PANCHA DEVI Vs. LIC OF INDIA

JUDGEMENT

(1.) THIS appeal arises out of order dated 5.3.2009 passed by the District Consumer Forum, (DCF), Sirohi where by the complaint was dismissed.

(2.) THE Husband of the Complainant Late Shri Chhagan Lal had obtained a policy of Rs.5,00,000 by submitting a proposal form on 1.7.2004. He died on 25.4.2005. A claim was filed by the Complainant, being the nominee under the policy, but the same was repudiated on the ground that the Life Assured (LA) had been suffering from heart disease at the time of submitting proposal form for which he had taken the treatment also but he suppressed this material fact and instead gave false answers. The question for consideration is whether the LA had been suffering from heart disease or had suffered from heart disease at the time when the proposal form was submitted by him.

(3.) THE Insurance Corporation has relied upon the prescription of S.A.L. Hospital and Medical Institute, Ahmedabad dated 18.8.2004 which goes to show that Dr. Tushar J. Shah had advised for valve replacement. It was also mentioned therein that the valve was conserved since 13 years by Doctor himself. The material on record goes to show that the cause of death was Acute Respiratory Distress Syndrome. The LA had been suffering from rheumatic heart disease since long and valve was put in which was conserved for 13 years and later on 16.8.2004 the replacement of valve was advised. The valve was replaced also. All these facts go to show that the LA had been suffering from heart disease and this fact was within his knowledge but he suppressed the same at the time of filling up the proposal form and therefore the Insurance Corporation was justified in repudiating the claim of the Complainant. The impugned order of the learned DCF suffers from no illegality or infirmity or perversity and therefore the appeal is found to be meritless.