NCDRC

NCDRC

RP/3521/2012

SBI LIFE INSURANCE CO. LTD. - Complainant(s)

Versus

SRI THIMMEGOWDA & ANR. - Opp.Party(s)

M/S. RAKESH MALHOTRA & ASSOCIATES

06 Dec 2012

ORDER

NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION
NEW DELHI
 
REVISION PETITION NO. 3521 OF 2012
 
(Against the Order dated 10/07/2012 in Appeal No. 1576/2011 of the State Commission Karnataka)
1. SBI LIFE INSURANCE CO. LTD.
Kapas Bhawan, Plot No-3A, Sector-10 Central Processing Centre , (CPC) CBD Belapur
Navi Mumbai - 400614
Maharastra
...........Petitioner(s)
Versus 
1. SRI THIMMEGOWDA & ANR.
S/o Sh Shivaiah R/o Madlihalli Kappalu Post Belagere Titpur Taluk
Tumkur
A.P
...........Respondent(s)

BEFORE: 
 HON'BLE MR. JUSTICE J.M. MALIK, PRESIDING MEMBER
 HON'BLE MR. VINAY KUMAR, MEMBER

For the Petitioner :
: Ms. Gunjan Malhotra &
Mr. Rakesh Malhotra, Advocates
For the Respondent :NEMO

Dated : 06 Dec 2012
ORDER

JUSTICE J.M. MALIK 1. One Smt. Thimmegowda, wife of the complainant, Thimmegowda, obtained three insurance policies from SBI Insurance Co. Ltd. for Rs.1,00,000/- each and one policy of SBI Life Savdhan Group Insurance for Rs.1,00,000/- on 01.04.2009. However, the assured died on 11.12.2009 due to cardiac arrest. The complainant who is nominee of all the four insurance policies submitted a claim. The claim made by the complainant was repudiated on 07.10.2010. Consequently, the complainant filed a complaint before the District Forum claiming in all, a sum of Rs. 6,00,000/- towards the death claim of her husband, along with interest @ 12% p.a. and Rs.20,000/- towards compensation. 2. The District Forum partly allowed the complaint with costs of Rs.2,000/-. It directed the SBI, Tiptur Branch and respondent No.1 to pay a sum of Rs.4,00,000/-, jointly and severally, with future interest @ 9% p.a. from the date of complaint, till its realization. 3. Aggrieved by that order, appeal was preferred before the State Commission, which dismissed the appeal. 4. Now, the present revision petition has been filed. We have heard the counsel for the petitioner. She submitted that the deceased had suppressed the material fact while obtaining the insurance policy as she did not disclose that she was suffering from Rheumatic Heart Disease (RHD) and had undergone Percutaneous Transvenous Mitral Commissurotomy (PTMC) operation on 08.08.2006, prior to obtaining of the insurance policies. In support of her case, she has invited our attention to few documents. First is the medical certificate, dated 20.01.2010. It bears the date as 05/12. The mention of the year is missing, true copy is dated 20.01.2010. It mentions about some history but does not reveal when the said ailment had started. The second document is Anx. R-10, Sri Jayadeva Institute of Cardiovascular Sciences & Research, dated 05.12.2009. It mentions the cause of death as Cardiac Arrest Asystole. It further mentions Rheumatic Heart Disease Post PTMC Status, Moderate Mitral Stenosis with Regurgitation. This is precisely the medical certificate of cause of death. The third document is Medical Attendant Certificate. It shows that the period of consultation was from 05.12.2009 to 11.12.2009. The fourth document which is connected with the third document, shows that the history was provided by the patient/complainant herself. Something is written against column of history of such disease, but it does not show any date as to when did it start. This document is signed by Dr.H.P.Prabhuswamy, Professor of C.T. Surgery. It clearly mentions that the information is based on reasons maintained in the Register No.229971, dated 11.12.2009. The last document placed before us is the medical attendant certificate. It mentions that secondary cause was post PTMC status, Regurgitation & asphyxiation. 5. All these documents, taken together, do not establish the fact that the deceased was suffering from all these ailments prior to her obtaining the above said policies. There is no cogent and plausible evidence which may go to show that the deceased had undergone PTMC operation on 08.08.2006. The Doctor who had conducted the operation should have been examined by the Investigator of the Insurance Company. If she had undergone PTMC on 08.08.2006, there must be some record. The person who gave the history or the Doctor should have filed affidavit on record. The Learned State Commission has rightly held that mere production of document or mere marking of documents, does not prove its contents. It must be borne that the respondent who is to carry the ball in proving that the assured was suffering from few diseases before she obtained the policies. The evidence led by the petitioner is vague, evasive and leads the court nowhere. The position does not begin to jell. The production of the document or filing of the affidavit of the Doctor or some authentic document was essential. In the absence of all these documents on record, the case of the petitioner does not stand proved. Consequently, we hereby dismiss the revision petition.

 
......................J
J.M. MALIK
PRESIDING MEMBER
......................
VINAY KUMAR
MEMBER

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