CHAND RATAN LAHOTI & 2 ORS. S/O. LATE SHRI HARDUTT RAIL LAHOTI, R/O. 2/263, VIDYADHAR NAGAR, JAIPUR RAJASTHAN Vs. AVIVA LIFE INSURANCE CO. INDIA LTD. & ANR. THROUGH MANAGER/SR. MANAGER, BRANCH OFFICE AT: S

JUDGEMENT

(1.) - The appellants are father and siblings of late Sh. Manoo Lahoti. The appellants being aggrieved of the order of the State Commission Rajasthan dated 28.10.2015 have preferred this appeal.

(2.) Briefly stated, the facts relevant for the disposal of the appeal are that the appellants filed a consumer complaint in the State Commission Rajasthan alleging that Sh. Manoo Lahoti on 26.06.2011 submitted a proposal for purchasing life insurance policy in the office of the opposite party. Pursuant to the proposal form, Manoo Lahoti was medically examined by the medical board constituted by the opposite party. The Board on examination found Manoo Lahoti fit and healthy and submitted its report to the OP No. 2 on 27.06.2011. Thereafter, insurance proposal of Manoo Lahoti for life insurance policy of Rs. 50 lakhs was accepted and manoo Lahoti issued a cheque dated 25.06.2011 for Rs. 16920.00 drawn on Bank of Boroda against the first insurance premium. The cheque was presented by the opposite party for encashment and amount of cheque was credited in the account of OP no.2 on 30.06.2011. It is alleged that beside life insurance cover of Rs. 50 lakhs, the policy also provide for payment of claim of Rs. 5 lakhs for the insured contracting a serious disease.

(3.) It is further alleged that on 28.06.2011 while in Delhi, Manoo lahoti felt severe headache and nausea. He went to General Hospital in Gurgaon and his MRI was done. As per the report of MRI, Space Occupying Lesion brain was found. Resultantly Manoo Lahoti was admitted in Paras Hospital Gurgaon for treatment. He remained hospitalized from 28.06.2011 to 07.07.2011. During said period, Manoo Lahoti underwent surgery and biopsy was done. Biopsy sample was sent to Ganga Ram Hospital and report of biopsy confirmed that Manoo Lahoti was suffering from cancer. Though prior to biopsy report, Manoo Lahoti was not aware of his disease. It is alleged that the information regarding health condition of Manoo Lahoti was given regularly to the opposite parties on 11.07.2011, 08.08.2011, 09.08.2011, 18.12.2012 and Jan. 2013 claiming for the benefit under serious ailment clause of the insurance contract. It is further the case of the complainants that Manoo Lahoti was subsequently treated at Deep Hospital Jaipur where he passed away on 13.10.2013 due to septicaemia. The appellants complainants being legal heirs of the deceased submitted insurance claim with the opposite parties but OP no.2 repudiated the insurance claim vide repudiation letter dated 09.01.2014.