Madhya Pradesh

StateCommission

A/16/816

MRS. SUMITRA WAHANE - Complainant(s)

Versus

LIC - Opp.Party(s)

SH. O.P.SUMUNDRE

27 Dec 2023

ORDER

M. P. STATE CONSUMER DISPUTES REDRESSAL COMMISSION, BHOPAL

PLOT NO.76, ARERA HILLS, BHOPAL      

 

                                  FIRST APPEAL NO. 816 OF 2016

 (Arising out of order dated 08.06.2016 passed in C.C.No.60/2014 by District Commission, Balaghat)

 

SMT. SUMITRA WAHANE.                                                                                  …          APPELLANT.

 

             Versus

                 

MANAGER, LIFE INSURANCE CORPORATION

OF INDIA BALAGHAT AND ANOTHER.                                                              ….        RESPONDENTS

 

    

BEFORE:

 

                  HON’BLE SHRI A. K. TIWARI              :      ACTING PRESIDENT

                 HON’BLE DR. SRIKANT PANDEY      :      MEMBER

                

                    

                                      O R D E R

 

27.12.2023

            Shri O. P. Samudre, learned counsel for the appellant.

            Shri Deepesh Shukla, learned counsel for the respondents.

                                   

As per A. K. Tiwari : 

           This appeal is filed by the complainant/appellant against the order dated 08.06.2016 passed by the District Consumer Disputes Redressal Commission, Balaghat (for short ‘District Commission’) in C.C.No.60/2014 whereby the complaint filed by the complainant/appellant has been dismissed on the ground that the opposite parties-LIC could not found deficient in service.

2.                The facts of the case in short are that the complainant’s husband Late Ramphal Sharma during his life time had obtained life insurance policies nos.371770922, 371445895 and thereafter had obtained policies nos. 373039155, 371836892 and 355788381. The deceased-insured died

-2-

on 18.09.2010. After his death, the complainant being nominee filed claim of the aforesaid policies with the LIC. The LIC paid the claim of the policy nos. 371770922, 371445895 and 373039155  however denied the claim of policy numbers 371836892 and 355788381 on the ground that the deceased-insured while obtaining the policy has given wrong information about his health in the proposal form. The complainant therefore alleging deficiency in service approached the District Commission seeking relief. The District Commission dismissed the complaint. Hence this appeal.

3.                Heard learned counsel for the parties.  Perused the record.

4.                Learned counsel for the complainant/appellant argued that the opposite party LIC paid all the benefits with regard to policy numbers 371770922, 371445895 and 373039155 however denied the claim of policy numbers 371836892 and 355788381 on false grounds which amounts to deficiency in service. The District Commission also committed grave error in dismissing the complaint. He therefore, argued that the impugned order deserves to be set-aside and the appeal be allowed.

5.                On the other hand, learned counsel for the opposite party/respondent-LIC argued that the deceased-insured at the time of taking the policy has suppressed his illness in the proposal form which is material information and therefore, the LIC has committed no deficiency in service in denying the claim of the policy. He therefore argued that this appeal

-3-

deserves to be dismissed. He placed reliance on the decision of Hon’ble Supreme Court in Mithoolal Nayak Vs Life Insurance Corporation of India 1962 AIR 814 (SC).

6.                After hearing learned counsel for the parties and on careful perusal of the record as also the impugned order we find that the complainant in the proposal form dated 28.03.2010 (R-2) for obtaining the insurance policy no. 371836892 and in the proposal form dated 30.03.2010 (R-8) for obtaining policy number 355788381 has given answers in negative to the queries regarding his health condition in the Column no.6 and 11 of ‘Personal History’ respectively whereas  he was suffering from Acute Hepatitis with HEV positive state  with NIDDM with related complications since 2008 for which he was admitted in Organge City Hospital, Nagpur from 24.11.2008 to 28.11.2008 which is evident from certificate given by the said hospital (R-4)  and on the basis of this disease he took medical leave from 21.07.2008 to 29.07.2008, 24.11.2008 to 05.01.2009 and thereafter from 18.05.2009 to 27.05.2009, 17.06.2009 to 19.06.2009 and 08.07.2009 to 15.07.2009 from his employer Food Corporation of India which is evident from the certificate given by his employer (R-3). Thus it is well established that the deceased-insured had obtained the questioned policices after suppressing the material information in the proposal form regarding his

 

-4-

health. Thus, we find that the LIC has rightly denied the complainant’s claim and while doing so the LIC has not committed any deficiency in service.

7.                In view of the above discussion, we do not find any illegality or infirmity in the impugned order passed by the District Commission dismissing the complaint. Accordingly, the impugned order is affirmed.

8.                In the result, this appeal being devoid of any merit is hereby dismissed with no order as to costs.

 

                     (A. K. Tiwari)               (Dr. Srikant Pandey)  

               Acting President                       Member