KERALA STATE CONSUMER DISPUTES  REDRESSAL COMMISSION VAZHUTHACAD, THIRUANANTHAPURAM

APPEAL NO.451/2009

JUDGMENT DATED: 13.7.2010

PRESENT

SMT.VALSALA SARANGADHARAN     : MEMBER

SRI.M.V.VISWANATHAN                         : JUDICIAL MEMBER

SRI.M.K.ABDULLA SONA                      : MEMBER

1. Divisional Manager,                              : APPELLANTS

    LIC of India, Divisional Office,

   Jeevan Prakash, PB No.177,

    Kozhikode – 673001.

2. The Zonal Manager,

     LIC of India, Southern Zonal Office,

     LIC Builidng, Anna Salai Road,

     Chennai – 600 007.

   (By Adv.G.S.Kalkura)

              Vs.

Nabeesa Hamsa,                                      : RESPONDENT

W/o late P.Hamsa, Residing at

Bilal Manzil Erol kunnummel, P.O.,

Bare, Hosdurg Taluk,

Kasargod District.

(By Adv.A.S.Anil kumar)

JUDGMENT

SMT.VALSALA SARANGADHARAN     : MEMBER

          The appellants are the opposite parties in CC.159/08 in the file of CDRF, Kasargod,  who are under orders to pay a sum of Rs.67900/- with 9% interest per annum from 10.3.08 till the date of payment with costs of Rs.2500/-.

          2. The case of the complainant is that her husband was insured with the opposite parties for a sum of Rs.1,00,000/- on 15.9.99.  The policy was lapsed in March 2005 and the same was revived on 27.7.06.  Her husband died on 10.10.07 and the claim made by the complainant was repudiated by the opposite party on the ground of suppression of pre-existing disease at the time of revival of the policy.  According to the complainant her husband has not suppressed any material fact at the time of revival of the policy. Hence alleging deficiency on the part of opposite parties,  she filed complaint before the Forum.

          3. The opposite parties filed version and contended that the policy holder had suppressed the pre existing disease while reviving the lapsed policy, hence the claim was not honoured in full and paid up value of the policy plus accrued bonus was paid.

          4. We heard the learned counsel for both sides.  The learned counsel for the appellants justified their action in repudiating the claim.  On the other hand the learned counsel for the respondent/ complainant disputed that the person shown in the treatment records produced by the appellants/opposite parties was not the complainant.

          5. On hearing the learned counsel for both sides and on perusing the records it is found that the identity of the life assured has not proved beyond doubt.  The definite case of the respondent/ complainant is that the patient mentioned in the treatment records and medical reports is entirely a different person and that the life assured has no sort of connection with those documents and that Ext.B4 and B5 are not related to the treatment of the life assured,  but at the same time the complainant has not produced the relevant documents which are in her possession.  More over it is not mentioned in the complaint, the cause of death, the time of death and the place of death of the life assured.  The avocation of the life assured is also not stated.  The materials on record would show that the life assured was employed in gulf.  The best piece of evidence to prove the identity of the life assured is the passport issued in his name and the certificate of the  employment if any.  No doubt that there will be documents to show the correct address including the door number of the house and the name of the father of the assured but the complainant has not produced any of those documents.  The opposite parties had also not taken steps to get the hospital records from High Land hospital with respect to the treatment records of the life assured. So for a just and proper disposal of the case, Both parties must be given opportunity to adduce evidence in support of their respective  pleadings.  We do feel that this is a fit case for a remand for the purpose of affording opportunity to both parties to adduce evidence in support of their contentions.

          6. In the result the order of the Forum is set aside and the matter is remanded to the Forum for fresh disposal in accordance with law.  The Forum is directed to permit both parties to adduce further evidence in support of their contentions and dispose of the matter on merits.

          7. The matter will stand posted before the Forum on 30.8.2010.

          Office is directed to transmit the copy of this order as well as the LCR to the Forum urgently.

          SMT.VALSALA SARANGADHARAN     : MEMBER

          SRI.M.V.VISWANATHAN                         : JUDICIAL MEMBER

          SRI.M.K.ABDULLA SONA                      : MEMBER

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