<br /> <br /> By ADV. RAVI SUSHA, MEMBER.<br /> <br /> This is a complaint filed for realization of Rs.75,000/- being the Insurance claim with interest and compensation.<br /> <br /> <br /> The averments in the complaint can be briefly summarized as follows:<br /> <br /> The complainant’s husband Sri. Sherrif was a policy holder bearing No.781834467 of the respondent. The policy was proposed the risk commenced from 15.12.1998. The mode of premium was paying half yearly. The policy lapsed and received on 25..3..2003. Mr. Sherif passed away on 30.7.2003./ The 1st complainant thereupon preferred claim which was repudiated by the 1st opp.party on the ground that there was suppression of material facts with regard to the health of the life assured in the personal declaration. Hence the complaint.<br /> <br /> The opp.parties filed a version contending, interalia, that the complaint is not maintainable either in law on or facts. The policy lapsed and revived on 25.3.2003. The revival was effected on the basis of a personal declaration regarding the health condition of the life assured by himself dated 24.3.2003. In the declaration of good health submitted by the life assured he had suppressed material facts regarding his illness and misrepresented LIC of India. On the basis of this false statement the policy happened to be revived on 25.3.2003. The life assured passed away on 30.7.2003. The reason for his death was recorded as “Carcinoma tongue’, in the application for settlement of his claim. While reviving the policy he has suppressed the fact that he was suffering from Carcinoma tongue and he was under Medical treatment from Regional Cancer Centre, Thiruvananthapuram. The policy was revived on 25.3.2003 by giving a false declaration by the Life assured. Where the death of the life assured occurs before the expiry of two years from the date of issue of the insurance policy or within two years from the date of revival of the policy, it was open to the Life Insurance Corporation to conduct an enquiry into the circumstances and cause leading to his death and whether the declaration by the life assured with regard to his health in the proposed form or revival form was accurate as to the material matters. Once it is found that the life assured has suppressed material facts of the LIC of India it is open to the Corporation to treat the contract of insurance as void and is empowered to repudiate the claim. The life assured has sufficient knowledge that he was suffering from cancer for which he was availing medical treatment from the Regional Cancer Centre and that the declaration of good health signed by him was false. On the basis of the enquiry report and the certificate of the doctor who treated the Life assured LIC of India repudiated the claim and intimated the matter to the complainant as per the letter dt. 7.1.2004. However the LIC of India has decided to disburse to the nominee the paid up value accrued before the revival of the policy with respect to the policy. There is no deficiency of service on the part of the opp.parties and the claim has been repudiated as per law. Hence the opp.party prays to dismiss the complaint.<br /> <br /> Based on the contentions the following points arise for consideration are:<br /> <br /> 1.Whether there is deficiency in service on the part of the opp.parties.<br /> 2.Reliefs and costs.<br /> <br /> <br /> <br /> For the complainant PW.1 and PW.2 are examined. Ext.P1 to P6 are marked.<br /> <br /> <br /> For the opp.party DW.1 is examined. Ext. D1 to D8 are marked.<br /> <br /> <br /> <br /> Points 1 and 2<br /> <br /> It is not disputed that the 1st complainant’s husband had taken Ext. D2 policy and that was revived on 25.3.2003. The complainant submitted claim which was repudiated by the opp.party as per Ext.D7 on the ground that in the declaration of good health submitted by the Life assured he had suppressed material facts regarding his illness.<br /> <br /> Now the question is whether at the time of reviving the policy the life assured has suppressed the fact that he was suffering from carcinoma tongue and was under medical treatment from R.C.C. , Thiruvananthapuram.<br /> <br /> In this the Life assured had given personal statement regarding health dt. 24.3.2003 [Ext. D3] in which he had given ‘No’ to the following question: Have you ever suffered from any illness/disease requiring treatment for a week or more. In Ext. D6 the Life assured had been suffering from Carcinoma Tongue since 23.10.2001 onwards and Ext. D5 reveals that the Life assured was treated in the hospital from 16.11.2001 to 22.11.2001 and from 23.12.2002 to 6.1.2003. These certificates clearly indicate that when the Life assured preferred Ext. D3, he was already suffering from the carcinoma Tongue Here it is clear that while reviving the policy, he has suppressed the fact that he was suffering from carcinoma tongue and he was under Medical treatment from R.C.C., Thiruvananthapuram In these circumstances we are of the view that the repudiation of the claim is proper. There is no deficiency in service on the part of the opp.party. Point found accordingly.<br /> <br /> <br /> <br /> In the result the complaint fails and the same is hereby dismissed.<br /> <br /> <br /> <br /> Dated this the 13th day of August, 2008.<br /> <br /> <br /> <br /> I N D E X<br /> <br /> <br /> List of witnesses for the complainant<br /> PW.1. – Najia<br /> PW.2. – T.K. Shamsudeen Kunju<br /> <br /> List of documents for the complainant<br /> P1. – Application for Policy revival<br /> P2. – receipt<br /> P3. – Letter sent by LIC of India to the complainant dt. 15.6.2004<br /> P4. – Repudiation of claim letter from Opp.party<br /> P5. – Letter sent by LIC of India to the complainant<br /> P6. – Passport.<br /> <br /> List of witness for the opp.party.<br /> DW.1. – K. Sundaresan<br /> <br /> List of documents for the opp.party<br /> D1. – Proposal Form<br /> D2. – Copy of the policy<br /> P3. – Personal Statement of Health<br /> D4. – Death Intimation letter<br /> D5. – Certificate of Hospital treatment<br /> D6. – Medical attendant’s certificate<br /> D7. – Repudiation Letter<br /> P8. – Case summary Record issued from RCC., Thiruvananthapuram.<br />