Delhi

New Delhi

CC/1022/2006

MTNL Employes COOP - Complainant(s)

Versus

M/S. Life Insurance Company Ltd. - Opp.Party(s)

31 Oct 2019

ORDER

 

 

CONSUMER DISPUTES REDRESSAL FORUM-VI

(DISTT. NEW DELHI),

                ‘M’ BLOCK, 1^STFLOOR, VIKAS BHAWAN, I.P.ESTATE,

                                                           NEW DELHI-110001

 

1. Case No.C.C./112/2014                                                                Dated:

           In the matter of:

M/s M.T.N.L. Employee Co-op

Thrift & Credit Society Ltd.
Room No. 101, Eastern Court,

Janpath, New Delhi - 110001                                                 …… Complainant

 

        Versus

            Life Insurance Corporation of India Ltd.

            (Unit No. – 113)

            Jeewan Tara Building, 1^st Floor, Gate NO. 4

            5 Parliament Street, New Delhi-110001

                                                                                …….Opposite Party

 

2. Case No. CC/939/2011

 

M/s M.T.N.L. Employee Co-op

Thrift & Credit Society Ltd.
Room No. 101, Eastern Court,

Janpath, New Delhi - 110001                                                 …… Complainant

 

        Versus

            Life Insurance Corporation of India Ltd.

            (Unit No. – 113) Jeewan Tara Building,

             1^st Floor, Gate NO. 4

            5 Parliament Street, New Delhi-110001

                                                                                …….Opposite Party

 

 

3. Case No. CC/1022/2006

 

M/s M.T.N.L. Employee Co-op

Thrift & Credit Society Ltd.
Room No. 101, Eastern Court

Janpath, New Delhi - 110050                                                …… Complainant

 

        Versus

            Life Insurance Corporation of India Ltd.

            (Unit No. – 115), N- 72,

            Connaught Circus, New Delhi - 110001

 

                                                                                   …….Opposite Party

 

4. Case No. CC/1023/2016

 

M/s M.T.N.L. Employee Co-op

Thrift & Credit Society Ltd.
Room No. 101, Eastern Court,

Janpath, New Delhi - 110001                                               …… Complainant

 

        Versus

            Life Insurance Corporation of India Ltd.

            Branch Office NO.- 113, H- Block

            Connaught Circus, New Delhi - 110001

                                                                               …….Opposite Party

           

 

 

 

 

H.M. VYAS – MEMBER

 

                                                                        ORDER

 

The complainant has filed all the four complaints as assignee of the policies by the insured challenging the repudiation of the claim in respect of the policy being on false grounds. The repudiation of the claim by the OP as alleged by the complainant is on account of non- disclosure of the material facts. In all the cases after notice, the OP filed version in respect of

Case No.C.C./112/2014

The OP filed written statement stating that the insured had suppressed  the true and material facts regarding his health as the insured was suffering from Left Empyema and Bronchitis and took treatment. The insured was also admitted in ICU in M.G.S. Hospital  from 14/02/2010 to 16/02/2010 and also remained  absent from his office on medical ground from 29/06/2006 to 07/07/2006, from 18/09/2006 to 23/09/2006, from 27/11/2006 to 08/12/2006 and from 11/03/2010  to 03/04/2010 as per the leave record filed . It is stated that the claim was rightly repudiated  and the complaint is liable to be dismissed with heavy and exemplary cost.

Case No. CC/939/2011

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   In the written statements, the OP alleged that the insured concealed the material facts from this Hon’ble Forum. He suffered from DM II (diabetes),      CHF(CongestiveHeartFailure), PAH (Primaryartery hypertension) and dilated Cardiomyopathy for which he had consulted and took treatment from M.G.S. Hospital. He was admitted in  Hospital on 22/06/2007 and was discharged on 27/06/2007 which was prior to date of filling up of proposal form. It was further stated that the insured made the wrong answers of every questions in the proposal form. The complainant is liable to be dismissed.

Case No. CC/1022/2016

 

OP was noticed and filed the advanced copy of written statement  on 22/02/2007 and sought time to file signed copy of written statement, however, the signed copy of written statement has not been filed by the OP. However, affidavit in evidence filed . The ground for repudiation  of claim was concealment of material informationby the insured.

Case No. CC/1023/2016

 

The OP in written statements has  alleged that the insured had died within 3 years of the commencement of risk and concealed the material information at the time of filling the proposal. He underwent Bypass surgrery in 1992 and had been suffering  from heart ailments diagnosed as CAD, LVF,CRF  for which he was treated by Dr. P.K. Goyal, M.D. Consultant, Jaipur Golden Hospital. It was also revealed that Sh. Bharat Lal Passi  used to be leave  on medical grounds quite often. He was also on leave from 21//01/2002 to 20/04/2002.

The Parties to all the complaints filed their respective evidence by way of affidavit and also addressed oral arguments.

We have considered the material before us and the submissions of the parties.

Repudiation of all the claims by OP is on the ground of non-disclosure of the material facts in the proposal Forum. Per contra the arguments on behalf of the complainant are that the proposal Forum was though signed by the  insured but the same was filled in by the agent of the OP and all material information was provided to the agent in response to the question raised by the agent.

The  Hon’ble Apex Court in the case of Reliance Life Insurance Company Ltd. & Ors Vs Rekha Ben, Naresh Rathore reported as 2019(6) SCALE has held that contracts of Insurance are governed by the principle of utmost good faith. The duty of mutual fair dealing requires all parties to a contract to be fair and open with each other to create and maintain  trust between them.  In a contract of Insurance, the insured can be expected to have information of which she/he has knowledge. This justifies a duty of  good faith, leading to a positive duty of disclosure.

In view of above discussions & legal position, we are of the considered view that once the signatures have been appended on the proposal Form which does not disclose the correct and complete information,, the insured is bound to bear the consequences of concealment and/or misrepresentation of the information filled  in the signed proposal Forum. We therefore, hold that the repudiation of the claim by the insurer is justified and the complaints are dismissed accordingly with no orders as to cost.

Copy of the order may be forwarded to the parties to the case     free of cost as statutorily required. 

 Announced in open Forum on 31/10/2019.

   The orders be uploaded on www.confonet.nic.in

   File be consigned to record room.

 

 

 

 

                                                      (ARUN KUMAR ARYA)

                                                               PRESIDENT

 

       (NIPUR CHANDNA)                                                                   (HM VYAS)

           MEMBER                                                                                 MEMBER