SOMA NATH Vs. LIFE INSURANCE CORPORATION

JUDGEMENT

(1.) THIS appeal has been directed against the judgment passed by the District Forum, Cooch Bihar on 21.1.2010 in the case No. DF/51/2007, wherein the learned Forum below was pleased to dismiss the complaint on contest without any cost. Being aggrieved by the said order the Appellant has preferred the present appeal contending the similar facts as stated by her in the petition of complaint before the learned Dist. Forum. In the grounds of memorandum of appeal the Appellant -Complainant has stated that the learned District Forum has miserably failed to appreciate that the policy was purchased on 31.3.2003 and the deceased husband of the Appellant was treated by the doctors in the years 2004 and 2006 and at the time of purchased the policy the husband of the Appellant was not suffering from any physical ailment and the material information in the proposal form was written correctly without suppressing any truth. But unfortunately the learned Forum below has dismissed the complaint on the ground of suppression of material fact in the proposal form at the time of purchasing the policy. The learned Forum has failed to appreciate that merely giving a declaration does not debar a person from claiming the relief of the insurance in respect of the policy after the death of the insured. It has been stated by the Appellant that the learned District Forum has failed to appreciate that the proposal form was given for giving information to policy holder and without making any inquiry the insurer cannot accept such policy as the insurer has an obligation to perform certain duties after receipt of the proposal form. But in the instant case the insurer has failed to discharge their obligation before issuance the policy in question upon receipt of proper premium amount. The Appellant has further mentioned that the policy was purchased on 31.3.2003 and Dr. Saha issued a certificate on 23.6.2006 on the basis of a statement made on 25.9.2004, from such averment it is clear that the policy was issued much prior to the certificate of Dr. Saha. At the time of purchasing of the policy the husband of the Appellant was not alcoholic and in this respect also current information was provided. But merely relying on a letter dated 17.7.2006 issued by the Sebayan Drug De -addiction Centre the Forum below has dismissed the complaint and LICI has repudiated the claim of the Complainant -Appellant. According to the Appellant the judgment passed by the Forum below being erroneous is liable to be set aside and has prayed for allowing the present appeal.

(2.) THE brief fact of the case of the Complainant in brief is that Sri Samit Kumar Nath, since the deceased husband of the Complainant -obtained several policies during his life time from the OP -LICI. The OP issued one of the policy on 31.3.2003 for sum assured of Rs. 5,00,000 and the Complainant was nominee in the said policy. Unfortunately, the husband of the Complainant died on 26.3.2004 and a police case was started due to unnatural death and inquest was done. The post -mortem was accordingly held but no final opinion was given about cause of death and the visera was sent to FSL for report. As per the opinion dated 31.4.2006 no poison could be detected in visera report. After collecting necessary documents the Complainant submitted her claim. The OPs settled the claim in respect of two policies but did not settle the claim in respect of the present policy being No. 453266051. The Complainant submitted all the documents asper requirement but the OPs intimated by a letter dated 25.1.2007 that the claim has been repudiated. Therefore, the Complainant has filed the complaint against the OP praying for some relief as mentioned in the petition of complaint.

(3.) BEFORE the learned Forum below it was stated by the OPs by filing W/v and evidence on affidavit as well as documentary evidence that the husband of the Complainant took four policies and the OPs have already settled the claim in respect of the 2 policies but the claim regarding the present policy has been repudiated correctly as. there was suppression of material fact in the proposal form before taking out the policy in question. After inquiry it has been revealed that suppression was made in respect of state of health of the insured is concerned. The policy holder was an alcoholic and consumed alcohol excessively. He started addiction in drug when he was at the age of 27 years. The fact has been ascertained by a letter issued by Sebayan Drug De Addiction Centre. The husband of the Complainant had also chronic epilepsy problem. The father of the policy holder submitted the statement on 25.9.2004 and the medical certificate of Dr. S.C.Saha dated 23.6.2006 also corroborated such fact. The deceased husband of the Appellant thus suppressed the material facts intentionally at the time of writing of the proposal form before taking out the insurance policy in question. It is well settled that the answers in the proposal form should be given with utmost good faith and if the insured deliberately provides false or wrong statement in respect of any questions the policy is liable to be vitiated. Before the Forum below the OPs have prayed for dismissal of the complaint.