Haryana

StateCommission

A/14/2015

LIFE INSURANCE CORP.OF INDIA - Complainant(s)

Versus

RAM NIWAS - Opp.Party(s)

NEHA SHARMA

08 Jan 2016

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION HARYANA, PANCHKULA

                                                 

First Appeal No  :        14 of 2015

Date of Institution:      07.01.2015

Date of Decision :       08.01.2016

 

1.     Life Insurance Corporation of India (LIC) through its Senior Divisional Manager, Divisional Office, Sector-17, Chandigarh.

 

2.     Life Insurance Corporation of India (LIC) through its Branch Manager, Kosli Road, Jhajjar.

 

3.     Life Insurance Corporation of India (LIC) through its Divisional Manager, Sector-1, Rohtak.

                                     Appellants/Opposite Parties

Versus

 

Ram Niwas s/o Sh. Shyojiram, Resident of Village Mehrana, District Jhajjar.

                                      Respondent/Complainant

 

CORAM:             Hon’ble Mr. Justice Nawab Singh, President.

                             Shri B.M. Bedi, Judicial Member.

                             Shri Diwan Singh Chauhan, Member   

 

Present:               Ms. Neha Sharma, Advocate for appellants.

                             Shri N.K. Malhotra, Advocate for respondent.

 

                                                   O R D E R

 

B.M. BEDI, JUDICIAL MEMBER

 

This appeal of opposite parties is directed against the order dated 25^th November, 2014, passed by District Consumer Disputes Redressal Forum, Jhajjar (for short ‘the District Forum’) in Consumer Complaint No.234 of 2013.

2.      Pawan Kumar (since deceased and hereinafter referred to as ‘the Life Assured’) son of Ram Niwas-complainant/respondent purchased two Life Insurance Policies Exhibit R-3 and R-5 from Life Insurance Corporation of India (LIC) on December 28^th, 2011. The sum assured was Rs.2,50,000/- per policy. The life assured died on December 2^nd, 2012 due to fall in a Well. On being informed, the Police recorded Daily Diary Report No.19 (Exhibit P-6) in Police Post, Dujana, District Jhajjar, on the same day, that is, December 2^nd, 2012. Autopsy of the deceased was conducted in General Hospital, Jhajjar, vide Post Mortem Report Exhibit P-4. The Police submitted ‘Natural Death Report’ Exhibit P-5. Sub Registrar, Birth/Death, Dujana, District Jhajjar, issued Death Certificate Exhibit P-7. The claim being filed, the LIC repudiated the same vide letter dated 30^th July, 2013 (Exhibit P-2) on the ground that the life assured was suffering from Post Polio Residual Paralysis before the date of purchasing the Life Insurance Policy but he did not disclose this fact in the Proposal Forms Exhibits R-4 and R-6, thus made deliberate mis-statement and withheld the material information. So, the LIC was not liable to pay the benefits of insurance to the complainant.  Hence, the complainant filed complaint under Section 12 of the Consumer Protection Act, 1986.

3.      The LIC in its reply denied complainant’s claim on the ground stated in the repudiation letter. Besides, it was stated that the life assured had committed suicide and therefore the LIC was not liable to pay the sum assured.

4.      On appraisal of the pleadings and evidence of the parties, the District Forum accepted complaint vide impugned order issuing direction as under:-

“…it is directed that the respondents shall make the payment of assured sum of the two policies i.e. policy bearing No.333570545 & bearing No.333570545 dated 28.12.2011 with accidental benefits etc, if any, under the policies in question along with an interest @ 9% p.a. from the date of death of life assured i.e.  2.12.2012 as is clear from death certificate Ex.P-7 till realization of final payment to the complainant. The complainant is also entitled for a sum of Rs.2,000/- on account of litigation expenses for the present unwanted and unwarranted litigation only due to the deficiency in service on the part of the respondents.”

5.      Learned counsel for the appellants/LIC, has assailed the order of the District Forum on the ground that the life assured had concealed fact regarding his health inspite of the fact that he was suffering from Post Polio Residual Paralysis RT Lower Limb and was 70% handicapped orthopaedically as per the disability certificate (Exhibit R-7) issued from the office of the Civil Surgeon, Jhajjar. Further contention was raised that the life assured committed suicide by jumping in a Well, within one year from the commencement of the policy, thus as per Clause 6 of the conditions of the policy, the LIC is not liable to pay the benefits of insurance to the complainant.

6.      The contention raised is not tenable because any physical deformity in the body can easily be seen with naked eyes, so there cannot be any kind of concealment on the part of the life assured to that extent. It was for the LIC to issue the policies or not to issue the policies to such a person and once the proposals submitted by the life assured were accepted and the policies were issued, then the LIC is liable to pay the sum assured with respect to the said policies.  

7.      So far as the other plea that the life assured had committed suicide, in fact, is a concocted and afterthought version because this plea was not raised by the LIC in the letter Exhibit P-2 whereby the claim of the complainant was rejected. More so, there is no evidence on the record to show that the life assured had committed suicide. It has been clearly mentioned in the DDR (Exhibit P-6) that on 2^nd December, 2012 at about 5.00 A.M. the deceased had gone for morning walk as usual but when he did not return, a search was made and he was found lying in a Well. This document nowhere suggests that suicide was committed by the life assured. Mere assumption and presumption cannot take the place of proof without any cogent supporting evidence. In this view of the matter, the LIC cannot escape from its liability to pay the benefits of insurance policies to the complainant. Thus, the District Forum has rightly allowed the complaint. No case for interference is made out.

8.      For the reasons recorded above, the appeal is devoid of merits and is hereby dismissed.

9.      The statutory amount of Rs.25,000/- deposited at the time of filing the appeal be refunded to the complainant against proper receipt and identification in accordance with rules, after the expiry of period of appeal/revision, if any.

 

Announced 08.01.2016

(Diwan Singh Chauhan) Member

(B.M. Bedi) Judicial Member

(Nawab Singh) President

CL