Petitioner insurance company was opposite party before the District Forum. Husband of the complainant took a life insurance policy on 28.7.2000 for a sum of Rs.50,000/-. Complainant’s husband died on 12.10.2001, i.e. within 15 months from the date of taking of policy. A claim was filed by the complainant/respondent which was not settled -2- by the petitioner insurance company which led to the filing of the complaint before the District Forum. The District Forum directed the petitioner to approach the civil court as the disputed questions of facts were involved which could not be decided by the consumer foras as the consumer foras have to decide the cases in a summary manner. Being aggrieved, respondent filed an appeal before the State Commission. The State Commission set aside order of the District Forum and held that with the material present on record, the dispute between the parties could be adjudicated. The State Commission, instead of remanding the case to the District Forum, permitted the parties to lead their evidence and decided the appeal on merits as well, and allowed the complaint. It was held that the respondent was not guilty of ‘Suppression of Facts’. It was further held that the Onus to prove that the respondent was suffering from psychiatric disease, was on the petitioner. This finding is evidently wrong. The complainant’s husband died within less than two years of taking of the policy and Section 45 of the Insurance Act provides that if the insured dies within two years of taking of the policy, then the Onus to -3- prove that there was no suppression of material facts at the time of taking of the policy, is on the insured. The State Commission has erred in holding that the onus was on the petitioner insurance company to prove to the contrary. Complainant’s husband had remained on leave on ‘Medical Grounds’ from 08.6.1999 to 12.6.1999 for a period of 5 days as per Certificate issued by the employer which has been put on record. To a question - as to whether the petitioner had remained absent from the place of work on ground of health during the last five years, the answer given by the insured was in the negative, meaning thereby that the complainant did not disclose the fact that he took leave for five days prior to taking of the policy on medical ground. The finding recorded by the State Commission on this point is also incorrect. Moreover, son of the insured, while lodging FIR had stated that his father was suffering from mental ailment for the last 2½ years before his death. Counsel appearing for the respondents states that the amount has already been disbursed to the respondent by the insurance company in the year 2006. -4- For the reasons stated above, the order under appeal is set aside. However, since the amount has already been disbursed to the respondent, the same be not recovered. Hon’ble Supreme Court in a number of cases has held that when a meager amount has been disbursed to the def3endants then the same be not recovered. Revision petition is disposed of in above terms.
......................JASHOK BHANPRESIDENT ......................B.K. TAIMNIMEMBER | |