LIFE INSURANCE CORPORATION Vs. SHANTA MALI

JUDGEMENT

(1.) THIS appeal has been filed by the appellants LIC against order dated 20.3.2008 passed by the District Forum, Udaipur in complaint No. 50/2005 by which the complaint of the complainant respondent was allowed in the manner that the appellants were directed to pay a sum of Rs. 1 lac the amount of the LIC policy along with interest @ 9% p.a. w.e.f. 16.12.2003 and further to pay Rs. 1000 as costs.

(2.) IT arises in the following circumstances - That the complainant respondent had filed a complaint before the District Forum, Udaipur on 18.2.2005 inter alia stating that her husband Tekchand Mali, now deceased had taken LIC policy bearing No. 183256734 from the appellants on 28.7.2002 for a sum of Rs. 1 lac and that policy was for a period of twenty years. It was further stated that the deceased had died on 14.7.2003 and after the death of the deceased claim was preferred by the complainant respondent being the wife and nominee of the deceased before the office of the appellants but that claim was repudiated by the appellants through letter dated 26.12.2003 on the ground that since the deceased had filled in up a declaration form regarding his health on 20.8.2002 in which he had not mentioned that he was suffering from any kind of disease but they had the sufficient proof to prove the fact that prior to two years he was a patient of Syndrome and since these facts were not disclosed by the deceased in his declaration form on 20.8.2002 at the time of taking the policy, therefore, the deceased was guilty of suppression of material facts regarding his health. It was further stated in the complaint that the appellants had informed the complainant respondent through letter dated 16.3.2004 that operation of hand of the deceased had taken place but since the cause of death of the deceased was Pancreatptis and, therefore, that too had no bearing with the cause of death of the deceased. Thereafter the present complaint was filed. A reply was filed by the appellants on 3.6.2005 and in the reply they have taken the same pleas which were taken by them in the repudiation letter dated 26.12.2003. It was further replied that since prior to taking the policy on 28.7.2002 operation had taken place for Comported Syndrome and since this fact was not disclosed by the deceased in his declaration form on 20.8.2002 therefore, claim was rightly repudiated by the appellants and complaint be dismissed. After hearing the parties the District Forum, Udaipur through impugned order dated 20.3.2008 had allowed the complaint of the complainant respondent inter alia holding - (i) That since the fact of Syndrome operation was found in the bed had ticket of the hospital but since no record of operation was produced, therefore, no cognizance of that operation could be taken especially when the doctor who had recorded the past history had not been produced and thus it was not a case of suppression of material facts regarding health on the part of the deceased. (ii) That the appellants were not justified in repudiating the claim of the complainant respondent and it had amounted to deficiency in service on the part of the appellants. Aggrieved from that order passed by the District Forum, Udaipur, this appeal has been filed by the appellants.

(3.) IN this appeal the main contention of the learned Counsel for the appellants is that before taking the policy in question, the deceased was suffering from the disease of Syndrome prior to taking the policy on 28.7.2002 and operation of hand had taken place for Comported Syndrome and since this fact was not disclosed by the deceased in his declaration form on 20.8.2002 and since these facts were not disclosed by the deceased deliberately in his declaration form on 20.8.2002 at the time of taking the policy, therefore, he was guilty of suppression of material facts regarding health and thus on that ground the claim of the complainant respondent was rightly repudiated by the appellants through letter dated 26.12.2003 and the District Forum had committed serious error and illegality in decreeing the claim of the complainant respondent. Hence the impugned order could not be sustained and liable to be quashed and set aside and this appeal deserves to be allowed.