DINESH Vs. BIRLA SUN LIFE INSURANCE COMPANY LTD

JUDGEMENT

(1.) This revision petition under Sec. 19 and 21 of the Consumer Protection Act, 1986 (in short, the 'Act') assails the order dtd. 18/8/2017 in First Appeal No. A/16/99 of the State Consumer Disputes Redressal Commission, Maharashtra, Mumbai Circuit Bench, Nagpur (in short, the 'State Commission') dismissing the appeal of the petitioner against order dtd. 2/5/2018 of the District Consumer Disputes Redressal Forum, Nagpur (in short, the 'District Forum') in Consumer Complaint no. CC/472/2007.

(2.) The brief facts of the case, according to the petitioner, are that he is the nominee of the deceased life assured (DLA), Sarjerao Kapse, who had paid a premium of Rs.25,000.00 on 1/3/2006 to the respondent insurance company for a life insurance policy under its 'Classic Life Premium Plan' for a life cover of Rs.10,00,000.00. The period of the policy was 30 years and the approval of the policy was accompanied by a medical examination on 27/3/2006 followed by a urine examination on 28/3/2006 by two doctors on the panel of the respondent following which policy no 000601590 was approved. On 7/4/2006 the respondent approached the DLA and suggested that the sum assured be reduced to Rs.5,00,000.00 in view of his drinking habit which was not consented to. On 14/4/2006 the DLA was admitted in the hospital of Medical College, Nagpur where he expired on 4/5/2006 due to 'Bilateral Aspiration with CRA (Cardio Respiratory Arrest)'. The petitioner submitted a claim on 29/5/2006 under the policy for Rs.10.00 lakhs which was repudiated by the respondent on 18/7/2006 on the grounds of the DLA being a chronic alcoholic who suffered from alcoholic diseases prior to his applying for the policy. The respondent states that this fact was disclosed in the application and that the policy was approved by the respondent after due medical examination after medical examination. The respondent complained to the Insurance Ombudsman who rejected the claim on 30/3/2007 but allowed withdrawal of 90% of the premium of Rs.25,000.00 paid. The thumb impression on the letter dtd. 10/4/2007 relied upon by the respondent was examined and held by the handwriting expert to be different to the specimen thumb impression of the DLA. The petitioner approached the District Forum seeking payment of the insurance cover with 10% interest and litigation cost which dismissed the complaint on contest. The appeal against this order was also dismissed by the State Commission on the ground of suppression of material information regarding pre-existing alcoholism of the DLA. This appeal impugns this order. The State Commission had earlier remanded First Appeal A/08/451 filed by the petitioner against the dismissal of his complaint by the District Forum which finally came to be dismissed on 2/5/2016. The subsequent appeal no. A/16/99 was again dismissed against which this RP is filed.

(3.) I have heard the learned counsel for both the parties and given careful consideration to the material on record.