DIVISIONAL MANAGER LIC OF INDIA Vs. SHOBHNA SHUKLA

JUDGEMENT

(1.) BRIEFLY stated, the facts of this case are that the husband of the complainant who is respondent herein had secured a policy for Rs.5 lakhs on 27.01.2002 from the Life Insurance Corporation of India in which the complainant was a nominee. During the life time of the insured, the premiums were paid regularly but the installments from July 2002 to January 2004 could not be deposited resulting in the lapse of the policy. On paying the defaulted installments of the policy and after complying with formalities, the policy was regularized. The insured expired on 21.02.2004. He fell ill on 03.02.2004 and was taken to a hospital since he had complained of constipation and stomachache. After detailed investigation, it was found that he was suffering from acute Pancreatitis and hence he was referred to the Sanjay Gandhi Post Graduate Institute of Medical Sciences where he remained admitted from 05.02.2004 till his death. The claim preferred by the complainant on the policy of her husband was, however, rejected by the petitioner Corporation vide letter dated 25.09.2004. She, therefore, approached the District Forum which accepted the complaint and passed the following order:- The complaint is accepted that the respondent Life Insurance Corporation of India will pay an amount of Rs.5,20,000/- (Five lacs twenty thousand only) within two months from today and pay interest @ 12% p.a. on the aforesaid amount with effect from 22.10.2004 otherwise the rate of interest would be 18% p.a. instead of 12% p.a.; respondent will also pay an amount of Rs.1000/- (one thousand only) to the complainant for the litigation expenses.

(2.) AGGRIEVED by the aforesaid order of the District Forum, the petitioner Insurance Co. challenged the same in appeal before the State Commission which accepted the appeal in part by modifying the order of the District Forum to the extent that the petitioner Insurance Co. will pay the policy amount of Rs.5 lakhs with bonus and 9% interest to the respondent/complainant from the date of the filing of complaint with the District Forum till the date of payment. Not satisfied with the partial relief given by the State Commission vide this impugned order dated 31.08.2010, the petitioner Insurance Co. has approached the National Commission challenging the same through the present revision petition.

(3.) WE have also gone through the judgement of this Commission in Kulwant Kumaris case and we are of the considered view that the fora below have rightly interpreted the same while rejecting the defence of the petitioner Insurance Co. So far as the other case of LIC Vs. Parasmal is concerned, it is to be noted that the fact of insured having undergone bye-pass surgery on 23.01.1995 in that case remained undisputed and hence repudiation of the claim based on suppression of material information by the insured person was held to be justified. Here, we find that the petitioner Insurance Co. has not been able to establish that the medical examination alleged to have been done on 08.02.2004 was actually done on that date and the fora below finding serious loopholes in the defence of the petitioner Co. rejected its contentions. The petitioner Insurance Co., therefore, cannot derive any benefit from the judgement in the Parasmal case. In view of these vital aspects and taking into consideration the totality of the facts and circumstances, we do not find any substance in the revision petition and dismiss the same at the threshold with no order as to costs.