NCDRC

NCDRC

RP/1574/2010

MANJULATA KUJUR - Complainant(s)

Versus

SENIOR MANAGER, LIC OF INDIA & ORS - Opp.Party(s)

MR. RAJESH KUMAR BHAWNANI

13 Jul 2010

ORDER


NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSIONNEW DELHIREVISION PETITION NO. 1574 OF 2010
(Against the Order dated 17/07/2009 in Appeal No. 330/2009 of the State Commission Chhattisgarh)
1. MANJULATA KUJURR/o. Near Prakash School, Ambikapur Road, PatthalgaonJashpurChhattisgarh ...........Petitioner(s)
Versus
1. SENIOR MANAGER, LIC OF INDIA & ORSDivisionla Office, Jeevan Prakash, Jeevan Beema Marg, PandriRaipurChhattisgarh2. BRANCH MANAGER, LIC OF INDIABranch Office, PatthalgaonJashpurChhattisgarh ...........Respondent(s)

BEFORE:
HON'BLE MR. JUSTICE ASHOK BHAN ,PRESIDENTHON'BLE MRS. VINEETA RAI ,MEMBER
For the Petitioner :MR. RAJESH KUMAR BHAWNANI
For the Respondent :NEMO

Dated : 13 Jul 2010
ORDER

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This order shall dispose of abovementioned Revision Petitions since the facts and point of law involved in them are the same.  Facts are being taken from Revision Petition No.1573/2010.

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Insured had taken two policies in the sum of Rs.1 Lac each in the year 2001 which were to mature in the year 2020.  Insured failed to pay the third premium on 23.3.2003, as a consequence the policies lapsed.  Insured filed an application for getting the policies revived and the same were revived on 08.3.2004.  Insured/husband of the petitioner died on 15.4.2005.  Petitioner lodged a claim with the respondent insurance company which was repudiated on the ground of suppression of material facts.  Aggrieved by the repudiation, petitioner filed two separate complaints before the District Forum which were allowed.  Respondent was directed to pay the insured amount along with interest @ 12% p.a.  Rs.5,000/- were awarded as compensation for harassment and Rs.3,000/- by way of costs. 

          Aggrieved against the order passed by the District Forum, respondent filed two separate appeals.  By the impugned order, the State Commission has set aside the order passed by the District Forum and dismissed the complaints.  The State Commission in its order has recorded a finding that the petitioner was guilty of suppression of material facts while getting the policy revived; that the


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petitioner had twice been admitted in the Vellore Hospital and was suffering from multiple diseases.  In para 5 of its order, the State Commission has recorded the following findings.

       5.      Learned counsel for the LIC Shri Dutta has drawn our attention towards a certificate Annexure B-1, which was issued by Dr. S. A. Kale, MD Medicine of Modern Medical Institute, Raipur.  It has been certified by him that “Mr. Shimon Kujur, 41 years, male S/o Shri Abraham Kujur, a resident of Jashpur, was admitted in Modern Medical Institute on 25.1.03 and discharged on 31.01.03 with diagnosis of Diabetes Mellitus, HTN, Retinopathy, advanced severe diffuse, nodular, global glomerulosclerosis with tubular atrophy and intestital fibrosis and inflammation.  He was readmitted on 05.03.03 and was discharged on 08.03.03.”  This certificate shows that in the month of January, 2003 the deceased was suffering from certain diseases like diabetes mellitus, retinopathy and kidney infection etc.  Thereafter he made proposal for revival of the insurance policy.  Treatment papers of Vellore Hospital, copy of which is available in the record of the District Forum, also shows that in that Hospital the deceased was admitted with a history of diabetes and hypertenstion for last four years and has been described as a known case

 

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of these diseases for last four years.  He was presented with history of pedal edema, deceased urine output, uremic symptoms of one month duration.  He was having complaints of breathelessness on exertion.  This certificate also shows that in the Vellore Hospital history of diabetes and hypertension for last four years, was given at the time of admission on 31.12.04, which shows that the deceased was suffering from these diseases from the year 2000.  Thus, from the certificate of Dr. S. A. Kale as well as from the history given in the discharge summary of Vellore Hospital, it is clear that the deceased was knowing well that he was suffering from diabetes mellitus and from hypertention, much prior from the date of making proposal for revival of the insurance policies, but at the time of making proposal for revival, he had deliberately chosen not to disclose anything in respect of those diseases in that proposal form and conveniently answered the questions in respect of such diseases in negative by saying that he is not suffering form hypertension or heart diseases or any disease in respect of kidney, diabetes etc.  Declaration of the insured, in the proposal form, further shows that it was declared by him that all these answers were true and he has not suppressed anything.  He has also declared that this information given by him would be the base for

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revival of the policy and if those statements are found false then the contract of insurance would be cancelled with forfeiture of the amount paid till date.

 

          State Commission relying upon the judgment of this Commission in “LIC Of India Vs. Smt. M. Bhavani (2009) 1 CPR 187 (NC)” held that if the policy is taken or got revived by suppressing preexisting material facts like preexisting disease, then the insurance company is not liable to pay the insured amount under the policy.

          We agree with the view expressed by the State Commission that the insured was guilty of suppressing material facts while getting the policy revived.  No merits.  Dismissed.



......................JASHOK BHANPRESIDENT
......................VINEETA RAIMEMBER