LIC OF INDIA Vs. LADDU LAL LUHAR

JUDGEMENT

(1.) THIS appeal has been filed by the appellants LIC which were opposite parties before the District Forum against order dated 26.2.2009 passed by the District Forum, Sawaimadhopur in complaint No. 309/2008 by which the complaint of the complainant respondent was allowed against the appellants in the manner that the appellants were directed to pay to the complainant respondent a sum of Rs. 1 lac the amount of the LIC policy along with interest @ 12% p.a. from the date of filing of the complaint i.e. 27.7.2008 and further to pay a sum of Rs. 1,000 as cost of litigation.

(2.) IT arises in the following circumstances: That the complainant respondent had filed a complaint before the District Forum, Sawaimadhopur on 26.7.2008 against the appellants inter alia stating that he is a BPL card holder bearing No. 5284 and is a very poor man and his wife Gauri Devi, now deceased had taken a life insurance policy with accidental benefit known as New Bima Gold Policy for a sum of Rs. 1 lac from the appellants bearing policy No. 195484950 on 28.4.06. It was further stated in the complaint that on 26.1.2007 when the deceased was in the area of municipality Sawaimadhopur and was doing the job and was sitting behind the tree, a snake had appeared there and had bite her as a result of which she was got admitted in General Hospital, Sawaimadhopur and thereafter she had died on 30.1.2007 and after the death of the deceased claim was preferred by the complainant respondent being the husband and nominee of the deceased before the office of the appellants but that claim was repudiated by the appellants through letter dated 10.1.2008 on the ground that at the time of taking the policy a declaration form regarding health was filled in up by the deceased on 27.11.2006 and in respect of illness she had answered all the questions in negative though the appellants had indisputable proof to prove the fact that about one week before 27.11.2006 she was suffering from enlargement of liver and pain in abdomen asthamatic and since these facts were not disclosed by the deceased in her declaration form on 27.11.2006 at the time of taking the policy, therefore, the deceased was guilty of suppression of material facts regarding her health but according to the complainant respondent repudiation of claim of the complainant by the appellants was not justified at all as the facts mentioned in the repudiation letter dated 10.1.2008 were not correct one and thereafter the present complaint was filed. A reply was filed by the appellants in shape of affidavit of Mr. M.L.Chaudhary on 29.1.2009 and in the reply they have taken the same pleas which were taken by them in the repudiation letter dated 10.1.2008. Apart from that it was stated in the reply that since the cause of death of the deceased was Cardiac Respiratory Arrest, therefore, the case of the complainant respondent that the deceased had died due to snake bite was wrong one but on the contrary as per record of the hospital, she was a patient of COPD and thus she had made incorrect statement in her declaration form dated 27.11.2006 and thus, it was a case of suppression of material facts regarding health on the part of the deceased and it was prayed that claim was rightly repudiated by the appellants and complaint be dismissed. After hearing the parties; the District Forum, Sawaimadhopur through impugned order dated 26.2.2009; had allowed the complaint of the complainant respondent in the following manner inter alia holding that

(3.) IN this appeal the main contention of the learned Counsel for the appellants is that before issuance of policy in question, the deceased was suffering from the disease of COPD and since these facts were not disclosed by the deceased deliberately in her declaration form on 27.11.2006, therefore, she was guilty of suppression of material facts regarding health and thus the claim of the complainant respondent was rightly repudiated by the appellants through letter dated 10.1.2008 and simultaneously the fact that the deceased had died due to snake bite had not been proved by the complainant respondent and thus the District Forum had committed serious error and illegality in decreeing the claim of the complainant respondent and therefore, the impugned order could not be sustained and liable to be quashed and set aside and this appeal deserves to be allowed.