which amounts to deliberate withholding  of material information about her health and this aspect was not considered properly by the District Forum and passed the impugned order, which is not proper and  fit to be set aside.

4.              Heard the counsel for the appellants - LIC as well as the counsel for the respondent. Perused the materials available on record along with impugned order in detail.

5.           Admittedly, the deceased assured Neera Sinha had a LIC policy under Jeevan Anand for sum of Rs.1lac   who died on 25-06-05 after revival of the said policy on 2-05-05 and after death of the assured  the claim filed by the nominee/complainant  under the policy before  the appellants LIC was repudiated for non discloser of materials facts regarding health  and treatment at the time of revival of the policy by assured. Now as far as the repudiation of claim on aforesaid grounds is concerned, we do not find any such evidence on record to substantiate that the Neera Sinha was ever treated for cancer or admitted for the same. Considering the case in its entirety ,    it appears  that the District Forum has appreciated the cases of the respective parties reasonably  well and  after proper consideration of  all the documents/medical prescriptions  adduced by LIC in support  with respect to treatment of cancer  and has rightly reached to conclusion on the basis of clear cut and credible evidences in favor of the complainant and  held repudiation of claim on the aforesaid grounds not justified and  the complainant entitled   to get the death claim under the policy. 

6.                   Accordingly,  we see no reason to disagree with the well reasoned  order passed by the District Forum., which stands affirmed. The appeal stands dismissed.

S.K. Sinha                             Upendra Jha                       Renu Sinha

President                              Member(M)                         Member(F)

        Mukund