Per Hon’ble Mr.S.R.Khanzode, Judicial Member
This appeal takes an exception to an order dated 29/03/2011 passed in consumer complaint no.440/2010, Smt.Zahirabai Ismail Nagare v/s. Divisional Manager, Life Insurance Corporation of India, Solapur; passed by District Consumer Disputes Redressal Forum, Solapur. Appeal is preferred by Life Insurance Corporation of India after feeling aggrieved by the impugned order.
It is a case of alleged deficiency in service on the part of Life Insurance Corporation of India (‘LIC’ in short) for repudiating the insurance claim, which arose on the death of husband of Zahirabai (herein after referred as ‘complainant’)/ respondent in appeal. Husband of the complainant-Ismail died on 29/12/2008 while receiving treatment at Gunjotikar Nursing Home (Krishna Memorial) at Solapur.
The claim was repudiated by the LIC as per its letter dated 05/12/2009 on account of breach of utmost good faith, since insured late Ismail suppressed the material facts of his illness i.e. suffering from Diabetes Mellitus for last three years prior to his death.
Forum did not accept the case of opponent -Divisional Manager, LIC, Solapur in respect of repudiation and directed it to pay all the insured amount under the policy along with interest @ 9% p.a. and also imposed costs of `1000/-. It may not be out of place to mention here that though the official of the LIC, namely, its one of the Divisional Managers is made as party opponent in original consumer complaint, in fact, it is a complaint against the LIC and it is also fought as such by LIC and LIC only has filed the appeal, accordingly.
We heard both the parties. Perused the record. In a letter of repudiation dated 05/12/2009, LIC informed in detail the reasons for repudiation by supplying the complainant, necessary information given in the proposal form by late Ismail, which indicates suppression of his material facts, supra and also referred to the hospital record on the basis of which LIC inferred that late Ismail while reviving the life insurance policy suppressed the information of his suffering from Diabetes Mellitus and also supplied to her the material indicating the same. Complainant obviously failed to answer to such material supplied to her while repudiating the claim, when the consumer complaint was lodged, it may not be out of place to mention here that the proposal form which is also on the record which was filled by late Ismail indicates that while answering to question no.2(A)(5), which pertains to query in respect of suffering from Diabetes amongst other illness mentioned therein, late Ismail has replied in the ‘Negative’. From the hospital record of his treatment received from CityHospital, Solapur and during his last illness at Gunjotikar Nursing Home, supra, it is well established that late Ismail was suffering from Diabetes Mellitus for about three years prior to giving the information in the proposal form at the time of reviving the life insurance policy. Diabetes and gravity of it from which he was suffering, the fact that due to diabetes he has even suffered Gangrene of his feet also indicates that he was suffering from such illness much prior to filling the proposal form, few days prior to revival of this lapsed insurance policy. In the instant case complainant herself did not discharge her initial burden to refute these facts. Therefore, approach of the forum not to consider this aspect resulted into miscarriage of justice.
For the reasons stated above, we find that since late Ismail suppressed material facts of his illness while reviving the lapsed insurance policy, repudiation of the insurance claim by LIC on the ground of suppression of facts of his diabetic condition and, thus, there is breach of utmost good faith; the repudiation cannot be faulted with. Therefore, LIC cannot be held guilty for arbitrary repudiating the claim and, thus, it did not incur any omission whereby it can be said that LIC is responsible for deficiency in service within the meaning of Consumer Protection Act, 1986. We hold accordingly and pass the following order:-
ORDER
Appeal is allowed.
Impugned order is quashed and set aside.
Consumer complaint stands dismissed.
No order as to costs.
Pronounced in the open court.
Copies of the order be furnished to the parties
Pronounced on 27th June, 2012.
