Haryana

StateCommission

A/181/2016

LIFE INSURANCE CORP.OF INDIA - Complainant(s)

Versus

DEEPAK GUPTA - Opp.Party(s)

RAJNEESH MALHOTRA

11 Apr 2016

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION HARYANA, PANCHKULA

 

                                                 

                                                          First Appeal No. 181 of 2016

Date of Institution: 29.02.2016

Date of Decision:   11.04.2016

 

1.      Life Insurance Corporation of India, Divisional Office, Post Office Box No.106, Jeevan Parkash, 489, Model Town, Karnal through its Senior Divisional Manager.

 

2.      Manager Claims, Life Insurance Corporation of India, Divisional Office, Jeewan Parkash Building, Sector 17B, Chandigarh.

                   Appellants-Opposite Parties

Versus

Deepak Gupta son of Sh. Suresh Pal Gupta, resident of House No.1076, Sector 2, Panchkula, Haryana.

                                      Respondent-Complainant

 

 

CORAM:             Hon’ble Mr. Justice Nawab Singh, President.

                             Mr. B.M. Bedi, Judicial Member.

                             Mr. Diwan Singh Chauhan, Member.                                                                                                              

 

For the Parties:  Shri Rajneesh Malhotra, Advocate for appellants.

 

                                                   O R D E R

 

NAWAB SINGH J.(ORAL)

 

          The instant appeal has been filed by Life Insurance Corporation of India and another-opposite parties (for short, ‘LIC’) against the order dated December 29^th, 2015 passed by District Consumer Disputes Redressal Forum, Karnal (for short, ‘District Forum’) whereby complaint filed by Deepak Gupta-complainant was allowed.  The LIC was directed to make the payment of the sum insured under the Insurance Policies No.176572154 and 176571773 alongwith interest at the rate of 9% per annum from the date of filing the complaint till its actual realization. 

2.      Suresh Pal Gupta (since deceased)-father of complainant had purchased two Insurance Policies No.176572154 and 176571773 respectively from LIC for a sum of Rs.5,00,000/- each. He expired on August 14^th, 2010.  The complainant being nominee filed claim with the LIC but the same was repudiated vide letter dated April 26^th, 2012 on the ground that the Life Assured was suffering from slipped disk and viral fever but this fact was not disclosed by him in the proposal form.

3.      Indisputably, Life Assured had obtained two policies from LIC.  He died on August 14^th, 2010.  LIC repudiated the claim on the ground that Life Assured got medical treatment for viral fever and remained on earned leave from May 24^th to 28^th, 2007 and June 05^th, to 12^th, 2009 (Exhibit C-9 to C-13) for slipped disk.  The life assured did not disclose these facts in the proposal form.  The document, that is, Earned Leave (Exhibit C-9 to C-13) does not inspire confidence that life assured suppressed material facts while submitting his proposal because he had viral fever in May, 2007 and slipped disk in June, 2007, which were completely cured.  He died due to sudden heart attack on August 14^th, 2010.  There was no nexus between viral fever, slipped disk and heart attack. Viral Fever and Slipped Disc cannot be considered as disease and are curable. Merely proceeding on medical leave is no ground to presume that life assured was suffering from any disease. 

4.      As a sequel to the aforesaid discussion, it has not been established by the LIC that the insured had any pre-existing disease which would justify repudiation of the claim.  The order under challenge does not require any interference.  Thus, the appeal fails and is hereby dismissed.

5.      The statutory amount of Rs.25,000/- deposited at the time of filing the appeal be refunded to the respondent-complainant against proper receipt and identification in accordance with rules, after the expiry of period of appeal/revision, if any filed in this case.

 

Announced 11.04.2016

(Diwan Singh Chauhan) Member

(B.M. Bedi) Judicial Member

(Nawab Singh) President

 

UK