Back
2010(2) CPR 370
DELHI STATE CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
J.D. Kapoor, President and Rumnita Mittal, Member
Smt. Seema Dugar —Complainant
versus
The Branch Manager, LIC of India and Ors. —Opp. Parties
Complaint Case No. C-215/1999
Decided on 4-3-2008
Counsel for the Parties:
For the Complainant:Mr. Sanjay Luthra, Advocate.
For the Opp. Party No. 1:Mr. M.N. Singh, Advocate.
Headnote:(i) Consumer Protection Act, 1986—Section 11—Territorial jurisdiction—There LIC policies were taken, two from Churu Rajasthan and third from Faridabad, Haryana—Maintainability of complaint for claim under policies filed in Delhi—Cause of action partly arose in Delhi as OP, was asking complainant to settle her claim with Delhi office—OP had a branch office in Delhi—Concept of territorial jurisdiction was ordinarily for benefit of aggrieved party—Forum at Delhi had jurisdiction to adjudicate complaint. (Paras 6 to 7)
(ii) Consumer Protection Act, 1986—Section, 12 and 17—Life Insurance Policy Claim—Three policies were taken by insured—Two of those policies had lapsed for non-payment of premium in time and were got revived 19 days before death of insured—12 months before the insured got lapsed policies revived, he was treated at AIIMS for UGI bleed, hyper kalemia, alcoholic cirrhosis and portal hypertension—Facts were not disclosed at the time of revival of policies—Case of concealment of facts in respect of those two policies was made out when insured died due to liver cirrhosis—Claim in respect of third policy was rightly found payable.
Held: Though the lapsed policies were revived on 16-08-1995 yet the complainant did not declare as to his health being sound and good as the proposal form was filled afresh. Revival of policy is always with retrospective effect i.e. in continuation of the lapsed policy. But at the same time the insured is also required to give declaration as to his health. The declaration given by him at the time of obtaining the policy is not relevant.
Thus in our view policies which were lapsed and revived and within days the deceased died makes out a case of concealment of facts by the complainant as to the state of his health, particularly when the cause of death has been liver cirrhosis and portal hypertension, hyper kalemia, UGI bleed etc.
As regards the policy obtained eight months prior to the death of the deceased neither he had been hospitalized and received treatment nor he had undergone any operation and therefore the claim of the complainant in respect of the policy obtained eight months prior to the death of the deceased was wrongly repudiated. It is contended by the counsel for the OP that the OP had offered Rs. 1 lac as ex-gratia payment to the complainant which was not accepted by the complainant.
In the result we allow the complaint in the following terms:-
(i) OP shall pay Rs. 50,000/- in respect of the policy which was obtained eight months prior to the death of the deceased with 9 % interest from the date of filing of the complaint till the date of this order.
(ii) OP shall pay Rs. 80,000/- towards other two policies which were Rs. 40,000/- each.
(iii) OP shall pay Rs. 25,000/- as compensation mental agony and harassment suffered by the complainant besides Rs. 10,000/- towards litigation expenses. (Paras 10 to 13)
J.D. Kapoor, President—Husband of the complainant late Sh. Mahender Kumar Dugar purchased three insurance policies No.500175377, 500176999 and 500178888 for Rs. one lac each from OP-1, L.I.C. of India, Churu (Rajasthan) and one policy No.120248121 from OP-2 at Faridabad for Rs. 50,000/-. Complainant is the nominee in all these policies. The insured died on 04.09.1995 and the complainant lodged the claims with the OPs. However, the OPs released the amount of Rs.1,10,645/- after a long period of 19 months only in respect of one Policy No.500178888 and the OP company deducted the premium of Rs. 2755/- which was due on 15.09.1995 though the insured had died on 04.05.1995. Claim against the remaining three policies was repudiated by the OP company and only an ex-gratia payment of Rs. 1 lac was offered. Hence the complaint seeking the insured amount with bonus against the three policies besides the not due premium and interest etc.
2. According to the OPs two policies No. 500175377 and 500176999 taken from OP-1 lapsed due to non-payment of the premium and same were got revived by the insured on 16.08.1995 after filing the declaration of good health. At the time of processing the claim, the OP company found that it was an early claim because the insured had died within 19 days of the revival of the two policies above mentioned and within 8 months of taking policy No. 120228121 from OP-2.
3. Hence investigation was carried out and it was found that about 12 months before the insured had revived the lapsed policies, he was suffering from UGI bleed, hyper kalemia, alcoholic cirrhosis and portal hypertension for which he was treated at AIIMS. The insured did not disclose this fact while getting the lapsed policies revived and taking the policy from the Faridabad branch of the company. Hence, the claim is respect of the three policies was repudiated by the company. However, an ex gratia payment of Rs. one lac was sanctioned and paid to complainant against these three policies on humanitarian ground. As to honouring the remaining one policy, it is stated that the insured did not know about these diseases at the time of taking the policy and hence payment in respect of this policy was made. It has been denied that any premium, which was not due, was deducted from the claim. OPs have also raised the plea of territorial jurisdiction as none of the policies was taken from Delhi.
4. In her rejoinder the complainant has denied that the insured was suffering from the diseases mentioned earlier and was treated at AIIMs as alleged. Ex-gratia payment of Rs. 1 lac has also been denied. As to the territorial jurisdiction, it is stated that OP-3 is the zonal office of the company at Delhi and hence this Commission has the territorial jurisdiction in the matter.
5. Parties have filed their evidence by way of affidavits.
6. We have heard the counsel for the parties at length and accorded careful consideration to the rival claims and contentions. The first and foremost objection raised by the learned counsel for the OP is territorial jurisdiction of this Commission inasmuch as that out of three policies two were taken at Churu, Rajasthan and one at Faridabad. However, in view of the fact that complainant was asked to settle her claim at Delhi office of the OP and they had been corresponding with Delhi office alone the jurisdiction at Delhi is available to the complainant. Even otherwise section 11 of the Consumer Protection Act, 1986 relating to jurisdiction of the District Forum allows the complainant to institute a complaint in a District Forum within the local limits of whose jurisdiction the OP or each of the OPs, where there are more than one, at the time of institution of the complaint, actually and voluntarily resides or carries on business or has a branch office or personally works for gain or where the cause of action wholly or in part arises. Section 11 reads as under:-
11. Jurisdiction of the District Forum.—(1) Subject to the oth
