BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, BHIWANI.
CONSUMER COMPLAINT NO.133 of 2014
DATE OF INSTITUTION: - 16.05.2014
DATE OF ORDER: -30.09.2015
Narender aged 30 years son of Sh. Dhrampal, resident of village Umarwas Tehsil and District Bhiwani.
……………Complainant.
VERSUS
- Life Insurance Corporation of India through its Zonal Manager, Jeevan Bharti, Connaught Circus, New Delhi.
- Divisional Officer, L.I.C. Jeevan Parkash, Tehsil & District Rohtak.
- Branch Manager, L.I.C. Tehsil and District Bhiwani.
………….. Opposite Parties.
COMPLAINT U/S 12 OF CONSUMER PROECTION ACT
BEFORE :- Shri Rajesh Jindal, President
Shri Balraj Singh, Member
Smt. Ansuya Bishnoi, Member
Present: - Shri Rajesh Sharma, Advocate for complainant.
Shri N.S. Vijayrania, Advocate, for the OPs.
ORDER:-
Rajesh Jindal, President:
The case of the complainant in brief, is that his wife Smt. Soni (now deceased) had obtained insurance policy in her name covering the risk for a sum of Rs.2,50,000/- from the Branch Office, Bhiwani under Table and Term 165-30, date of commencement of the policy was 14.03.2013 and the mode of payment of premium was half yearly. The complainant was nominated as nominee in the above said policy. Unfortunately, on 19.07.2013 the wife of the complainant expired and the intimation was given to OP no. 3 & OP no. 3 got completed the necessary formalities from the complainant. The complainant being the nominee of his wife was repudiated by OP no. 1 vide letter dated 31.03.2014 on the ground that the deceased life assured deliberately with held the correct information from opposite party that deceased had ceaserian delivery on 03.10.2011 at Shivam Hospital. The complainant alleged that the Ops have not followed Section 45 of the Insurance Act, while repudiating the claim of the complainant. The complainant further alleged that he made several requests with the Opposite Party to release the insurance claim amounting to Rs. 2,50,000/- but it did not pay any heed. Hence, it amounts to deficiency in service on the part of OPs and as such he had to file the present complaint.
2. On appearance, OPs filed written statement and took preliminary objections and denied the allegations of the complainant. It is submitted that after receiving the intimation of the death of life assured the matter was investigated. It is submitted that the policy had run 04 months 05 days from the date of commencement i.e. 14.03.2013. It is submitted that complainant’s wife did not disclose about her ceaserian delivery undergone in Shivam Hospital Bhiwani on 03.10.2011 at the time of taking the policy. It is submitted that the complainant is not entitled to receive Rs. 2,50,000/- alongwith premium and interest at the rate of 18 % per annum. Hence, in view of the facts and circumstances mentioned above, there is no deficiency in service on the part of OPs and complaint of the complainant is liable to be dismissed with costs.
3. In order to make out his case, the counsel for complainant has placed on record Annexure C1 to Annexure C-3 and closed the evidence.
4. In reply thereto, the counsel for OPs has placed on record Annexure R1 to Annexure R-7 and closed the evidence.
5. We have gone through the record of the case carefully and have heard the learned counsels for the parties.
6. Learned counsel for the complainant reiterated the contents of the complaint. He is submitted that the Ops have illegally repudiated the claim of the complainant on the ground that the life assured had deliberately concealed the fact of ceaserian delivery on 03.10.2011 in the proposal form for getting the insurance policy.
7. Learned counsel for the opposite parties reiterated the contents of reply. He submitted that the life assured intentionally withheld the correct information regarding her health in the proposal form Annexure R-7. The life assured had undergone ceaserian delivery on 03.10.2011 and she suppressed this material fact in the proposal form while replying to Column 11 (b) in the proposal form Annexure R-7.
8. We have examined the entire material on record and given a thoughtful consideration to the arguments advanced before us. Admittedly, the life assured had undergone the ceaserian delivery on 03.10.2011. Now the question arises, whether the non-disclosure of this fact in the proposal form, as alleged by the Ops, amounts to suppression of material fact? The counsel for the Ops could not bring to our notice any cogent material in support of his contention that non-disclosure of the ceaserian delivery by the life assured was the suppression of material fact for the issue of the insurance policy. The Ops have not contended that ceaserian delivery has connection or nexus with the cause of death. The cause of death has not been disputed by the Ops.
9. Taking into account every aspect of the case and in the light of the discussion above, we hold that the repudiation of the claim of the complainant by the opposite party is not justified. Resultantly, we allow the complaint of the complainant and Ops are directed to pay Rs. 2,50,000/- the sum assured to the complainant within 45 days from the date of passing of this order, otherwise the Ops shall be liable to pay the interest at the rate of 8 % per annum from the date of passing of this order till the date of payment. Certified copies of the order be sent to the parties free of costs. File be consigned to the record room, after due compliance.
Announced in open Forum.
Dated: 30-9-2015.
(Rajesh Jindal)
President,
District Consumer Disputes
Redressal Forum, Bhiwani.
(Ansuya Bishoni), (Balraj Singh),
Member. Member.
