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2009(2) CPR 13 (NC)
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION,
NEW DELHI
Ashok Bhan, President and B.K. Taimni, Member
Bhagwati Prasad Borasi —Petitioner
versus
Divisional Manager, Life Insurance Corporation of India —Respondent
Revision Petition No. 1332 of 2004
Decided on 3.3.2009
Counsel for the Parties:
For the Petitioner:Mr. R.C. Sobhani, Advocate.
For the Respondent:Mr. Ashok Kashyap, Advocate.
IMPORTANT POINT
In revisional jurisdiction, National Commission can interfere only if the State Commission has exercised a jurisdiction not vested in it by law, or has failed to exercise a jurisdiction so vested, or has acted in exercise of its jurisdiction illegally or with material irregularity.
Headnote:Consumer Protection Act, 1986—Section 21(b)—Complainant’s wife took two Insurance Policies from respondent Company—Death of insured within two years of taking of policy—Repudiation of claim by LIC on ground that deceased wilfully suppressed facts about her state of health—Evidence on record showed that deceased, Agent of LIC, brother of deceased as well as Doctor, who was father-in-law of deceased acted in collusion with each other in suppressing existence of serious ailment of deceased while obtaining insurance policies as well as while seeking their subsequent revival—Possibility of prolonged ailment ultimately causing problem of pancreatitis and resulting in death of deceased, could not be ruled out—Respondent was justified in repudiating claim of petitioner as deceased had suppressed material facts while taking policies as well as at the time when policies were got revived—Finding regarding suppression of facts was finding of fact based on evidence—Such a finding could not be set aside in exercise of revisional jurisdiction under Section 21 of Act of 1986—Revision petition having no merit, dismissed. (Paras 9 to 11)
Result: Revision Petition dismissed.
Ashok Bhan, President—Complainant/petitioner being aggrieved against the Order passed by the M.P. State Consumer Disputes Redressal Commission, Bhopal (hereinafter referred to as ‘the State Commission’ for short) in Appeal No. 910 of 2001 dated 05.03.2004, has filed the present Revision Petition. By the impugned Order, the State Commission upheld the Order of the District Consumer Disputes Redressal Forum, Ujjain (hereinafter referred to as ‘the District Forum’ for short) and dismissing the complaint filed by the petitioner.
2. Shortly stated, the facts of the case are:
Smt. Poornima Borosi-deceased wife of the complainant, took two insurance policies from respondent for a sum of Rs.1,00,000/- and Rs.25,000/- on 30.10.1995. She died on 19.05.1997, i.e., within two years of the taking of the policy. The claim made by the petitioner was repudiated by the Life Insurance Corporation (LIC)-respondent herein on 16.06.1999 on the ground that deceased wilfully suppressed facts about her state of health. It was discovered that the policy had been taken by the deceased through LIC Agent, Shri Bhushan Chaudhary, the brother of the deceased.
3. On the repudiation of the claim, the petitioner filed a complaint before the District Forum. The District Forum dismissed the complaint and held that the deceased was guilty of wilful suppression of facts regarding her state of health. A compensatory cost of Rs. 1,000/- was awarded to the respondent.
4. Being aggrieved against the Order passed by the District Forum, the petitioner filed an Appeal before the State Commission. The State Commission set aside the Order of District Forum imposing compensatory cost of Rs.1,000/- and maintained the rest of the Order of the District Forum. State Commission also came to the conclusion that the petitioner was guilty of wilful suppression of facts about the state of health of the deceased.
5. Counsel for the parties have been heard at length.
6. The suppression of facts is unfolded by the overwhelming evidence present on the record. Deceased was on long medical leave from 18.08.1992 to 29.08.1992, 24.04.1993 to 01.05.1993, 11.01.1994 to 17.01.1994, 18.07.1994 to 26.07.1994, 28.08.1994 to 11.11.1994 (83 days), 20.11.1994 to 10.02.1995 (82 days), 20.06.1995 to 17.09.1995 (90 days) and 19.09.1995 to 14.12.1995 (86 days). At the time, when the policies were taken, the deceased was on long medical leave. In the proposal form against column - as to whether, she had consulted any Doctor in the last 5 years in connection with the disease, which required leave for more than 7 days? - the answer was in the negative. Similarly, against query - as to whether she had remained absent in the last five years on the ground of ill health? - the answer was again in the negative. To the third question - as to whether she had ever suffered or was suffering from disease relating to stomach, heart, lungs, kidney, brain, liver or was suffering from Asthma? - the answer was again in the negative. To the fourth question - as to whether she was suffering from Tuberculosis, High or Low Blood Pressure, Diabetes, Epilepsy, etc.? - the answer was again in the negative. To the fifth question - as to whether she was enjoying the good health? - the answer was in the affirmative.
7. It may be noted that the policies taken by the deceased had lapsed on account of non-payment of premium and were revived in April, 1997, i.e., about 1-½ month prior to the death of the insured. In the application form, again the answer to questions regarding the existence of any ailment and taking of medical leave, was in the negative. The certificate given by the employer of the deceased, revealed that after taking of the policy, deceased had been on medical leave on several occasions, i.e., 20.08.1996 to 21.08.1996, 23.09.1996 to 26.09.1996, 20.11.1996 to 26.11.1996, 06.01.1997 to 14.01.1997, 05.03.1997 to 14.03.1997, 17.03.1997 to 09.04.1997, 17.04.1997 to 19.04.1997, 05.05.1997 to 11.05.1997 and 13.05.1997 to
