Mr.Narendra Kawde – Hon’ble Member:
(1) This appeal takes an exception to an order dated 30.07.1999 in Consumer Complaint No.69/1998 (Sangita Rajiv Sonak V/s.Life Insurance Corporation of India) passed by the District Consumer Disputes Redressal Forum, Amravati. By way of the said order the complaint of the Respondent/original Complainant was allowed and directions were issued to the Appellant L.I.C. to pay the policy proceeds together with interest @18% per annum along with Rs.4,000/- as compensation and Rs.1,000/- as costs of litigation within 45 days from the date of the order. Aggrieved with this order the Appellant – L.I.C. preferred this appeal
(2) Brief summary of the case is that, Shri Rajiv Prabhakar Sonak, husband of the Complainant subscribed the Policy No.821255003 under Salary Saving Scheme of the Appellant L.I.C. The policy commenced on 28.12.1995. The policy holder Shri Rajiv Sonak expired on 25.05.1996. The Complainant as a nominee under the policy filed death claim with the Opponent L.I.C. which was repudiated on the ground of suppression of material facts of pre-existing disease. Aggrieved and dissatisfied with the repudiation, the Complainant filed the consumer complaint before the District Forum, Amravati. The District Forum allowed the complaint.
(3) Appellant L.I.C. preferred this appeal, on the ground that the life assured died within five months from the date of commencement of the policy. Being the early claim, investigations were initiated and medical report history was collected in respect of deceased, the life assured. The Appellant L.I.C. relied on the medical certificate issued by Dr.P.N. Dhawad of Government Hospital, Amravati and also one more medical report from Dr.Mahendra Sawarkar. Both the medical certificates were disputed by the Complainant. Certificate issued by Dr.Sawarkar mentioned that life assured was treated for ‘viral fever’ during the period from 19th September, 1995 to 6th November, 1995. Certificate issued by Dr.Dhawad of the Government Hospital demonstrates that the deceased life assured was suffering from ‘acute myo cardial infarction’, who died on 25.05.1996 in the Government Hospital, Amravati due to ischemic heart disease (IHD).
(4) This is an old appeal placed on the board from sine die list for hearing and disposal. The appeal was fixed for hearing on 6th July, 2011 by issuing intimation to the Appellant. At the time of hearing the Advocate of the Appellant was present, but, the Respondent remained absent. The matter was again fixed for hearing on 22.08.2011. The matter was finally listed for hearing on 5th January, 2012. Advocate of the Appellant was present. However, Respondent preferred to remain absent.
(5) Heard Ld. Counsel for the Appellant and perused the record. The Appellant L.I.C. relied on medical report issued by the Government Hospital which attributes to the cause of death of the deceased to ‘ischemic heart disease’. Dr.Mahendra Sawarkar’s certificate shows that that deceased was suffering from ‘viral fever’. There was no major disease which was required to be disclosed. Deceased Life Assured, as can be seen on perusal of medical reports relied by Appellant L.I.C. did not suffer any major disease at the time of subscribing to life policy, which warranted to disclose as alleged by the Appellant/L.I.C. Appellant L.I.C. did not adduce any evidence as per Provisions of Section 13(4) of the Consumer Protection Act, 1986 to establish their contention that the deceased life assured was suffering from heart disease prior to issue of the subject policy. Therefore, the Appellant L.I.C. has rendered ‘deficiency in service’ in not settling the claim under the policy. Appeal is devoid of facts and therefore, impugned order passed by the District Forum, Amravati, cannot be faulted with. We hold accordingly and pass the following order:
O R D E R
(i) Appeal stands dismissed.
(ii) Parties to bear their own costs.
(iii) Inform the parties accordingly.
Pronounced on 5th January, 2012.
