1. This Revision Petition seeks to challenge the order of Maharashtra State Consumer Disputes Redressal Commission in First Appeal No. 1560 of 2008. The Revision Petitioner, L.I.C. of India, was the appellant before the State Commission. The State Commission has dismissed the appeal and confirmed the order of the District Form, which had directed the L.I.C. to pay the Complainant Rs.1 lakh together with interest, compensation and costs. 2. The case of the Complainant is that he had taken a “Komal Jivan” policy on 23.06.2003 for his six months old child, for an insured sum of Rs.1 lakh. The child died on 23.10.2005, nearly 2 ½ years after commencement of the policy. The insurance claim of the Complainant was rejected by the Revision Petitioner/Opposite Party and therefore, a complaint was filed before District Consumer Redressal Commission Sangli. 3. The Revision Petitioner/Opposite Party took the stand that coverage of risk under the relevant policy started after only after completion of the age of seven years by the assured. While the age of seven years could have been reached only on 26.06.2010, the child died on 23.10.2005 itself. Hence, only the premia amounts were refundable. This was challenged by the Complainant on the ground that he was given no information on this condition at the time of taking the policy. The District Forum came to the conclusion that the information regarding the date of commencement of risk was not made available to the Complainant before completion of the proposal and therefore the claim was allowed. In appeal, it was argued before the State Commission that there was a specific condition in the brochure that the risk is cover from completion of seven years of age or two years from the date of commencement of policy, whichever is later. The State Commission rejected this plea, holding that the broacher cannot be treated as part of the agreement between the parties. As stipulations in the broacher were not made part of the policy document, it cannot be said that the terms contained in the broacher are conditions of the policy. The State Commission therefore, as already noted, dismissed the appeal of LIC and confirmed the order of the District Forum. 4. We have gone through the contentions raised in the Revision Petition, perused the documents on record and heard the counsel for the Revision Petitioner. The delay of 17 days in filing the Revision Petition has been condoned before taking up the matter on merits. The RP has very substantially relied upon his claim that the risk under the policy had not started before the death of the assured and therefore, the L.I.C. was right in rejecting the claim. This was not the issue before the State Commission. The issue was whether this condition was part of the contract between the LIC and the Complainant. The claim of the Revision Petitioner that the brochure, which contained this condition, formed part of the contract cannot be accepted and has rightly been rejected by the State Commission. 5. The Revision Petitioner has also sought to rely on the terms and conditions contained in similar other polices. This too has been rightly rejected by the State Commission. The claims of the two parties regarding this condition, have to be seen only with reference to the specific policy regulating the contract between them. This becomes all the more necessary in view of the following observation of the State Commission:- “What is interesting to note that in the present matter the policy documents when it was submitted to the insurance company, the insurance company has put up a stamp on the said document showing that said document is cancelled. After putting the stamp of cancellation an extra stamp has been placed by the insurance company on the date which is mentioned as against the column “date of commencement of risk”. In fact that date was material in order to fix up the liability. Therefore, while making stamp of cancellation, the insurance company should not have placed a stamp as against the said column. In fact, one stamp would have been sufficient to cancel said document. But specifically when there is additional stamp, particularly on date which shows that insurance company was interesting in suppressing the said date in order to avoid the liability”. 6. The State Commission has treated this Act of putting the stamp of cancellation with the effect of destroying the entry against the column of the date of commencement of risk as a an act of suppression of a material fact and has drawn adverse inference against the Appellant/Revision Petitioner. This inference has been challenged by the Revision Petitioner, stating that the putting of the stamp incidently on the date of commencement of risk, after having made the payment, was neither intentional nor deliberate but bonafide. We are unable to accept this bland statement as the RP/OP has failed to produce any independent evidence to establish the date of commencement of risk in the present case. In fact, the State Commission has even observed that in spite of the Ombudsman directing the insurance company to produce on record any other document, which will show the date of commencement, it was never produced. Moreover, the claim of the RP that it was “after making the payment”, itself is misleading. The dispute is about payment of the claim under the policy and not of the premium collected from the complainant. Hence, whether the stamp of cancellation was before it or after, is a totally irrelevant fact. 7. Learned counsel for the Revision Petitioner has argued that this issue was also raised before the Ombudsman, who also found the entry against the date of commencement of risk not readable. But he allowed the LIC to produce similar policies. It was observed that commencement of risk was printed in the policy schedule using a computer programme. And thereafter, the Ombudsman came to the conclusion that in this case the risk commenced on 26.10.2010. It has been argued that as the Ombudsman has accepted the information coming from other polices, this Commission should also accept the same. However, the Consumer fora, both at the District and State level, have rejected such information whether coming from other policies or the brochure, on the ground that its existence in the particular policy had not been proved. We see no ground to disagree with the conclusion drawn by the fora below. 8. Accordingly the Revision Petition of the Life Insurance Corporation of India against the order of the Maharashtra State Consumer Disputes Redressal Commission in F.A.NO.1560 of 2008 is dismissed with no order as to costs. |
