SHEELA Vs. LIC OF INDIA

JUDGEMENT

(1.) The complainants are the L.R.S. (wife and children) of the deceased Sasidharan who had availed an L.I.C. policy from the opposite parties 1 to 4/L.I.C. authorities. A sum of Rs. 35 lakhs is claimed towards the assured sum and a sum of Rs. 1 lakh as compensation and 10,000/- as cost.

(2.) The deceased died on 17.1.2004in an accident. It is stated that he was a PWD contractor. The first complainant is the wife and the rest are the children. It is alleged that the 6th opposite party Abdul Asharaf/L.I.C. agent was a close friend of the deceased and that he used to visit their house frequently and he is very familiar to them for the past 8 years. The above agent is a Member of the Panchayat wherein the complainants are residing. The above agent/6th opposite party used to persuade the assured to avail an L.I.C. policy. Meanwhile on 6.3.2002, the deceased met with a bike accident and was hospitalized. He got fully recovered from the injuries and the opposite parties 5/Development Officer and 6 Agent were thoroughly aware of the above accident. They came to the house and assured the deceased that if he avails the LIC Policy , it will help his family to have a secured life, if any such accident happens in future. The deceased had studied up to 10th standard but was very poor in English. He can not read and understand the contents of the application form /proposal form or fill up the relevant details in the form for joining in the policy. The 6th opposite party/agent was fully aware of the above fact. He brought a proposal form and acting as the agent of the L.I.C. enquired and collected the details and asked the deceased to put his signatures where ?x? marks are put and assured that he will fill up the entire details in the form and submit it in the concerned office. The deceased had disclosed the entire personal details including his health to the opposite parties 5 and 6. They were fully aware of the above details. The above agent did not read over the application form or explain the contents. The deceased understood its contents. Believing the assurance of the agent, the deceased put his signatures where cross marks are put and handed over the unfilled form to the agent in the presence of 5th opposite party, Development officer along with an amount of Rs. 24,225/- at the office of the 4th opposite party/branch manager. It can be gathered that the opposite parties 5 and 6 have willfully neglected to enter some details in the proposal form with an evil motive of achieving both monetory and professional gain and for making business advancement for the first opposite party, LIC. As directed by opposite parties 5 and 6 the deceased had undergone medical check up prescribed by the L.I.C. The proposal form was accepted by the first opposite party and policy certificate No. 774432934 was issued. There was no reason to repudiate the policy by O.Ps 1 to 4. The deceased was of good health when he joined the policy until his death. As stated in the notice dated 14.8.2004, sent by the 3rd opposite party/Sub Divisional Manager, the assured/deceased happened to submit a disability certificate before the United India Insurance Company upon their assurance that he will be entitled to a better claim if it is submitted. The allegation in the above notice that the assured was diagnosed to have I.V.D.P. L-4-L5, tardy ulnar nerve palsy (Left) Type 2 Diabetes, Mellitus are false. The death of the assured is in no manner connected with the reasons mentioned in the above notice or with the accident caused to him on 6.3.2002. The assured died by drowning due to an accident.

(3.) The complainants are in very poor circumstances. The act of the opposite parties repudiating the claim is illegal. It is further alleged that the opposite parties 5 and 6/Development officer and Agent respectively are the representative of the L.I.C. and hence the L.I.C. is vicariously liable for the acts done by the opposite parties 5 and 6.