(Per Shri S.R.Khanzode, Hon’ble Presiding Judicial Member)
(1) This appeal takes an exception to the order dated 02/05/2000 in Consumer Complaint No.50/1999, Smt.Sulabha Krishnrao Surve Vs. Branch Manager, Life Insurance Corporation of India, Branch Kudal, Dist.Sindhudurg and ors., passed by District Consumer Disputes Redressal Forum, Sindhudurg (the Forum in short).
(2) The consumer complaint pertains to alleged deficiency in service on the part of the Life Insurance Corporation of India which issued an Indowment Assurance Policy with profits of `50,000/- with risk commencing from 20/08/1997 for late Vijay Krishnrao Surve, who is son of Smt.Sulabha Krishnarao Surve, the respondent/original complainant. Under the same policy, name of the Smt.Sulabha Krishnarao Surve is shown as nominee. Late Vijay died due to tuberculosis on 15/09/1997 and thereafter insurance claim was made which was repudiated on the ground that late Vijay suppressed material facts of previous illness-tuberculosis and, thus, there is breach of utmost good faith. Consequently, the claim was repudiated. The Forum below, upholding the claim, directed the opponents i.e. appellants to pay sum assured `50,000/- along with interest @20% p.a. and further compensation of `500/- towards mental torture and `500/- towards the cost of the complaint. Feeling aggrieved thereby, the original opponents filed the appeal.
(3) We heard both the parties and perused the record. Consumer complaint, as drafted, is against officials of Life Insurance Corporation of India and not against the Life Insurance Corporation of India itself. Life Insurance Corporation of India is a separate and distinct person than its officials in view of Sec.2(1)(m) of the Consumer Protection Act, 1986 (hereinafter referred to as ‘the Act’). Thus, the officials of the Life Insurance Corporation of India namely 1) Branch Manager, L.I.C., Branch Kudal, 2) Sr.Divisional Manager, L.I.C. Division Office, Kolhapur, 3) Regional Manager, L.I.C. Western Zone, Mumbai are not the one who provided sevice to the complainant with relation to the insurance policy. Therefore, consumer complaint ought to have been dismissed on this count only.
(4) Considering other aspects vis-à-vis merit of the case; the insurance policy for `50,000/- in favour of late Vijay is not in dispute. It is not disputed that within a month after the policy was issued, late Vijay died due to tuberculosis. The death certificate one record is an undisputed document. His death occurred at T.B.Hospital at Goa which is a near place from Sawantwadi where deceased was residing.
(5) Coming to the ground of the repudiation of the claim i.e. breach of good faith, supra, Life Insurance Corporation of India (LIC, in short) relied upon the proposal form filled-in by the deceased on 20/08/1997 itself and the basis of which the policy was issued. In the said proposal form (Exh.1), deceased had recorded answers in negative to the question about the previous illness, hospitalization, treatment received etc. Thereafter, he was examined by Civil Surgeon at local place. The complainant attached medical attendant’s certificate (Exhibit ‘G’) issued by Dr.Sateesh Patil to the compilation of the complaint which clearly shows that the deceased was taking anti-tubercularsis medicines from November 1996 and had undergone treatment in TB/Chest Hospital, Goa. This document was filed by the complainant herself. Besides this, deceased prior to taking the insurance policy was receiving medical treatment from Dr.Rajesh Gupta. Said doctor was examined by LIC. It is revealed that late Vijay was taking the treatment from this doctor. Referring to the document wherein the date 05/09/1997 was mentioned as the date on which for the first time Dr.Gupta examined late Vijay, it is submitted that there is interpolation of the date and year 1998 is changed to 1997 and as such the evidence be discarded. We find no merit in such submission. Further it is also revealed from the documents and statements of the complainant herself e.g. medical certificate by Dr.Gupta on 05/09/1997 that late Vijay was taking treatment till November 1996.
(6) Thus, we find that suppression of material fact of his illness i.e. tuberculosis being established, the repudiation of the insurance claim by the LIC cannot be faulted with. We hold accordingly and pass the following order.
ORDER
(1) Appeal is allowed. Impugned order dated 02/05/2000 passed in Consumer Complaint No.50/1999 by District Forum, Sindhudurg is set aside. In the result, consumer complaint No.50/1999 stands dismissed.
(2) No order as to costs.
Pronounced on 24th August, 2011.
