Haryana

Jind

CC/15/157

Chandermuni - Complainant(s)

Versus

LIC - Opp.Party(s)

Sh Anil Sheokand

29 Jul 2016

ORDER

BEFORE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, JIND.
                            Complaint No. 129 of 2015
                            Date of institution:-24.9.2015
                            Date of decision:- 29.7.2016
Chandermuni w/o late Sh. Shamsher Singh s/o Sh. Lal Chand, VPO Surbara, Tehsil Narwana, District Jind (Haryana).
                                       ..Complainant.
Versus
Life Insurance Corporation of India through its Branch Manager, Narwana, District Jind.
The Zonal Manager, LIC of India, Jeevan Bharti Connaught Circus, New Delhi.  

                                          …Opposite parties.
Complaint under section 12 of
                Consumer Protection Act, 1986.

Before:     Sh. Dina Nath Arora, President.
            Smt. Bimla Sheokand, Member.
            Sh. Mahinder Kumar Khurana, Member.  

Present:-    Sh. Anil Sheokand, Adv. for  complainant. 
        Sh. R.S. Sindhwani, Adv.for opposite parties.  
Order:-
         Brief facts of the complaint are that complainant’s husband namely  Late Sh. Shamsher Singh insured his life for a sum of Rs.1,00,000/- with the opposite parties vide policy No.177581287 under T-T-179-16 dated 28.2.2011. The complainant’s husband had expired on 3.9.2013. The complainant is legal heir of deceased Shamsher being wife and nominee in the above said policy. The 
            Chandermuni Vs. LIC etc.
                    …2…
complainant informed the opposite parties immediately regarding the death of her husband and submitted all the necessary documents. The complainant lodged a claim with the opposite parties. The opposite party No.2 has repudiated the claim of the complainant vide letter dated 4.8.2014 on the ground of concealment of facts at the time of taking the policy. At the time of taking the policy the life assured was not suffering from any disease and he was hale and healthy. The complainant served a legal notice dated 10.4.2015 through her counsel Sh. Anil Kumar Sheokand Adv. upon the opposite parties but all in vain.  Deficiency in service on the part of the opposite parties is alleged. It is prayed  that the complaint be accepted and opposite parties be directed to make the payment of Rs.1,00,000/-  as amount of claim besides other benefit along with interest @ 18% p.a. as well as to pay a sum of Rs.5,500/- as litigation expenses to the complainant.   
2.  Upon notice, the opposite parties have appeared and filed the written statement by taking some preliminary objections such as  complainant has no cause of action  to file the present complaint and the complaint is false and frivolous. On merits, it is contended that the competent authority had repudiated the death claim due to deliberate mis-statement and withholding of material information  by the deceased life assured regarding his health at the time of taking the policy. In fact deceased was suffering from cancer prior to the date of insurance.  The insurance is a contract of utmost good faith and insured is bound to disclose all information regarding his health truthfully in proposal form. The life assured had concealed the 
            Chandermuni Vs. LIC etc.
                    …3…
material facts about his health so the opposite parties have rightly repudiated the claim of the complainant vide letters dated 4.8.2014 and 7.1.2015.  Therefore, there is no deficiency in service on the part of the opposite parties. Dismissal of complaint with cost of Rs.25,000/- is prayed for.
3.    In evidence, the complainant has  produced his own affidavit Annexure C-1,  copy of legal notice dated 10.4.2015 Annexure C-2, acknowledgment Annexure C-3,  postal receipt Annexure  C-4, copy of  application dated 23.3.2015 Annexure C-5, postal receipt Annexure C-6, copy of status report Annexure C-7, copy of letter dated 19.5.2015 Annexure C-8, copy of death certificate Annexure C-9, copy of letter dated 4.8.2014 Annexure C-10, copy of proposal form Annexure C-11, copy of application Annexure C-12, acknowledgment Annexure C-13 and  copy of aadhaar card Annexure C-14 and closed the evidence. On the other hand, the opposite parties have produced the affidavit of Balihar Singh Manager  Annexure  OP-1, copy of  status report Annexure OP-2,  copy of letter dated 7.1.2015 Annexure OP-3, copy of document Annexure OP-4,  copy of letter dated 4.8.2014 Annexure OP-5, copies of admission discharge record Annexure OP-6 and Annexure OP-7, copy of  document Annexure OP-8, copy of proposal form Annexure OP-9, copy of form No.3251 Annexure OP-10 and copy of schedule Annexure OP-11 and closed the evidence.
4.    We have heard Ld. counsel of both the parties and also perused the record placed on file. The counsel for complainant argued that the complainant had purchased one life insurance policy from opposite 
            Chandermuni Vs. LIC etc.
                    …4…
party No.1 on 28.2.2011 for a sum assured of Rs.1,00,000/-. Unfortunately, the complainant’s husband had died on 3.9.2013. During  taking of the  policy the life insured was hale and healthy. The opposite parties have repudiated the claim of the complainant on false and frivolous ground. 
5.    On the other hand, the counsel for opposite party argued that the claim of the complainant was rightly repudiated on the ground of concealment of facts about his health. The insurance is a contract of utmost good faith and insured is bound to disclose all the informations regarding his health truthfully in the proposal form but the life assured during  taking of the policy has concealed that he is suffering from the disease-cancer and as such the complainant is not entitled for any claim. 
6.    After hearing Ld. counsel of parties and going through on record from the perusal of the document- proposal form dated 20.2.2011 Annexure C-11& OP-9 wherein the life assured in his personal history given the answer of question “e” – Are you suffering from or have ever suffered from diabetes, Tuberculosis, High Blood Pressure, Low Blood pressure, Cancer, Epilepsy, Hernia Hydrocele, Leprosy or any other disease – No. We have also gone through the discharge admission report dated 31.5.2010 Annexure OP-6  and discharge  admission report dated 23.6.2010 Annexure OP-7 issued by the Jindal Institute of Medical Science, Hissar wherein it is clear that the complainant is suffering from cancer disease since 31.5.2010 whereas the complainant has purchased the policy in question on 28.2.2011. 
            Chandermuni Vs. LIC etc.
                    …5…
Hence, it clearly shows that the complainant has purchased the policy by suppressing the true facts from the company regarding his health as he was suffering from the cancer disease before taking the policy in question.
7.       In view of the above said discussion, we are of the firm view that the complainant has concealed the true facts about his health from the insurance company, hence the present complaint is hereby dismissed with no order as to costs. Copies of order be supplied to the parties under the rule. File be consigned to the record-room.
Announced on: 29.7.2016

                                  President,
    Member     Member                    District Consumer Disputes                                         Redressal Forum, Jind

 

 

 

 

 

 

 

 

                     Chandermuni Vs. LIC etc.
                    
Present:-    Sh. Anil Sheokand, Adv. for  complainant. 
        Sh. R.S. Sindhwani, Adv.for opposite parties.  
                Arguments heard.  To come up on  29.7.2016 for orders.
                                        President,
        Member             Member                               DCDRF/Jind
                                        26.7.2016

Present:-    Sh. Anil Sheokand, Adv. for  complainant. 
        Sh. R.S. Sindhwani, Adv.for opposite parties.  
        Order announced. Vide our separate order of the even date, the complaint is dismissed. File be consigned to the record room after due compliance. 
                                                                                             President,
        Member             Member                               DCDRF/Jind
                                        29.7.2016