Pronounced on 30th September, 2011 O R D E R PER VINEETA RAI, MEMBER Life Insurance Corporation of India (hereinafter referred to as the ‘Petitioner’) has filed this revision petition being aggrieved by the order of the State Consumer Disputes Redressal Commission, Rajasthan (hereinafter referred to as the “State Commission”) in Appeal No.1720/1999 wherein Shri Tara Chand was the Respondent. The facts of the case according to the Respondent are that his wife Smt.Sharda Devi (hereinafter referred to as the ‘insuree’) had obtained a life insurance policy for a sum of Rs.95,000/- on 28.04.1998 from the Petitioner/Insurance Corporation and the premium was paid regularly on a half yearly basis. The insuree passed away on 09.07.1998 and the Respondent being her nominee filed an insurance claim with the Petitioner/Insurance Corporation. Petitioner, however, repudiated the claim on the grounds that insuree had suppressed material information pertaining to her illness and treatment in the hospital. Aggrieved by this, Respondent filed a complaint before the District Forum stating that the claim was wrongly repudiated since the insuree had not suppressed any material information and she was in good health as certified by a doctor who was on the panel of the Petitioner/Insurance Corporation. It was, therefore, requested that the Petitioner/Insurance Corporation be directed to settle the insurance claim of Rs.95,000/- in favour of the Respondent along with interest, bonus and other benefits and Rs.6,000/- as litigation cost. The Petitioner/Insurance Corporation denied the above contentions of the Respondent and stated that the claim was rightly repudiated because the insuree had given a wrong reply in respect of a specific question which sought information whether during the last 5 years, insuree had consulted a medical practitioner for any ailment requiring medical treatment for more than one week and hospitalization. In this connection, it is on record that the Petitioner was suffering from Gastroenteritis for which she was admitted in Seekar Hospital & Research Institute from 21.04.1998 to 27.04.1998. i.e. for a period of one week. Therefore, the Petitioner rightly repudiated the claim of the Respondent. The District Forum after hearing both parties and considering the evidence on record allowed the complaint and directed the Petitioner/Insurance Corporation to pay the Respondent a sum of Rs.95,000/- being the insurance claim along with bonus and other benefits with interest @ 12% within one month from the date of filing of complaint i.e. 28.04.1997. Aggrieved by this order, Petitioner/Insurance Corporation filed an appeal before the State Commission stating that the complaint be dismissed on merits as well as grounds of territorial jurisdiction because the District Forum, Jhunjhunu did not have the jurisdiction to hear the complaint since the cause of action arose at Churu. The State Commission upheld the order of the District Forum and dismissed the appeal by concluding that there was no suppression of material facts since the insuree did not suffer from any pre-existing disease which would affect her life span and the disease from which she was suffering i.e. Gastroenteritis is not a permanent disease but is a common and temporary medical problem. So far as the issue of territorial jurisdiction is concerned, the State Commission observed as follows: “So far as the point that the complaint was filed at Jhunjhunu and not at Churu is concerned, for that it could be said that Jhunjhunu office had also the branch office of the appellants, therefore, it could not be said that it was out of jurisdiction.” Hence, the present revision petition. Counsel for both parties made oral submissions. Counsel for Petitioner reiterated that the learned Fora below erred in not accepting its appeal both on merits as well on grounds of territorial jurisdiction and brought to our notice an order of the Hon’ble Supreme Court in Patel Roadways Ltd. Vs. Prasad Trading Company – (1991) 4 SCC 270 by which the jurisdictional aspect of this case is squarely covered. Counsel for Petitioner further contended since insurance is a contract entered into in utmost good faith between the two parties, the insuree by not giving correct information sought in the insurance policy violated this good faith because of which the claim was justifiably repudiated. Counsel for Respondent on the other hand stated that as observed by the State Commission, the insuree did not suppress any material fact regarding her health since Gastroenteritis, like cough and cold, is a common medical ailment caused due to temporary inflammation of the stomach and intestine and does not adversely affect the insuree’s life span. The insuree had also fully recovered from the same. The State Commission, therefore, rightly upheld the order of the District Forum in favour of the Respondent. We have heard the learned Counsel for both parties and have carefully gone through the evidence on record. We note that the Petitioner has already paid a sum of Rs.95,000/- and other amounts in compliance with the order of the District Forum to the Respondent. Taking note of this fact and because the insuree committed essentially only a technical violation of the terms and conditions of the insurance policy by not disclosing her temporary ailment and treatment, we are inclined to take a lenient and compassionate view in this case and therefore, without going into the question of law and leaving it open or making this case as a precedent, we confirm the order of the State Commission and dismiss the revision petition. Sd/- …………..………………… (ASHOK BHAN J.) PRESIDENT Sd/- ………….………………. (VINEETA RAI) MEMBER /sks/ |