Delhi

New Delhi

CC/56/2009

Yoegsh Kumar Gupta - Complainant(s)

Versus

M/S. Life Insurance Corporation Of India - Opp.Party(s)

26 Nov 2015

ORDER

CONSUMER DISPUTES REDRESSAL FORUM-VI

(DISTT. NEW DELHI), ‘M’ BLOCK, 1^STFLOOR,

VIKAS BHAWAN, I.P.ESTATE,

NEW DELHI-110002.

 

Case No.CC/56/09                                Dated:

In the matter of:

Sh. Yoegsh Kumar Gupta,

2643/196, Tri Nagar, Delhi-35

……..COMPLAINANT

       

VERSUS

Life Insurance Corporation of India,

Jeevan Bharti, 124, Connaught Circus, New Delhi-01

And also through:

Zonal Manager, LIC of India,

Northern Zonal Office, Connaught Circus, Delhi01

And also through:

Branch Manager,

LIC of India, Branch Unit 12T,

Panchwati, Adarsh Nagar, Delhi

                                         ……. OPPOSITE PARTY

 

ORDER

President: C.K Chaturvedi

               

The Complainant is nominee of a LIC policy in the name of his deceased wife Usha Aggarwal, for a sum of Rs.10 lakhs. She died of cancer on 11.10.07. The Complainant made a claim on her death. The OP repudiated the same on the ground that she has suppressed her treatment of left breast cancer and removal of left breast on May 06 in Bhagwati Hospital Sector-13, Rohini. The case of the complainant is that OP’s agent Mr. Singhal told her that since breast cancer was very common, she should be insured which would cost a little higher premium. It is stated that she was also got medically examined and if any misrepresentations were made the same were by against who filled the form, as she was not literate.

The OP filed a reply stating that Smt. Usha Agarwal filled the form on 25.11.06, and she deliberately withheld information with respect to previous treatment since May 2006. She made a request to date back the policy w.e.f 04.06 in the proposal made in 11.06, to cover the treatment already done in May 2006.

The OP has placed relevant hospital records to show her admission and treatment since 2006 till death.

We have considered the evidence of OP and submissions made. It is settled position (See III(2002) CPJ 10 and in R.P 1167 of 77) that insurance is a contract of good faith, and any mala fide suppression vitiates the contract. In this case, there was suppression of facts and deliberate ante dating of date of commencement. She being fully aware of her treatment, the Family Court shifts the blame to Insurance Doctor or Insurance Agent. In the circumstances, the repudiation is justified and we do not find any deficiency in repudiation of claim. The complaint is dismissed.

 File be consigned to record room.

Copy of the order be sent to the parties free of cost.

 

        Pronounced in open Court on 26.11.2015.

 

 

 

(C.K.CHATURVEDI)

PRESIDENT

 

 

 (Ritu Garodia)

MEMBER