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BIHAR STATE CONSUMER DISPUTES
REDRESSAL COMMISSION, PATNA
Hon’ble Mr. Justice B.N. Sinha (Retd.) Member;
Mr. K.P. Sinha, Member; Smt. Kalpana Ashok, Member
THE LIFE INSURANCE CORPORATION OF INDIA & OTHERS—Appellants
versus
URMILA SRIVASTAVA & OTHERS—Respondents
Appeal No. 104 of 1991—Decided on 24.9.1992

Advocates:
Counsel for the Parties :
For the Appellants :Mr. Subhash Kishore Verma, Advocate.
For the Respondents:Mr. Jeyoti Saran, Advocate.

Headnote:Consumer Protection Act, 1986 - Section 15 - Insurance Claim - Group Savings Link Insurance Scheme w.e.f. 1.3.1989 - L.I.C. has not paid any amount to the deceased insured on the ground that he was on sick leave from February 1989 till his death on 9-5-1989 L.I.C. did not take proper steps to satisfy itself about the health condition of an employee covered under the scheme - L.I.C. can be said to have waived this Condition of satisfactory health on the date of the commencement of the policy - No evidence as to what was the cause of death and that the sickness of the deceased on account of which he was on sick leave, ultimately led to his death - Order of the District Forum directing the insurer to pay the insured amount of Rs. 75,000/- is legally sustainable.

       Result: Appeal dismissed.

       

ORDER

Smt. Kalpana Ashok, Member — This is an appeal against the order dated 1.10.91 in complaint case no. 29 of 91 before Patna District Forum by which the appellant had been directed to pay to the respondent that the insured amount of Rs. 75,000/- along with interest @ 18% per annum and also to pay compensation of Rs. 10,000/- to the respondents.

2. The appeal was filed after the expiry of the limitation period as envisaged u/Sec. 15 of the Consumer Protection Act, 1986 (hereinafter referred to as the Act). It was contended by the appellants that this appeal was not time-barred as it was filed within one month of the receipt of the order of the District Forum. He was heard in detail and his contention was rejected vide orders passed by this Commission on 18.2.92. Since, however, there was sufficient cause for not filing this appeal in time the appellant were permitted to file an application along with an affidavit as provided for under Rule 8(4) of the Bihar Consumer Rules. This was done and after hearing both the parties the Commission is satisfied that there was sufficient cause for the late filing of the appeal and hence this appeal was admitted for hearing vide orders passed on 10.3.92.

3. We have heard the learned Advocates for the appellants and the respondents and perused the records of the District Forum. This appeal was fixed for orders on 26.8.92 but on 25.8.92 the learned Advocate for the L.I.C. requested to postpone the judgment to any other date as the LIC were considering as to whether or not ex-gratia payment could be made in the matter. This was therefore fixed for orders on 22.2.92. Nothing has since been heard in this regard from the L.I.C. On account of the very sad and untimely demise of Hon’ble Justice B.N. Singh, all judicial work were postponed to 24.9.92, after the sad news were received. Orders in this case are, therefore, passed today.

4. The facts of the case have been set out in detail in the orders of the learned District Forum. In brief, the Bihar State Road Transport Corporation insured its employees with the L.I.C. under the Group Savings Link Insurance Scheme. This insurance took effect from 1.3.89. As it happened one of the employee viz. Shri K.K. Srivastava whose name appeared at the top of the list of the employees insured under this scheme died on 9th May, 1988. The Bihar State Road Transport Corporation paid amounts under other heads due to the deceased employee and recommended to the LIC to pay the amount of Rs. 75,000/- which was the amount payable on death to Shri K.K. Srivastava who was category-II employee of the BSRTC. The LIC has not paid this amount to the respondent on the ground that Shri Srivastava was on sick leave with effect from February, 1989 till his death on 9.5.89. This was a material fact which was not revealed to the Insurance Company and, therefore, they were not bound to pay this sum of Rs. 75,000/- to the heirs of Shri K.K. Srivastava because it was covered by the dictum of Suppressio veri suggestion Falsi. In support of their contention the L.I.C. drew the attention of the District Forum as well as our attention to the leaflet which was issued by it under the Group Savings Link Insurance Scheme giving details about the various provisions of this scheme. It is mentioned in this leaflet that “an employee will be admitted to the scheme without any medical examination provided he is not absent on grounds of sickness on the commencement date”. It was argued vehemently that since Shri Srivastava was on sick leave on the date the commencement of the Master Policy under Group Savings Link Insurance issued to the Bihar Suite Road Transport Corporation for its employees, this stood in the way of admitting the claim of Shri K.K. Srivastava and hence no amount was paid to his heirs under this scheme.

5. The only point, therefore, to determine is whether Group Insurance was vitiated or not in the case of Late Shri Srivastava being on sick leave. The learned District Forum have com









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