SENIOR BRANCH MANAGER Vs. SUKANTI PANIGRAHY

JUDGEMENT

(1.) President. - The captioned appeal is directed u/s 15 of erstwhile Consumer Protection Act, 1986 (hereinafter called the Act) against the impugned order dtd. 29/11/2004 passed by the learned District Forum, Ganjam at Berhampur in C.D. Case No. 25 of 2003 directing the OPs to settle the complainant's claim forthwith and pay the total sum assured of Rs.40,000.00 under the policy to the complainant. The OPs were further directed to pay compensation of Rs.5,000.00 besides Rs.500.00 towards cost of litigation within month to the complainant failing which the amount would carry interest at the rate of 9% per annum till payment is fully made. Parties to this appeal shall be referred to with reference to their respective status before the District Forum. FACTS:-

(2.) The factual matrix leading to the case of the complainant is that the deceased assured being husband of the complainant purchased life insurance policy bearing No.570851987 with Money Back facility for assured sum of Rs.40,000.00 having quarterly premium payable for Rs.733.00. It commenced from 28/11/2001 and maturing on 28/11/2021, but the life assured died on 11/12/2001 after 13 days of commencement of the LIC policy. So the complainant lodged claim before the OPs claiming the assured amount. The OPs repudiated the claim stating that he has got chronic alcoholism and due to alcoholism, he has fallen certain times. The OPs have also informed that the deceased assured has suppressed such material fact for which he is not entitled to any relief. The complainant showing such repudiation being deficiency of service on the part of the OP filed complaint before the learned District Forum, Ganjam at Berhampur. Hence, the complaint.

(3.) Per contra, the OPs filed written version stating that the complaint is not maintainable and there is no cause of action to file the complaint. They admit that the life assured has purchased the policy for assured sum of Rs.40,000.00. It was issued on 4/12/2001 but the life assured died on 11/12/2001. According to them, on investigation, they found that in the Bed Head Ticket dtd. 10/12/2001 the hospital authority has mentioned that the complainant has history of chronic alcoholism and head injury by fall but the said fact has not revealed from the proposal form as the life assured has answered in negative to the questionnaires such as (a) Did you ever have any accident or injury? (b) Do you use or have you ever used (i) Alcoholic Drinks, (ii) Narcotics, (iii) Any other drugs, (iv) Tobacco in any form? Since the diseased has deliberately withheld the material fact ad upon revealing such fact there was occasion for the OPs to decide whether to accept the proposal or not, there is breach of insurance contract. Thus, the OPs have got every right to call the policy in question as death occurs within two years. Therefore, the OPs averred in the written version that in repudiating the claim they have no any deficiency of service. So the complaint has no merit and it should be dismissed.