The court clarified the entitlement to accident benefit under the insurance policy and emphasized the importance of disclosing material facts in the proposal form.

Mr. D.D. Bahuguna, Member—In this appeal the appellant Life Insurance Corporation of India, has challenged the validity of the judgment and order dated 24.3.2001 passed by District Forum Bulandshahr in Complaint Case No. 709/98. Briefly stated the facts of the case are as follows :

The husband of the complainant Smt. Sushila Saxena had taken a fifteen year Jeevan Surabhi Policy with profits (with accident benefit), from the oposite party vide Policy No. 561013217. The policy was effective from 28.3.1996 and the sum assured was Rs. 1 lac. The amount of monthly premium to be paid to the opposite party was Rs. 1,000/-. The husband of the complainant died on 18.10.1996 in Jaswant Rai Hospital at Meerut. The complainant was the nominee in the said policy and is entitled to receive the amount of insurance allongwith bonus and other benefit but she has not been paid the claim preferred by her before the opposite party inspite of the fact that she had been cooperating with them. A registered notice was given by her on 30.12.1997 to the opposite party but no satisfactory answer was given. The opposite parties do not want to settle the claim of the complainant and are harassing her. Again on 4.9.1998 she gave an application to the opposite party and in reply she was informed that enquiry in regard to the claim is going on but desired cooperation was not being extended by the complainant. On 24.11.1998 the complainant was informed that her claim will be treated as no claim. The complainant, therefore, lodged a claim before the District Forum for award of insured amount of Rs. 1 lac alongwith bonus and interest etc. She also claimed Rs. 50,000/- as compensation for mental and financial harassment alongwith interest @ 24% p.a. from the date of filing the claim. The cost of Rs. 25,000/- was also claimed.

2. In the written version before the District Forum the opposite party admitted the insurance. It was also stated that the complainant inspite of being given several opportunities did not furnish to the opposite parties the details of illness and treatment done of the life assured. Several letters were sent to the complainant on 30.12.1997, 5.2.1998, 12.9.1998 and 24.11.1998 in which the details of the illness and treatment done were asked from the complainant but no details were made available by the complainant and, therefore, the claim could not be settled because of non-cooperatiion on the part of the complainant. The claim has been repudiated on 4.10.1999. The claim form submitted by the complainant states that the life assured died because of chronic liver disease on 18.10.1996. The death of life assured occured after about 7 months from the date of taking insurance policy. The life assured was treated by Dr. J.C. Mudgal at Bulandshahr and later on in Meerut but the details of the treatment were not given by the complainant or by the doctor. The chronic lever disease is such disease which develops gradually and cannot be of two months duration. Because of non-cooperation of complainant and doctor concerned it is clear that the complainant’s husband was having this illness at the time of taking insurance and the same fact was concealed by the life assured and, therefore, the contract of insurance becomes void. In the circumstances the complaint is not maintaiable before the District Forum. The complainant is not liable for any relief.

3. The parties led their evidence in the form of affidavits before District Consumer Forum and the Forum after hearing the two parties decreed the claim directing the opposite parties to pay to the complainant an amount of Rs. 1 lac along with accident benefit and bonus. Interest is also allowed @ 12% p.a. from the date of institution of the complaint till the date of payment besides a compensation of Rs. 5,000/- and cost of Rs. 500/- was also ordered to be paid to the complainant.

4. Aggrieved of this order the opposite party Life Insurance Corporation of India has come in this appeal.

5. We have hea