BEFORE A.P STATE CONSUMER DISPUTES REDRESSAL COMMISSION AT HYDERABAD
F.A.No.555 OF 2012 AGAINST C.C.NO.15 OF 2011 DISTRICT FORUM NIZAMABAD
Between:
1. HDFC Standard Life Insurance Co.Ltd.,
Regd.Off: Ramon House, H.T. Parekh Marg
169, Backbay, Reclamation, Church Gate
Mumbai-020
2. HDFC Standard Life Insurance Co., Ltd.,
Dr.No.1-1-2/2-D/ABC, First Floor, Vinayaknagar
Nizamabad
Smt Asha Agarwal W/o Harinath Aggarwal
Aged about 39 years, Occ: Household
R/o H.No.7-137/4, Near Bus Stand
Bichkunda, Nizamabad-306
Counsel for the Appellant
Counsel for the Respondent
QUORUM:
SRI THOTA ASHOK KUMAR, HON’BLE MEMBER
Oral Order (As per Sri R.Lakshminarasimha Rao, Hon’ble Member)
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1. `5,12,300/- towards sum insured along with interest thereon and an amount of`2,00,000/- towards compensation and costs. The District Forum allowed the complaint and awarded an amount of`4,99,000/- with interest @9% p.a. from the date of repudiation and a sum of`1,000/- towards costs.
2. `5,00,000/-. The BDM of the appellant, Anantha Krishna Reddy prompted the respondent’s husband to take the insurance policy and he filled up the proposal form as also obtained her husband’s signature on it in presence of Shaik Jaleel and Narsimhloo.`50,000/- from her husband towards premium for the insurance policy. The appellant issued the insurance policy one week thereafter and the respondent is shown as nominee of the insured in the insurance policy.
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2a. - Caner tumor growth or cyst of any kind
- Musculo- skeletal disorder
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3. Apart from minor ailments, such as colds and flu, have you received any treatment from any doctor or specialist or been hospitalized or undergone hospital treatment, in the last 5 years. |  Yes
12. . 13. 14. ‘the husband of the complainant not died due to demyelinating polyneuropathy c’, respiratory arrest but he was died due to suffering with Neuro muscular disease and prostate enlargement since from long time, but these facts are suppressed by the husband of the PW-1 at the time furnishing the details. 15. Non-disclosure of neuro muscular disease and prostate enlargement were material to issuance of the policy and ought to have been disclosed in the proposal form. 16. i) Sree Devei Amma vs LIC of India ii) LIC of India vs Shashi Bala 17. After claim was repudiated, the petitioner alleging deficiency in service filed complaint which was contested by the respondent. It was alleged that as the life assured had died within a short period of the taking of policy, the respondent got an investigation made which revealed that the assured had undergone tumour decompression surgery on 20.8.1992 at the Neurological Department, Medical College Hospital, Trivandrum. Post-operative radiation was given to him from 3.9.1992 to 9.10.1992. At the time of filling proposal form, this material fact was suppressed by the life assured. Holding that there was suppression of said material fact by the life assured, the complaint was dismissed by District Forum which order was upheld by the State Commission. 18. In our view there is enough evidence on record to show that the deceased indeed was having diabetes and he was aware of this. We see no contradiction in the report of the Sr. Manager who conducted the claim-enquiry. It is true that Urine Reports were not produced. We are not looking into a case of medical negligence, what we are looking into is the veracity of the entries made by the deceased in the Proposal Form at the time of getting Life Insurance Policy. Doctors in a small place know the patients personally and in this case this is what Dr. Arora has to say in his cross examination. 19. Demyelinating polyneuropathy. On application of the ratio laid in above mentioned decision to the facts of the case, we are of the considered view that both parties be given opportunity to adduce evidence in support of their respective claims. 20. కె.ఎం.కె.* |
