Before the District Consumer Disputes Redressal Forum, Rohtak.
Complaint No. : 409.
Instituted on : 14.07.2017.
Decided on : 09.07.2019.
Smt. Shanti w/o Late Sh. Naresh Chander Kaushik s/o Sh. Bhagirath Lal R/o village & P.O. Bhainsru Kalan, Distt. Rohtak.
..………..Complainant.
Vs.
- Life Insurance Corporation of India, through its Divisional Manager, Subhash Road, Opp. All India Radio, Rohtak.
- Life Insurance Corporation of India through its zonal Manager(N), Jeevan Bharti, Post Box No.630, Connaught Circus, New Delhi.
- The Insurance Ombudsman SCO No.101-103, 2nd Floor Batra Building, Sector 17D, Chandigarh.
……….Opposite parties.
COMPLAINT U/S 12 OF CONSUMER PROTECTION ACT,1986.
BEFORE: SH.NAGENDER SINGH KADIAN, PRESIDENT.
SH. VED PAL, MEMBER.
DR. RENU CHAUDHARY, MEMBER.
Present: Sh.Krishan Kaushik, Advocate for the complainant.
Sh. Krishan Lal, Advocate for opposite party No.1 & 2.
Opposite party No.3 exparte.
ORDER
NAGENDER SINGH KADIAN, PRESIDENT:
1. Brief facts of the case are that complainant is widow of Naresh Chander since deceased and complainant’s husband had insured himself with the respondents vide policy No.179837880 on dated 28.09.2014 for Rs.150000/- and the complainant is appointed as nominee in the alleged policy. That the said Naresh Chander had died on 08.11.2015 due to cardiac arrest. That respondents were duly informed by the complainant with a request to pay the insurance amount. That on 20.01.2016 complainant furnished all the requisite documents and performa duly completed and signed for considering the claim. That complainant requested the opposite parties many times to settle the claim and also sent reminders and representations dated 15.06.2016 & 04.11.2016 and 23.12.2016 but till now no reply has been received from Insurance Ombudsman, Chandigarh. That the husband of the complainant was duly medically examined by the doctor on panel of the respondents and they did not find any discrepancy in the health of insured person and there is no concealment on the part of insured person and the insurance company cannot take plea of concealments of previous disease. That act of opposite parties is illegal and amounts to deficiency in service. As such, it is prayed that opposite parties may kindly be directed to pay insurance amount of Rs.150000/- alongwith accrued bonus and interest and litigation expenses to the complainant as explained in relief clause.
2. After registration of complaint, notice was issued to the opposite parties. Opposite parties in their reply has submitted that the opposite parties issued a policy bearing no.179837880 on the life of Sh. Naresh Chander Kaushik son of Shri Bhagirath Lal with date of commencement 28.09.2014. The policy has run over only for a period of one year. The deceased life assured was taking treatment from PGIMS, Rohtak and remained admitted there under the CR No.215225. He was suffering from Perfoiration Periutonitis. He was operated there on 31.01.2014 prior to taking policy. The deceased life assured was admitted in Hospital on 30.01.2014 to 13.02.2014, but he did not disclose these facts about his health at the time of taking the policy. The claim of the complainant has been repudiated as per terms and conditions of the policy. That there is no deficiency in service on the part of opposite parties .All the other contents of the complaint were stated to be wrong and denied and dismissal of complaint has been sought.
3. Ld. counsel for the complainant in his evidence has tendered affidavit Ex.PW1/A to Ex.PW3/A, documents Ex.P1 to Ex.P19 and closed his evidence on dated 17.12.2018 of this Forum. Ld. counsel for the opposite parties tendered affidavit Ex.RW1/A and documents Ex.RW1 to Ex.RW11 and closed his evidence on 18.02.2019.
4. We have heard learned counsel for the parties and have gone through material aspects of the case very carefully.
5. Perusal of the documents shows that opposite parties issued a policy bearing no.179837880 on the life of Sh. Naresh Chander Kaushik son of Shri Bhagirath Lal with date of commencement 28.09.2014. The date of death of life assured is 08.11.2015. The claim of the complainant has been repudiated by the opposite parties on the ground that at the time of proposal for the policy, the deceased life assured was taking treatment from PGIMS, Rohtak and remained admitted there under the CR No.215225. He was suffering from Perfoiration Periutonitis. The deceased life assured was admitted in Hospital on 30.01.2014 to 13.02.2014 and was operated there on 31.01.2014 prior to taking policy but he did not disclose these facts about his health at the time of taking the policy. To prove its contention, opposite party has placed on record documents Ex.RW6 to Ex.RW10. Ld. counsel for the opposite parties has also placed reliance upon the law of Hon’ble National Commission, New Delhi in IV(2018)CPJ532 (NC) titled as Prashant Dattarya Patre Vs.SBI LIFE Insurance Co. Ltd. and 2014(1)CPC(NC) 670 titled as LIC Vs. S.S.Jamuna. Perusal of these documents shows that the deceased was suffering from the alleged disease and had taken treatment for the same prior to taking the policy.
6. In view of the aforesaid law, which are fully applicable on the facts and circumstances of the case, we have observed that there is no deficiency in service on the part of opposite parties and claim of the complainant has rightly been repudiated. As such, we hereby dismiss the complaint with no order as to costs.
8. Copy of this order be supplied to both the parties free of costs. File be consigned to the record room after due compliance.
Announced in open court:
09.07.2019
................................................
Nagender Singh Kadian, President
..........................................
Ved Pal Hooda, Member.
..........................................
Renu Chaudhary, Member.
