LIC OF INDIA Vs. VIMLA VERMA

JUDGEMENT

(1.) The present revision petition has been filed by the Life Insurance Corporation of India and another (hereinafter referred to as the 'Petitioner') being aggrieved by the order of the State Consumer Disputes Redressal Commission, Himachal Pradesh (hereinafter referred to as the 'State Commission'). Smt. Vimla Verma who was the original complainant before the District Form is the Respondent herein.

(2.) The facts of the case according to the Respondent are that her son, Munish Kumar Verma had taken a life insurance policy from the Petitioner on 10.02.2002 for a sum of Rs. 1 lakh for a period of 20 years. Respondent was the nominee under the said policy in case of accidental or natural death of the policyholder. During the subsistence of the policy for which the premium was fully paid, the insuree died on 20.05.2002 following a short illness for which he was admitted in P. G. I. Chandigarh. Respondent, therefore, lodged a claim with the Petitioner/Insurance Corporation seeking payment of Rs. 1 lakh and bonus for three years amounting to Rs. 25,000/-. Respondent also supplied the required documents to the Petitioner/Insurance Corporation to enable early settlement of the claim. However, Petitioner refused to settle the claim on one pretext or the other and finally repudiated the same in August, 2003. Aggrieved by this, Respondent filed a complaint before the District Forum on grounds of deficiency in service and requested that the Petitioner be directed to settle her claim by paying Rs. 1 lakh insurance amount, Rs. 25,000/- as bonus, Rs. 3,000/- on account of litigation cost and Rs. 10,000/- as compensation for harassment, inconvenience etc. along with interest @ 12% per annum from the date of death of the policyholder till the date of payment.

(3.) Petitioner refuted the above contentions and stated that the claim was rightly repudiated because in violation of the terms and conditions of the insurance policy which is a contract made in utmost good faith, insuree suppressed material information that he had suffered from Enteric Fever & "LGI Bleed" in the year 1998 for which he had undergone treatment at P. G. I. , Chandigarh. This fact was certified in a document signed by the Assistant Professor, Department of Gastroentology, P. G. I. Chandigarh. Further, in the year 2002, when the insuree was admitted for the illness because of which he expired, insuree himself had given facts about his earlier illness which was duly recorded in the medical history sheet of the hospital. However, in the Proposal Form of the insurance policy, he had specifically stated "No" in respect of the columns pertaining to previous illness, hospitalization and treatment undergone by him.