LIC OF INDIA Vs. KUCHERLAPATI KRISHNA KUMARI

JUDGEMENT

(1.) AGGRIEVED by the order in C. D. No. 14 of 2004 on the file of District Forum, Vizianagaram opposite parties preferred this appeal.

(2.) THE brief facts as set out in the complaint are that the complainant's husband late Kutcherlapati Satyanarayana Raju who is the policy holder took two policies one for Rs. 10,000 on 28. 3. 1996 and another for Rs. 50,000 on 14. 10. 1997 and paid the premium regularly till his death on 1. 2. 1998. He died of cardiovascular failure after which his nominee i. e. , the complainant herein approached the opposite parties for the amounts due under the two policies. Opposite parties issued a cheque for Rs. 11,917 dated 31. 8. 1999 towards full satisfaction of the first policy and failed to pay the amount due under the second policy. The complainant submits that the policy holder's death was sudden and he never suffered from chronic duodenal ulcer. The endoscopic report dated 20. 1. 1998, 12 days before his death shows that there was no ulcer. The case sheet of ESI Hospital never showed any symptoms of duodenal ulcer. The case sheet of Annapurna Nursing Home never revealed the symptoms of duodenal ulcer and pancreatitis. The complainant submits that the patient died due to cardiovascular failure. The complainant issued a notice to opposite parties on 8. 1. 2000 claiming the amount under the second policy, but there was no response. Hence the complaint, seeking directions to opposite parties to pay the second policy amount together with interest, compensation and costs.

(3.) OPPOSITE party No. 2 filed counter and opposite party Nos. 1 and 3 adopted the same. Opposite parties submitted that the complainant did not die due to cardiovascular failure and that he suppressed his ill health that he was suffering from duodenal ulcer. The second policy was taken on 14. 10. 1997 and he died on 1. 2. 1998. As per the letter dated 31. 3. 1999 from ESI Hospital Superintendent, he was admitted on 18. 1. 1997 and discharged on 26. 3. 1997 and was treated for chronic pancreatitis. He was on sick leave from 1. 2. 1997 to 30. 4. 1997 i. e. , 89 days. Therefore, they submit that the repudiation is justified.