DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-I, LUCKNOW
CASE No.705 of 2009
Smt. Shubhawati,
W/o Late Sri S.S. Gupta,
Present R/o 2/4, Khadra Daliganj,
Lucknow.
Permanent R/o Pandit Tola,
Purani Basti, Mangal Bazar,
District Basti.
……Complainant
Versus
- SBI Life Insurance Co. Ltd.,
SBI Life Insurance,
1st Floor, Moti Mahal Marg,
Lucknow.
Through its Manager.
- SBI Life Insurance Co. Ltd,,
Kapas Bhawan, Flat No.314,
Sector 50, CBO Belapur,
Navi Mumbai.
.......Opp. Parties
Present:-
Sri Vijai Varma, President.
Smt. Anju Awasthy, Member.
JUDGMENT
This complaint is filed by the Complainant against the OPs for directing the OPs to make the full maturity amount to the Complainant against the policy and for payment of Rs.50,000.00 as compensation and cost of the complaint.
The case in brief of the Complainant is that on the persuations made by the agent of the LIC Co. Mr. Abhay Pratap Singh the husband of the Complainant had taken the LIC policy No.19001241410 dated 20.02.2006. The husband of the Complainant died on 21.12.2006 due to heart attack. The husband of the Complainant had deposited the premium of the said policy i.e. Rs.24,000.00 through the said agent at
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Lucknow and he had executed all the necessary documents at Lucknow. The said policy was valid for 20 years but since the husband of the Complainant died, hence the Complainant has lodged the claim for the payment of the maturity amount in respect of the said policy i.e. Rs.1,20,000.00 but the OPs have refused to make the payment of the maturity amount against the said policy and after the hectic efforts made by the Complainant the OP has paid only RS.45,939.00 and the remaining amount has not been paid by the OPs. The Complainant has written several letters and reminders to the OPs stating therein that the husband of the Complainant was not suffering from any chronic disease at the time of taking the policy and her husband has died due to heart attack, thus the full amount of the maturity against the said policy may be made to the Complainant but nothing has been done and the remaining amount of the policy was detained on false pretext that the husband of the Complainant was suffering from Semiparesis Asthama prior to the date of commencement of the policy which is totally wrong and incorrect. The Complainant served a legal notice upon the OPs on 01.04.2009 but nothing has been done, hence this complaint.
The OPs have filed the WS wherein it is admitted that the policy No.19001241410 having date of commencement as 08.03.2006 was issued in the name of Sri Shiva Sahai Gupta, based on the information provided by the DLA in the proposal form No.19-90149 dated 20.02.2006. During the investigation of the claim it was revealed that the DLA was suffering from Hemiparesis and TB- asthma prior to the date of proposal and commencement of policy. The DLA suppressed this material fact about his health while submitting the proposal form. The OPs have further submitted that in the proposal form the DLA has mentioned the Complainant to be his wife as his nominee. It has been challenged by Sri Vijay Shankar Gupta stating that the DLA is left by his wife Vidya Devi and his three sons
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Vijay, Shyam and Vitthal and the Complainant Shubhadevi has been a Dai, cooking food etc. for them. In support of their statement copy of ration card has also been enclosed. During the claim investigation it has been revealed that Suhbhadevi is the wife of Sri Chandradev residing at Karupura baba ka Sthan Basti. This fact is also clear from the PAN card, voter card, Ration Card and electricity bills of Smt. Shubhavati. According to the statements of Smt. Vidya Devi wife of the DLA and Vijay the son of the DLA also the DLA was sick since long and was taking treatment since 2002 suffering from asthma (TB) and had a heart attack once and paralysis attack three times. Before his death he was taking treatment from Dr. M.K. Sinha at Basti. The term of the policy taken by the DLA was 20 years and the basic sum assured is Rs.1,20,000.00. The annual premium instalment was Rs.24,000.00. The claim of the Complainant has been repudiated on the basis of suppression of material facts about his health by the DLA at the time of taking insurance cover which is just and legal as per the terms and conditions of the policy. The OPs have paid the fund value of Rs.45,939.00 to the Complainant as per the terms and conditions of the policy. Non disclosure of material information is fatal to the doctrine of utmost food faith and thus vitiates the contract of insurance, hence the OPs repudiated the claim on the life of the DLA based on the documentary evidence. The declaration signed at the end of the proposal is in the nature of a warranty and hence any breach of warranty makes the contract of insurance void ab-initio. The Complainant had been duly informed about the reasons for repudiation of the claim. The OPs have not received any legal notice, hence there is no question of replying the same. The OPs have replied all the communications of the Complainant promptly. The OPs have already paid the fund value of the policies as per the terms and conditions of the policy and the Complainant is not entitled to
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get any other amount. The DLA himself is responsible for the repudiation of the claim because he suppressed the material facts while availing the insurance cover. The OPs have not disbursed any loan to the Complainant. The complaint is not at all maintainable and deserves to be dismissed with costs.
The Complainant has filed her affidavit and 13 annexures with the complaint. The OPs have filed the affidavit of V. Srinivas and annexure A to Q with the WS. The parties have also filed written arguments.
Heard Counsel for the OP. None appeared from the side of the Complainant to argue the case and perused the entire record.
Now, it is to be seen as to whether the insured the deceased Sri Shiv Sahai Gupta concealed material information at the time of filling of the proposal form for issuance of the insurance and hence the OPs rightly repudiated the claim of the Complainant or not? If so, its consequences.
In this regard, it is argued by the learned Counsel for the OPs that the claimant Smt Shubhawati Devi is shown as the wife of the deceased Sri Shiv Sahai Gupta whereas she is not the wife of the deceased, hence materially wrong information is provided by the deceased. It is also argued by the learned Counsel for the OPs that the deceased had with regard to his disease did not provide the correct information as he has concealed the information regarding his disease showing himself to be not suffering from any disease in the past whereas he was suffering from TB on the date of filling up the form for insurance. In support of his argument learned Counsel for the OPs have filed the photocopy of the certificate issued by Dr. Himayat-u-allah on 20.04.2007 where he has certified that he knew Sri Shiv Sahai Gupta as he has been his family doctor and Sri Gupta was suffering from asthma (TB) for about last 4 years and he has been referred to District Hospital, Basti. Another photocopy of the Mantoux tests dated
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03.10.2003 which is annexure F has been filed where this test has come out positive. This test is taken for finding out whether the person is suffering from TB or not. He has also filed the photocopy of the prescription written by Dr. Sinha where the deceased Sri Shiv Sahai Gupta was advised medicines Econox 800 or Forcox which are the medicines given to the TB patient. A literature to this effect has also been filed by the learned Counsel for the OPs. Thus, from the aforesaid documents learned Counsel for the OPs has tried to establish that the deceased Sri Shiv Sahai Gupta was suffering from TB prior to the filling of the form and that is why the information regarding this disease was wrongly given by the deceased that he was not suffering from the aforesaid disease. There is no justification which could discredit the evidence provided by the OPs regarding the deceased suffering from the serious disease of TB. Therefore, it is clear that the deceased had concealed material information with regard to the deadly disease of TB from the OPs. Besides it is also argued by the learned Counsel for the OPs that the Complainant was not the wife of the deceased as was disclosed by the deceased in his proposal form and in this regard the OPs have filed a copy of the letter written by the sons of the deceased Vijay, Shyam and Vitthal to the Manager SBI LIC Mumbai wherein it is stated that Smt. Shubhawati Devi is merely a maid servant and was not the wife of the deceased Sri Shiv Sahai Gupta as his wife Smt. Vidyawati is alive. A Photocopy of the ration card has also been filed to show that Smt. Vidyawati is the wife of the deceased Sri Shiv Sahai Gupta. A photocopy of the voter ID card issued by the Election Commission of India has also been filed wherein the name of the husband of Smt. Shubhawati Devi is shown as Sri Chandradev. A photocopy of the letter written by Smt. Shubhawati Devi to the Power Corporation on 19.11.2005 has also been filed wherein Smt. Shubhawati Devi is showing herself as the wife of Late Sri Chandradev. All
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these documents show that the Complainant Smt. Shubhawati Devi was not the wife of the deceased Sri Shiv Sahai Gupta, therefore obviously the deceased Sri Shiv Sahai Gupta had given wrong information with regard to the status of Smt. Shubhawati Devi as she was not the wife of the deceased deceased Sri Shiv Sahai Gupta but the wife of Late Sri Chandradev. Therefore, it is again materially wrong information given by the deceased in his proposal form. Therefore, it is absolutely clear that the deceased had given wrong information regarding the status of Smt. Shubhawati Devi and had concealed the material information with regard to the deadly disease of TB with which he was suffering from prior of the filling of the form. Therefore, the OPs rightly repudiated the claim of the Complainant. There has not been any kind of deficiency in service on the part of the OPs, hence this complaint deserves to be dismissed.
ORDER
The complaint is dismissed.
The parties are to bear their own costs.
(Anju Awasthy) (Vijai Varma)
Member President
Dated: 30 January, 2016
