DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION: WEST TRIPURA : AGARTALA

 

CASE   NO:   CC- 83 of  2023

 

Smt.  Priyanka Saha (Das),

W/O- Sri Tapan Das,

D/O- Late Bidhan Saha,

Jogendranagar, Katasheola,

P.O. Agartala College,

P.S. East Agartala,

District- West Tripura,

Pin- 799004. ...........Complainant.

 

-VERSUS-

 

The Divisional Manager(I/C)

Branch No-1, L.I.C.I.,

Hospital Road Extension,

P.O. Agartala, P.S. West Agartala,

District- West Tripura.

Pin- 799001.     .........Opposite Party.

  

________PRESENT__________

 

 SRI GOUTAM DEBNATH

PRESIDENT,

  DISTRICT CONSUMER  

DISPUTES REDRESSAL COMMISSION,

      WEST TRIPURA, AGARTALA. 

 

DR (SMT) BINDU PAL

MEMBER,

  DISTRICT CONSUMER 

DISPUTES REDRESSAL COMMISSION, 

  WEST TRIPURA, AGARTALA.

 

SRI SAMIR GUPTA

MEMBER,

  DISTRICT CONSUMER  DISPUTES  

REDRESSAL COMMISSION,

WEST TRIPURA,  AGARTALA. 

 

 

 

 

C O U N S E L

 

 

For  the  O.P. : Sri Sayantan Talapatra,   

 

 

 

 

F I N A L    O R D E R

1. Smt. Priyanka Saha (Das), here-in-after called the 'Complainant' has filed this Complaint against the Divisional Manager, L.I.C.I. alleging deficiency in service on the ground that the mother of the complainant Sumitra Ghosh Saha obtained policy of Insurance from the O.P. commencing from 28.04.2022 till 28.04.2042 on the half yearly premium for Rs.6181/-. The first premium was paid but Sumitra died on 11.06.2022 i.e., within 2 months from the date of the policy. The total disbursement amount was Rs.3 lakhs which the complainant claimed after the death of her mother but the O.P. rejected the claim on the ground that suppression of material fact of illness at the time of commencing of policy. 

1.1 The complainant submitted policy of Insurance, Medical Attendance Certificate, Death Certificate & Legal Notice.

 

2. The O.P. contested the case by submitting written objection wherein the O.P. pleaded suppression of illness and submitted form B & B1 i.e., Medical Attendance Certificate.

 

3. Both the parties submitted evidence on affidavit.

 

4. Hearing argument the following point is taken up for discussion and decision:-

 

5. As a matter of law, the Policy of Insurance is the Policy taken on good faith which is the foundation of such agreement of Insurance Policy. Meaning thereby, at the time of accepting the proposal of the Insured, the Insurance Company believes the declaration given by the Insured in the proposal Form. 

5.1 From the documents submitted by the complainant as well as the Medical Attendance Certificate of Form B & B1, we find that the cause of death was Acute Exacerbation of Chronic Obstructive Pulmonary Disease(AECOPD). The complainant died within 2 months from the date of acquiring the policy. Acute Exacerbation of chronic Pulmonary Disease  did not occur all on a sudden to the Insured, rather the Insured had been suffering from AECOPD at the time of taking the Policy of Insurance which is a material fact of illness which the Insured suppressed. Therefore, the Insured suffers from suppression of material facts for which the O.P. can not be held responsible. 

6. The point is decided accordingly.

7. In the  result, the complaint is dismissed however,  without cost.

8. Supply copy of this Final Order free of cost to the parties.

 

Announced.

 

 

 

SRI  GOUTAM DEBNATH

PRESIDENT,

DISTRICT CONSUMER  DISPUTES 

REDRESSAL COMMISSION,

WEST TRIPURA,  AGARTALA

 

 

 

 

DR(SMT) BINDU PAL

MEMBER,

DISTRICT CONSUMER DISPUTES

REDRESSAL COMMISSION,

WEST TRIPURA,AGARTALA.

 

 

 

SRI SAMIR  GUPTA

MEMBER,

DISTRICT CONSUMER DISPUTES

REDRESSAL COMMISSION,

WEST TRIPURA,AGARTALA.