SARAMMA VARGHESE Vs. LIC OF INDIA

JUDGEMENT

(1.) THE revision petitioner was the complainant before the District Forum. She is the wife of the deceased N. Varghese who had taken an Endowment Policy of Rs. 50,000 form the Divisional Office, LIC, Kozhikode. Shri Varghese died on 14. 7. 1996. The Insurance Company repudiated the insurance claim on the ground that the insured had suppressed his ailment of coronary artery disease. The District Forum held that it was not possible for the deceased to know about his ailment at the time of submission of the proposal from. Accordingly, he could not be accused of suppression of material information as contended by the Insurance Company. Therefore, the District Forum directed the Insurance Company to pay an amount of Rs. 50,000 to the complainant within one month from the date of its Order along with Rs. 500 with costs.

(2.) DISSATISFIED by the Order of the District Forum, the LIC has filed an appeal before the State Commission. The State Commission after hearing the learned Advocates for the parties, examined the proposal for Insurance Policy wherein there is a column which states that: "and I further agree that if after the date of submission of the proposal but before the issue of the First Premium Receipt, (i) any change in my occupation or any adverse circumstance connected with my financial position or the general health of myself or that of any members my family, occurs or (ii) if a proposal for assurance or an application for revival of a policy on my life made to any office of the Corporation has been withdrawn or dropped, deferred or accepted at an increased premium or subject to a lien or on terms other than as proposed, I shall forthwith intimate the same to the Corporation in writing to reconsider the terms of acceptance of assurance. Any omission on my part to do shall render this Assurance invalid and all monies which shall have been paid in respect thereof forfeited to the Corporation. " (Emphasis supplied)

(3.) IN this case, there was a failure of the insured to intimate the change in the condition of health of the insured to the Insurance Company, a pre-condition which was not complied with. Hence, the policy was rendered invalid. Accordingly, there was no deficiency on the part of the Insurance Company for repudiating the claim. Therefore, the State Commission allowed the appeal setting aside the Order of the District Forum.