STATE CONSUMER DISPUTES REDRESSAL COMMISSION,

UNION TERRITORY, CHANDIGARH

Kumud Sharma, minor, aged 12 years, daughter & nominee of Late Smt.Ranju Sharma, H.No.185-C,
Sector 51-A, Chandigarh through her uncle/appointee Sh.Mahesh Chander Kalia.  

                                         …..Appellant/Complainant

Versus

1. Life Insurance Corporation of India, Jeevan Parkash Building, Sector 17-B, Chandigarh through its Divisional Manager.
2. Life Insurance Corporation of India, Sangrur, Punjab, through its Branch Manager. 

                                   …..Respondents/Opposite Parties

BEFORE:  JUSTICE RAJ SHEKHAR ATTRI, PRESIDENT.

                 MRS. PADMA PANDEY, MEMBER

                 MR. RAJESH K. ARYA, MEMBER

Argued by:  Sh. Pankaj Chandgothia, Advocate for the Appellant.

                None for the respondents.

PER PADMA PANDEY, MEMBER

              This appeal is directed against an order dated 20.09.2019, rendered by District Consumer Disputes Redressal Forum-II, UT, Chandigarh, now District Consumer Disputes Redressal Commission-II, U.T., Chandigarh (hereinafter to be called as the District Commission only), vide which, it dismissed the complaint, with no order as to cost, filed by the complainant (now appellant).

2. In brief, the facts of the case, are that the mother of complainant, took Life Insurance Policy No.166392338 vide proposal dated 05.03.2017 and the policy was issued on 18.03.2017 having risk commencement date as 07.03.2017, for sum assured of Rs.5,30,000/- (Annexures C-1 & C-2).  It was stated that the mother of the complainant/life assured had severe headache on 28.04.2017, so she was admitted in Hospital on 05.05.2017 and discharged on 19.05.2017.  It was further stated that the mother of the complainant was diagnosed to have been suffering from Blood Cancer for the first time on 04.05.2017, after the biopsy report dated 28.04.2017.  It was further stated that the complainant on being advised to consult neurology department on 21.04.2017, visited Neurology Department, PGI, Chandigarh and the doctor advised her bone marrow aspiration/trephine biopsy, which diagnosed her with acute Myeloid Leukemia (Annexure C-3 colly.).  It was further submitted that the mother of the complainant/life assured was admitted in PGI on 05.05.2017 and discharged on 19.05.2017, then again admitted there at PGI on 25.06.2017 and remained admitted till 13.07.2017, when unfortunately she expired due to her illness (Annexure C-4).  It was further stated that after her death, the complainant being nominee lodged claim with Opposite Parties in respect of the policy in question, but the Opposite Parties repudiated the same vide letter dated 31.03.2018 on the ground of suppression of material facts and refunded the premium amount of Rs.70,336/- paid by policyholder. It was further stated that the aforesaid acts of the Opposite Parties, amounted to deficiency in service and unfair trade practice and filed the complaint, and prayed for recovery of sum due under the policies i.e. Rs.10.00 lakhs alongwith interest, compensation and costs of litigation.
3. The Opposite Parties filed their joint reply and admitted the factual matrix of the case, that DLA (deceased life assured) signed the Proposal Form on 05.03.2017 and before signing the proposal, the DLA had regularly visited some private doctors & PGI, Chandigarh for her treatment, but did not disclose this material fact/information regarding her health at that time (Annexures R-3 to 4).  It was stated that the DLA had regularly visited PGI Chandigarh from 28.09.2016 under CR No.201605241243 and as per OPD Card dated 03.03.2017 of PGI Chandigarh, DLA had visited and taken treatment at PGI, Chandigarh under CR No.201701846851 and after that DLA was under regular treatment for Acute Myeloid LUKEMIA.  It was further stated that as the death of life assured occurred within 2 years of the policy, so the case was sent for investigation and during investigation, it came to light that DLA was not keeping good health and was aware of her health/disease before taking the policy in question, so the claim was repudiated as per terms & conditions of the policy. It was further stated that there was no deficiency, in rendering service, and remaining averments, were denied, being wrong, on the part of the Opposite Parties.

4. The Parties led evidence, in support of their case.
5. After hearing the Counsel for the parties,and, on going through the evidence, and record of the case, the District Commission, dismissed the complaint, as stated above. 
6. Feeling aggrieved, the instant appeal, has been filed by the appellant/complainant, against the order dated 20.09.2019.
7. We have heard the Counsel for the appellant, and have gone through the evidence, and record of the case, carefully.
8. After giving our thoughtful consideration, to the rival contentions, raised by the Counsel for the appellant and the evidence, on record, we are of the considered opinion, that the appeal is liable to be dismissed for the reasons to be recorded hereinafter.
9. After going through the record of the case, this Commission feels that the District Commission was correct in dismissing the complaint of Kumud Sharma nominee of Late Smt. Ranju Sharma. On a perusal of the medical record annexed as C-3, especially the medical documents annexed with that, it is abundantly clear that late Smt. Ranju Sharma, the policy holder of LIC was suffering from serious ailments and was aware of its impending fatal consequences of the disease she was suffering from, but chose not to disclose them while filling up the proposal form on 05.03.2017 for availing the said policy. The intention of the appellant was to hide the said facts, so that the policy could be issued to her smoothly. Therefore, the respondents were rightin repudiating the claim vide their letter dated 31.03.2018 on the ground of suppression of material facts and refunded the premium amount of Rs.70,336/-.In view of the above, we are of the firm opinion that the learned Commission had rightly dismissed the complaint and accordingly the said appeal is dismissed, with no order as to cost.
10. The District Commission, was, thus right, in holding that the Opposite Parties, was neither deficient, in rendering service, nor indulged into unfair trade practice. The order of the District Commission, being legal and valid, is liable to be upheld.
11. No other point, was urged, by the Counsel for the appellant.
12.         For the reasons recorded above, the appeal, being devoid of merit, must fail, and the same is dismissed, with no order as to costs. The order of the District Commission is upheld.Accordingly, the application for condonation of delay of 5 days in filing the appeal, is also disposed of, being infructuous.
13. Certified copies of this order, be sent to the parties, free of charge.
14. The file be consigned to Record Room, after completion.

Pronounced.

17.05.2021

                                                                     Sd/-

                        [JUSTICE RAJ SHEKHAR ATTRI]

PRESIDENT

Sd/-

[PADMA PANDEY]

MEMBER

Sd/-

[RAJESH K. ARYA]

 MEMBER

Gp