Per Mr.S.G.Deshmukh, Hon’ble Presiding Judicial Member
These two appeals filed by ICICI Prudential Life Insurance Co. Ltd./original opponents against the common judgement and order dated 24/01/2011 in consumer complaint nos.1841/09 & 1842/09 passed by District Consumer Disputes Redressal Forum, Sangli are decided by this common judgement.
There is delay of 43 days in filing both these appeals. Delay is properly explained. Therefore both Misc. application nos.11/236 & 11/237 for condonation of delay are allowed and delay stands condoned.
The respondents case before the forum is that deceased Chandrakant Hanmant Shinde husband of Sulabai (complainant in consumer complaint no.1841/09 and father of Pradeep Chandrakant Shinde (complainant in consumer complaint no.1842/09) had obtained two policies for sum assured `1,25,000/- each under Life Time Super Pension Plan. It is alleged that Chandrakant Hanmant Shinde died on 27/11/2008. Complainants being nominees submitted the claims before the appellant for respective policies. Both the claims were repudiated on 19/03/2009 on the ground that the policy holder suppressed the material particulars about his health at the time of submission of proposal forms and, thus, both the complainants approached before the forum.
Present appellant appeared before the forum in both the complaints and resisted the claim contending that they have rightly repudiated the claims as the policy holders suppressed the material particulars about his health while obtaining policies.
It is further their contention that the policy holder was admitted in the hospital for the period 22/08/2008 to 30/08/2008 and he was advised for Liver Transplantation and was suffering from Liver Cirrhosis.
Forum after going through the papers and hearing the parties allowed both the complaints and directed appellant to pay the sum assured with interest @ 9% p.a. from 19/03/2009 in respective policies. Forum also directed appellant to pay both the complainants amount of `3000/- each towards the mental agony and cost. Being aggrieved by the said judgement and order ICICI Prudential Life Insurance Co.Ltd. came in appeal.
We heard Mr.Ashok Singh-Advocate a/w. Mr.Rupesh Gaokar-Advocate for the appellant.
Ld.counsel submitted that the appellant had rightly repudiated both the claims as the policy holder was admitted in the hospital for the period 22/08/2008 to 30/08/2008 prior to taking of the policies in question and the doctor had advised policy holder for transplantation of Liver which has been suppressed by him while obtaining policies. Ld.counsel submitted that they had produced medical papers in that respect. According to the Ld.counsel forum did not consider these papers and erred in allowing the complaints.
We perused the papers and gave anxious consideration to the arguments advanced by the Ld.counsel.
The policies are not in dispute. It is also not disputed that the policy holder died on 27/11/2008. It is the contention of the appellant that the policy holder suppressed the material particulars about his health at the time of obtaining policies. It is contended that the policy holder answered the question 22(a) in positive and 23(c), 23(f) and 23(h) in negative, which is incorrect. In that respect appellant rely on so called case papers brought before the forum. It appears that appellants simply produced xerox copies of the so called case papers before the forum. Affidavit of the doctor who is alleged to have treated or who is alleged to have advised for transplantation of Liver is not brought on record by the appellant before the forum. Even the affidavit of the concerned person who is alleged to have issued those case papers from the hospital is not brought on record. In the absence of affidavits of the concerned persons, xerox copies of the case papers cannot go on record. It was necessary for the appellant to prove those by producing affidavits of the persons who are stated to have treated policy holders or who are stated to have advised him for transplantation of the Liver. Forum has rightly considered these aspects. In case of suppression of material facts, onus heavily lies on the party alleging the same. There is absolutely no evidence to show that policy holder suppressed these material facts.
In the circumstances, we are not inclined to interfere order of the forum. Hence the following order:-
ORDER
Both the appeals stand dismissed summarily.
No order as to costs.
Ld.counsel for the appellant requested for stay. We are not inclined to give stay when we are not admitting the appeals. His request for stay is rejected.
Copies of the order be furnished to the parties.
Pronounced
Dated 19th May, 2011.
Ms.
