Madhya Pradesh

StateCommission

A/17/835

LIC - Complainant(s)

Versus

SMT.RAMDULARI LODHA - Opp.Party(s)

SH.RAJESH PANDEY

02 Nov 2022

ORDER

M. P. STATE  CONSUMER  DISPUTES  REDRESSAL  COMMISSION,                         

                             PLOT NO.76, ARERA HILLS, BHOPAL

 

                                      FIRST APPEAL NO. 835 OF 2017

(Arising out of order dated 12.04.2017 passed in C.C.No.113/2014 by District Commission, Rajgarh)

 

LIFE INSURANCE CORPORATION OF INDIA

THROUGH REGIONAL MANAGER, LAW

CENTRAL REGIONAL OFFICE,

JEEWAN SHIKHA, 60 B, HOSHANGABAD ROAD,

BHOPAL (M.P.)                                                                                                        … APPELLANT.

 

                       Versus

 

SMT. RAMDULARI LODHA,

W/O LATE SHRI RAMDAYAL LODHA,

R/O VILLAGE-KHEDI, POST-KALIPEETH,

DISTRICT-RAJGARH (M.P.)                                                                                   … RESPONDENT.                                

                                 

BEFORE :

            HON’BLE SHRI JUSTICE SHANTANU S. KEMKAR   :  PRESIDENT

           HON’BLE SHRI S. S. BANSAL                                     :  MEMBER

            HON’BLE DR. (MRS) MONIKA MALIK                         :  MEMBER

                     

COUNSEL FOR PARTIES :

                Ms. Preetima Shrivastava, learned counsel for the appellant.

           None for the respondent.

                  

                                                  O R D E R

                                       (Passed on 02.11.2022)

                   The following order of the Commission was delivered by Dr. (Mrs) Monika Malik, Member:

           

                   This appeal by the opposite party/appellant (hereinafter referred to as ‘appellant’) is directed against the order dated 12.04.2017 passed by the District Consumer Disputes Redressal Commission, Rajgarh (hereinafter referred to as ‘District Commission’) in C.C.No.113/2014, whereby the complaint filed by the complainant/respondent (hereinafter referred to as ‘respondent’)has been partly allowed.

 

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2.                Briefly put, facts of the case as narrated by the respondent are such that the respondent’s late husband Shri Ramdayal Lodha (hereinafter referred to as ‘deceased-insured’) during his life time had obtained two life insurance policies nos. 201782518 & 201782519 from the appellant 22.04.2013 for sum assured of Rs.8,00,000/- and Rs.1,00,000/- respectively. During currency of the policy covers, deceased-insured died in an intervening night of 15.02.2013-16.02.2013, due to hailstorm.  The respondent approached the appellant seeking sum insured and compensation but the same was denied by the appellant vide letter dated 16.01.2014. Therefore, alleging deficiency in service on part of the appellant, the respondent approached the District Commission, seeking relief.  

3.                The appellant resisted the complaint stating that the deceased-insured was registered at serial no.113/13 in ward no.3 in the ‘Below Poverty Line’ (BPL) list for the year 2003-2004. He had wrongly obtained the aforesaid policy covers, disclosing his source of income as Rs.2,00,000/- per year.  Therefore, the respondent is not entitled to any relief.

4.                The District Commission partly allowed the complaint and directed the appellant to pay sum insured to the respondent under both the

 

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above mentioned policies. In addition, a sum of Rs.2,000/- as costs of litigation was also awarded. Hence this appeal.

5.                Heard. 

6.                Learned counsel for the appellant argued that as per investigation report which is available in the record of the District Commission, the deceased-insured was a ‘Below Poverty Line’ card holder. However, while filling up the proposal form, the deceased-insured had declared his annual income as Rs.2,00,000/-, which is not possible considering his source of income. The District Commission has thus wrongly passed the impugned order which deserves to be set-aside.

7.                The main allegation of the appellant is that the deceased-insured had concealed the material information regarding his annual income while filling up the proposal form.  It is alleged that the deceased-insured, who was a ‘Below Poverty Line’ card holder had wrongly mentioned his annual income as Rs.2,00,000/- in the proposal form. It is submitted by the appellant that an investigation was carried out in the aforesaid regard by the investigation committee and the said investigation report is placed on record by the appellant.

8.                Thus the only objection which is raised by the appellant is that the deceased-insured had exaggerated his annual income while filling up the proposal form. It is never alleged by the appellant that the deceased-

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insured had defaulted in payment of premium due to the aforesaid, which means that the deceased-insured was regularly paying the premium amount for the aforesaid policies. The claim repudiation of the policies is based on alleged mis-statement by the deceased-insured while filling up the proposal form. The appellant has specifically referred to the proposal form dated 17.01.2013, which is annexed with the investigation report and is placed on record.

9.                As we carefully peruse the proposal form (on the basis of which the investigation committee had derived at the aforesaid conclusion) we find that the said proposal form, allegedly filled by the deceased-insured, is not accompanied with the declaration and signatures of the deceased-insured. Therefore, due to non-availability of any declaration/consent, signed by the deceased-insured we are not bound to rely on the said proposal form, which is the only basis for non-entitlement of sum assured of Rs.8,00,000/- under the said policy by the investigation committee. Also, in the policy for sum assured of Rs.8,00,000/- (annexed as Exhibit R-23), the column of proposal number and date is left blank. But the same is not the case with the other policy for sum assured of Rs.1,00,000/- where there is specific mention of proposal number with date and the proposal form is accompanied with the  declaration of the proposer with signatures.

 

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10.              In view of the aforesaid, the appeal filed by the appellant is partly allowed. The impugned order deserves to be modified to an extent that the appellant shall pay sum assured of Rs.8,00,000/-, towards the concerned policy  only as against both the policies (as has been awarded by the District

Commission). Rest of the directions contained in the impugned order shall remain unaltered. There is however no order as to costs.

 

(JUSTICE SHANTANU S. KEMKAR) (S. S.BANSAL) (DR. MONIKA MALIK)                      

                  PRESIDENT                           MEMBER              MEMBER