NCDRC

NCDRC

RP/380/2013

SBI LIFE INSURANCE CO. LTD. - Complainant(s)

Versus

HARVINDER KAUR & ANR. - Opp.Party(s)

M/S. RAKESH MALHOTRA & ASSOCIATES

18 Jul 2014

ORDER

NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION
NEW DELHI
 
REVISION PETITION NO. 380 OF 2013
 
(Against the Order dated 14/12/2012 in Appeal No. 55/2009 of the State Commission Punjab)
1. SBI LIFE INSURANCE CO. LTD.
1ST FLOOR,KAPAS BHAWANM, PLOT NO-3A, SECTOR-100, CENTRAL PROCESSING CENSTER, (CPC) CBD BELAPUR
NAVI MUMBAI - 400614
MAHARASTRA
...........Petitioner(s)
Versus 
1. HARVINDER KAUR & ANR.
W/O LATE SH SUKHVINDER SINGH, R/O VILLAGE KASHBA BHURAL TEHSIL , MALERKOTLA
SANGRUR
PUNJAB
2. GURDEEP SINGH KEHAL,
R/O VILLAGE SANDAUR, TEHSIL MALERKOTLA,
SANGRUR
PUNJAB
...........Respondent(s)

BEFORE: 
 HON'BLE MR. JUSTICE AJIT BHARIHOKE, PRESIDING MEMBER
 HON'BLE MR. SURESH CHANDRA, MEMBER

For the Petitioner :
Mr. Rakesh Malhotra, Advocate
For the Respondent :
For the Respondent :Mr. Prabhoo Dayal Tiwari, Advocate
No.1
For the Respondent : Nemo
No.2

Dated : 18 Jul 2014
ORDER

This revision is directed against the order of the State Consumer Disputes Redressal Commission Punjab, Chandigarh (in short, he State Commission) dated 14.12.2012 in First Appeal No. 55/09 whereby the State Commission dismissed the appeal preferred by the petitioner insurance company against the order of the District Forum Sangrur. 2. Briefly put, the facts relevant for the disposal of this revision petition are that the respondent Harvinder Kaur filed a consumer complaint in District Forum Sangrur alleging that her husband Sukhwinder Singh had obtained a life insurance policy from the petitioner OP for a sum of Rs.1,00,000/- appointing the respondent as the nominee. The date of maturity of insurance policy was 24.08.20122. The insured suffered an attack of breathlessness on 17.11.2007 which persisted for 2/3 days. The insured, was, therefore admitted in Tagore Hospital, Jalandhar City on 20.11.2007. He was discharged on 07.12.2007. The insured, however, died on 08.12.2007. The intimation of the death of the insured was given to the petitioner. The petitioner, however, repudiated the claim on the ground that insured while obtaining the insurance policy concealed that he was already suffering from pulmonary hypertension. This led to the filing of the consumer complaint. 3. The petitioner OP in its response to the complaint admitted that Sukhwinder Singh had obtained life insurance policy for Rs.1.00 lacs and that he died on 08.12.2007. The petitioner, however, justified repudiation of the claim on the ground that insurance policy was obtained by concealing the material fact that the insured was suffering from primary pulmonary hypertension. 4. In the rejoinder respondent complainant took the stand that nothing was concealed at the time of obtaining of the insurance policy. The insured Sukhwinder Singh was neither suffering from any disease prior to the filling up of the proposal form nor he knew about it. 5. The District Forum on consideration of the pleadings and evidence on record allowed the insurance claim and directed the petitioner to pay to the complainant a sum of Rs.1.00 lac with benefits alongwith interest of 9% p.a. from the date of repudiation i.e. 14.07.2008 till realization and also to pay additional sum of Rs.3000/- as compensation. 6. Being aggrieved of the order of the District Forum, the petitioner preferred an appeal on the plea that the District Forum has committed a grave error in ignoring the fact that insured Sukhwinder Singh was suffering from pulmonary hypertension at the time of filling of proposal form and that he concealed the aforesaid fact. The above plea of the petitioner, however, did not find favour with the State Commission and State Commission dismissed the appeal vide the impugned order. 7. Learned Shri Rakesh Malhotra, Advocate, counsel for the petitioner insurance company has contended that the impugned order of the foras below are perverse as both the foras below have failed to appreciate that the insurance policy was obtained by the insured by concealing the material fact that he was suffering from pulmonary hypertension. In support of this contention, learned counsel for the petitioner has referred to the discharge card of the insured Sukhwinder Singh issued by Tagore Hospital on 21.06.2007 wherein against the history and findings it is recorded K/C/O Primary Pulmonary hypertension x 2 yrs on Rx and the diagnosis K/C/O Primary Pulmonary Hypertension c Mod.PAH C. It is contended that though the State Commission has taken note of the fact that the insured Sukhwinder Singh was admitted and treated in Tagore Hospital from 20.11.2007 to 07.12.2012 yet it has ignored the earlier discharge certificate issued by Tagore Hospital which clearly prove that the insured has concealed information regarding his medical condition while filling the proposal form Thus, it is contended that the impugned order is liable to be set aside. In support of this contention, the petitioner has relied upon the judgment of the Supreme Court in the matter of Satwant Kumar Sandhu Vs. New India Assurance Company Limited (2009) 7 SCC 316. 8. Counsel for the respondent on the contrary has argued in support of the impugned order. It is contended that since the petitioner has taken the plea of concealment of material fact while filling the proposal form for obtaining insurance policy, the onus of proving the concealment was on the petitioner. The petitioner, however, has failed to discharge the said onus by adducing evidence i.e. either by examination of the treating doctor or by producing the original record of the treatment. It is argued that since the concealment has not been proved, orders of the fora below cannot be faulted. 9. We have considered the rival contentions and perused the record. Undisputedly, the petitioner OP has repudiated the claim of the respondent on the ground that the insurance was obtained by the deceased Sukhwinder Singh by concealing the fact that he was suffering from primary pulmonary hypertension. The onus of proving the above ground for repudiation of insurance claim lies heavily on the petitioner opportunity. The petitioner in order to prove concealment of previous ailment on the part of the deceased Sukhwinder Singh is relying upon the photocopy of the discharge card allegedly issued by the Tagore Hospital Jallandhar. If this discharge card is taken to be proved, then patient Sukhwinder Singh was admitted in the above noted hospital from 14.06.2007 to 21.06.2007 and at the time of admission, he gave the history of pulmonary hypertension for the last two years. The core question, however, is whether the petitioner has proved the above noted discharge card and linked it with the insured Sukhwinder Singh?. 10. On perusal of record, we find that the concerned doctor who allegedly treated the insured Sukhwinder Singh from 14.06.2007 to 21.06.2007 and recorded that the patient was admitted with the history of Pulmonary Hypertension for the last two years was not examined by the petitioner to prove the photocopy of the discharge card relied upon by the petitioner nor the affidavit of said doctor has been filed. Even the original record of the Tagore Hospital has not been produced to prove the discharge card, which obviously, is a secondary evidence. Since the petitioner has failed to produce primary evidence to establish the ground for repudiation of claim, the foras below in our considered view were right in declining to rely upon the photocopy of the discharge card produced by the petitioner to establish that the petitioner while obtaining the insurance policy concealed the fact that he was suffering from Pulmonary Hypertension. 11. In view of the discussion above, we find no reason to interfere with the concurrent findings of the foras below particularly when the counsel for the petitioner has failed to point out any jurisdictional error or material irregularity in the impugned orders. The revision petition is, therefore, dismissed with no order as to costs.

 
......................J
AJIT BHARIHOKE
PRESIDING MEMBER
......................
SURESH CHANDRA
MEMBER

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