NCDRC

NCDRC

RP/930/2008

BIRLA SUN LIFE INSURANCE - Complainant(s)

Versus

SMT. ASHA - Opp.Party(s)

MR. PANKAJ SETH

05 Aug 2014

ORDER

NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION
NEW DELHI
 
REVISION PETITION NO. 930 OF 2008
 
(Against the Order dated 11/12/2007 in Appeal No. A-609/2007 of the State Commission Delhi)
1. BIRLA SUN LIFE INSURANCE
THE CHAIRMAN, 6TH FLOOR, VAMAN CENTRE, MAKHWANA ROAD, OFF. ANDHERI KURLA ROAD, NEAR MAROL NAKA,
ANDHERI EAST,
MUMBAI - 400059
...........Petitioner(s)
Versus 
1. SMT. ASHA
RESIDENT OF M. S. 12, M. E. S. COLONY,
SUBROTO PARK,
NEW DELHI - 110010
...........Respondent(s)

BEFORE: 
 HON'BLE MR. JUSTICE K.S. CHAUDHARI, PRESIDING MEMBER
 HON'BLE MR. VINAY KUMAR, MEMBER

For the Petitioner :
Mr. P.K. Seth, Advocate
For the Respondent :
Ex-parte

Dated : 05 Aug 2014
ORDER

This revision petition has been filed by the petitioners against the order dated 12.11.2007 passed by the State Consumer Disputes Redressal Commission, Delhi (in short, he State Commission in Appeal No. A-07/609 The Chairman, Birla Sun Life Insurance Co. Ltd. & Anr. Vs. Smt. Asha by which, while dismissing appeal, order of District Forum allowing complaint was upheld. 2. Brief facts of the case are that complainant/respondent husband Balram obtained life insurance policy from OP/petitioner on 18.12.2002 for a sum of Rs.1,00,000/-. Insured died on 11.2.2005 due to Hypertension and Diabetes. Complainant submitted claim to the OP which was repudiated on false and frivolous grounds. Alleging deficiency on the part of OP, complainant filed complaint before District Forum. OPs resisted complaint and submitted that insured suppressed material facts in respect of his health and in such circumstances, claim was rightly repudiated and prayed for dismissal of complaint. Learned District Forum after hearing both the parties, allowed complaint and directed OP to pay all the benefits under the policy with 9% p.a. interest and further granted compensation of Rs. 4,000/- and Rs. 2,000/- as cost of litigation. Appeal filed by the OP was dismissed by learned State Commission vide impugned order against which, this revision petition has been filed. 3. None appeared for the respondent even after service and she was proceeded ex-parte. 4. Heard learned Counsel for the petitioner and perused record. 5. Learned Counsel for the petitioner submitted that as deceased insured suppressed material facts regarding his previous disease and obtained policy, which was voidable due to suppression of material facts, petitioner has not committed any error in repudiating claim even then learned District Forum committed error in allowing complaint and learned State Commission further committed error in dismissing appeal; hence, revision petition be allowed and impugned order be set aside. 6. Perusal of record clearly reveals that in proposal form deceased Balram has replied as under: 3) Have you ever had or sought advice for the following: a) chest pain, high blood pressure, storke, heart attack, heart murmur or other heart disorders? : No b) *asthma, chronic cough, pneumonia, Shortness of breath, T.B. or any Other respiratory or lung disorders? : No c) *diabetes or sugar in the urine? : No 7. Complainant herself mentioned in the complaint about the death of insured due to Hypertension and Diabetes. Petitioner has placed on record Discharge Slip of N.D.M.C. Hospital, Moti Bagh, New Delhi according to which, deceased was admitted in the hospital on 26.6.1995 and was discharged on 19.7.1995 and diagnosed Pulmonary Koch with IDDM. Perusal of death certificate dated 11.2.2005 clearly reveals that Balram died due to IDDM with Hypertension. In this certificate it has further been observed that other significant disease contributing to the death was Pulmonary Tuberculosis. 8. Thus, it becomes clear that Balram was diagnosed with Pulmonary Koch with IDDM in the year 1995 and he died due to same disease and Pulmonary Tuberculosis, but he suppressed this fact in the proposal form and gave false reply regarding his health and in such circumstances, the policy was voidable under Section 45 of the Insurance Company in the light of his declaration which runs as under: . All material facts, being facts which may influence the assessment of this application have been disclosed on this application, it being understood that failure to make such disclosure renders the contract voidable 9. Learned Counsel for the Petitioner placed reliance on (2008) I SCC 321 P.C. Chacko and Another Vs. Chairman, Life Insurance Corporation of India in which it was observed that : isstatement by itself is not material for repudiation of the policy unless the same is material in nature. But, a deliberate wrong answer which has a great bearing on the contract of insurance, if discovered may lead to the policy being vitiated in law. The purpose for taking a policy of insurance is not very material. It may serve the purpose of social security but then the same should not be obtained with a fraudulent act by the insured. Proposal can be repudiated if a fraudulent act is discovered Thus, it becomes clear that policy can be assailed on the ground of deliberate wrong answer on material issue. We have also observed in R.P. No. 2313 of 2008 Life Insurance Corpn. of India & Anr. Vs. Smt. Vinod Devi that on the basis of suppression of material facts regarding health conditions, repudiation of claim does not come within the purview of deficiency. 10. In the light of aforesaid judgment, we do not find any deficiency on the part of petitioner in repudiating claim and leaned State Commission has committed error in dismissing appeal and learned District Forum committed error in allowing complaint. 11. Consequently, revision petition filed by the petitioner is allowed and impugned order dated 12.11.2007 passed by learned State Commission in Appeal No. A-07/609 The Chairman, Birla Sun Life Insurance Co. Ltd. & Anr. Vs. Smt. Asha and order of District Forum dated 22.7.2005 in Complaint Case No.762./2005 - Smt. Asha Vs. The Chairman, Birla Sun Life Insurance Co. Ltd. & Anr. are set aside and complaint stands dismissed with no order as to costs.

 
......................J
K.S. CHAUDHARI
PRESIDING MEMBER
......................
VINAY KUMAR
MEMBER

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