The Manager,

Life Insurance Corporation of India,

Gandhi Nagar,

Port Blair                                                                                                                                                                                                                              Appellant.

 

-Versus-

Smti Sethurani

W/o Late N. Vardha Rajan,

 R/o Phoenix Bay, Port Blair                                                                                                                                                                                         Respondent

Present:

1. Justice S.N Bhattacharjee, President, State Commission

2. Smti Bimal Behari Chakravarthy, Member, State Commission.

3. Ms. Vijay Lakshmi, Member, State Commission

1. This appeal has been directed against the order passed by the District Forum in C.D.Case No.12 of 2005, whereby the application under Section 12 of the Consumer Protection Act filed by the Respondent herein was allowed.

2. Respondent’s husband, a Mazdoor, under Electricity Department, Port Blair had taken a policy of Life Insurance for a sum of Rs.50, 000/- on 15/7/2000 from the Appellant L.I.C for a period of 15 years. Next half- yearly premium could not be paid by the policy holder due to financial crisis. The policy lapsed. Subsequently, in the month of January 2003 the policy was revived and renewed by the Insurance company on receipt of Rs.9, 604/- with late fees of Rs.1039/- from the assured. The assured died at G.B Pant Hospital on 19/3/2003. The Claimant/Respondent claimed the amount in question before the Insurance Company on 19/12/2003, but the payment was refused by the L.I.C.

3.The Appellant herein denied the claim of the claimant under Section 45 on the grounds that the deceased availed leave on medical ground from his office from 17/4/2001 to 13/3/2003 and the deceased suppressed of material facts at the time of revival of the policy that he was attacked with cancer.

4. The Forum below, having heard both the sides, allowed the Claimant’s application granting a sum of Rs.60,500/- against the opposite parties along with a cost of Rs.500/- to the Claimant. Being aggrieved by the aforesaid order of the Forum below, the Respondent has preferred this appeal.

5. It has been contended by the Ld. Counsel for the Appellant Insurance company that the Forum below committed both the errors of facts and law in as much as the Claimant’s husband was a patient of Cancer and got himself treated at Appollo in Chennai in 2001 long before the renewal of the policy. From the certificate of the Employer, it will be clear that he was a patient of Cancer and was given Chemotherapy. The patient attended first at Apollo Specialty Hospital at Chennai. Thereafter, continued treatment at Apollo Hospital, Madurai. The assured concealed all these facts before the Corporation.

6. The Forum below considering the evidences on record allowed the Petitioner’s case and passed the order under challenge before us.

7. It has been argued before us by the Ld. Counsel for the Respondent herein that the Forum below committed errors of facts and laws in deciding the case. The Forum below failed to take notice that the policy holder suffered from Cancer from the very beginning and got the Policy renewed within two years from the date of default in payment of the premia through an agent of Corporation who took resort to falsehood. It is further argued that the Ld. Forum below failed to take proper notice of exhibit 9 which is Respondent’s reply to the Claimant. The order passed by the Forum below was without jurisdiction as no notice was taken of the exhibit 9 by the Forum.

8. The Ld. Advocate for the Respondent herein tried to contradict the contention of the Appellant by stating that the enquiry was made three years after the insurance of the policy. According to him the Life Insurance Policy No.422018569 commenced from 15/7/2000 and the enquiry was held three years thereafter. Such enquiry was not held within two years from the date of the policy and as such any adverse report of such enquiry will not stand in the way of the Claimant’s getting compensation.

9. The main question before us is whether the Forum below was justified in allowing the Claimant’s case.

10. That the policy holder died of Cancer has not been disputed by the Claimant (vide paragraph 10 of the Complaint). The date from which the deceased was a patient of Cancer has not been disclosed by the Claimant in the Petition. The Respondent by virtue to exhibit 9 has stated before the Forum that the assured had been suffering from C.A Lung for which he had gone to Apollo Speciality Hospital at Chennai in the month of July 2002 for Chemotherapy.

11. Before this Commission the Appellant has filed a certificate from Apollo Speciality Hospital, Chennai by a certificate dated July 17, 2002 stating that Mr. Varadarajan 42/M has got Lung Cancer for which he was given chemotherapy.

12. The date of administering Chemotherapy had not been mentioned. This certificate discloses that Chemotherapy was administered on 15/7/2002 and definitely subsequent to the detection of the disease like cancer. The Forum below did not come to a finding as to when the disease was detected. Be that as it may, the assured came to know his disease before renewal of the policy and also underwent a treatment of administering chemotherapy before the application for renewal and got the policy renewed through an agent of the Respondent. So renewal of the policy was not valid. The proviso to Section 45 of Life Insurance Act will apply in this case and an enquiry by the Respondent after two years of the policy must be held valid under said Proviso. The Policy , therefore, could not be renewes and has been rightly repudiated by the Respondent. The finding of the Forum below is, therefore  not legal and as such the same cannot be accepted.

13. We, therefore, hold that the Appeal has merit and the order passed by the Forum below is liable to be set aside. The Appeal is allowed. The parties ,will bear their      own cost.