ZONAL MANAGER LIC OF INDIA Vs. M SUNITHA

JUDGEMENT

(1.) Fa. No.579/97 is filed by the opposite parties 1 to 3 in CD. No.189/95 and FA. No.117/98 is preferred by the complainant in CD. No.189/95.

(2.) The complainant in the C. D. is Smt. M. Sunitha w/o late M. Ramesh. Her case in the CD is as follows : The husband of the complainant took Jeevanmitra Policy (double cover endowment plan) bearing No.642160781 for Rs.25,000/- on 23.11.1991. Under Jeevanmitra policy, double the sum insured is given in case of accidental death of the insured. As per the policy Smt. Sunitha was the nominee, the subscription was deducted by the employer i. e. University of Hyderabad, at the source and paid to the opposite parties. The maturity date for the said policy was 23.11.2016. The insured, Sri M. Ramesh died on 8.7.1993 due to cardio-respiratory arrest. The complainant submitted the legal heir certificate issued by the Mandal Revenue Officer, Serilingampally, Ranga Reddy District and the death certificate was issued by the Registrar, Births and Deaths, Circle-6, MCH, Hyderabad. She intimated the death of her husband to the opposite parties and later the claim form duly filled in. However, the opposite parties repudiated the claim through their letter dated 24.3.1995 (Ex. A7) on the ground that the deceased had suppressed the fact that he was suffering from Diabetes and Hypertension since a long time prior to his proposal for the policy. According to them in his application dated 6.10.1991 he had given wrong answers to question Nos.11 (a) (e) and (i ). They also produced the discharge summary (Ex. B2) of Medwin Hospital wherein it was mentioned that he was a chronic diabetic since 12 years, that he was readmitted in May, 1991 in Medwin Hospital "with severe 'azotaemia' and received three 'haemodialysis' and that he had "last dialysis on 17.5.1993 on irregular dialysis".

(3.) The opposite parties 2 and 3 filed their counter and contested that it was not a consumer dispute. They agreed that insurance policy was issued in the name of late M. Ramesh and M. Sunitha was the nominee under the policy. However Ramesh died on 8.7.1993 and thus the claim had arisen after one and a half years. Since it was an early claim they enquired into the genuineness of it and came to the conclusion that the deceased suppressed the material information under questions 11 (a) (e) and (i ). They also filed the proposal form dated 6.10.1991, original policy bond, claim forms B and B (i), and discharge summary issued by Medwin Hospital. They reiterated that the deceased was a chronic diabetic patient which fact he suppressed in the original proposal and thus violated the principle of utmost good faith. The insured underwent treatment in Medwin Hospital. Opposite party No.4 was doctor of Medwin Hospital at the relevant time and he was a dis-interested party and hence his discharge certificate should be accepted without questioning it. They contended that on these grounds the complaint should be dismissed and the question of payment of Rs.50,000/- with 24% per annum interest did not arise.