LIC OF INDIA Vs. VIDYA DEVI

JUDGEMENT

(1.) Facts as they emerge from the record of this case are that deceased Karan Singh was insured, he had obtained policy of insurance on 15.3.2001 and passed away on 5.8.2001 Policy was in the sum of Rs. 50,000/ -. After his death, respondent filed her claim for being indemnified with the appellants. It was repudiated on 31.3.2002. This resulted in filing of the Consumer Complaint No. 296/2003. This complaint was resisted on the ground that the deceased had violated the basis of insurance in as much as that he purposely and with an ulterior motive did not disclose while filing. in the proposal form that he was suffering from Pulmonary TB. Had this fact been disclosed appellant might not have been insured the deceased or the rate of premium could go on higher side and the possibility of his having been got medically examined further in such a situation was also there. Good faith is the basis of insurance having been violated by the deceased, therefore, appellant were not liable for payment of any amount.

(2.) The District Forum below after hearing the parties and taking note of the material before it, and after holding them jointly and severally liable has directed the appellants to pay Rs. 50,000/ - alongwith vested bonus within 30 days of the receipt of copy of the order. In addition to this, appellant are also directed to pay Rs. 5,000/ - jointly and severally as compensation for causing her harassment etc. In case amount was not deposited within 30 days of the receipt of copy, the same was to carry interest @ 9% per annum from the date of filing of the compliant i.e. 16.8.2003 till its realization. Hence this appeal by the appellants.

(3.) Learned counsel in support of the appeal urged that the deceased was suffering from Pulmonary TB is clearly made out from the copy of certificate Annexure R -IV issued by Senior Medical Officer, TB Sanatorium, Tanda, District Kangra, H.P. Its perusal shows that the deceased was advised rest between 18.4.2000 to 30.6.2000. He had gone to said Sanatorium as out door patient. In this very certificate Annexure R -IV is a mentioned that he (the deceased) has become smear negative, it is dated 23.6.2000. In additional to the reliance, is also placed on Annexure R -V leave record issued by the employer of the deceased. From 18.4.2000 on different dates, he (the deceased) had availed sick leave on medical grounds. He had produce medical certificate i.e. Annexure R -IV. By referring to these two documents it was pointed out that deceased was suffering from the above disease and therefore appeal deserves to be allowed by setting aside the impugned order. These pleas have been controverted by Mr. Chandel learned counsel for the respondent. He submitted that annexure R -V does not advance the case of the appellant. Per him in order to succeed on its plea that the disease was pre -existing, it had also to be established further by the appellant that he was suffering from it on 15.3.2001. when he got himself insured. Regarding medical leave record Annexure R -V, he submitted that what the nature of sickness when he availed medical leave, there is nothing on record. He also pointed out that no advantage can be taken by the appellate from Annexure R -ll from No.3816.