NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
V.B. Gupta, Presiding Member and Mrs. Rekha Gupta, Member
Smt. A. Sujata —Petitioner
versus
Life Insurance Corporation of India, Through : Branch Manager & Anr. —Respondents
Revision Petition No. 776 of 2011
(From order dated 27.01.2011 in Appeal No.528 of 2010 of Chhattisgarh State Consumer Disputes Redresdsal Commission, Raipur)
Decided on 4.3.2014
Counsel for the Parties:
For the Petitioner:Mohd. Anis-Ur-Rehman, Advocate.
For the Respondents:Ms. Ritika Nagpal, Advocate.
IMPORTANT POINT
When information on a specific aspect is asked for in proposal form, assured is under solemn obligation to make true and full disclosure.
Headnote:Consumer Protection Act, 1986—Sections 15 , 17, 19 and 21—Insurance—Repudiation of death claim on ground that deceased deliberately suppressed information regarding his pre-existing ailments at the time of making proposal for insurance—Complaint dismissed by State Commission in appeal—Since deceased was suffering from Cirrhosis of liver, CKD and was on Hemodialysis since 2005, deceased had suppressed material facts from respondents while obtaining insurance policy—Impugned order passed by State Commission in dismissing complaint of petitioner and allowing appeal of respondents upheld. (Paras 11 to 15)
V.B. Gupta, Presiding member—Petitioner/complainant has filed the present revision petition under Section 21(b) of the Consumer Protection Act, 1986(for short,’Act’).
2. Brief facts are that Sh. A. Venkatravi,(since deceased)husband of Petitioner/Complainant who was working as a Crane Operator in the Bhilai Steel Plant had purchased life insurance policy of Rs.5,00,000/- on 24.4.2006 from Respondents/Opposite Parties. He died on 07.10.2008 on account of renal failure with other ailments. It is alleged by the petitioner that, on 07.09.2007 deceased was admitted in the Hospital of BSP and after conducting certain tests, it was found that he was having excessive blood urea. His kidney failed on 07.10.08 and he died. Death was intimated to the agent of the respondents and claim was preferred, However, respondents repudiated the claim on 24.10.09, on the ground that deceased was suffering from hypertension with chronic renal disease and cirrhosis of liver from 19.10.04 and deliberately suppressed the information regarding his pre-existing ailments at the time of making proposal for insurance.
3. In its reply, respondents have averred that deceased was guilty of suppression of material facts regarding his pre-existing serious ailments and thus violated the terms of the policy and the mutual confidence between insured and insurer. So, petitioner is not entitled of getting any amount under the insurance policy.
4. District Consumer Redressal Forum Durg (Chhattisgarh) (for short, ‘District Forum’) allowed the complaint vide order dated 30.07.2010,with the following directions;
“1. The opposite parties will pay the amount of Rs.5,00,000/- to the complainant within one month from the date of order.
2. On the said amount the opposite parties will pay the interest @ 6 % to the complainant from the date of repudiation of claim 20.4.2010 till the payment.
3. The complainant will also be entitled for the amount of Rs.1,000/- as the cost of suit which will be payable by the opposite parties.
4. From the said amount the amount of Rs.2,50,000/- will be fixed deposited in the name of the complainant in any nationalized bank for three years in the saving account. In which the direction may be issued that without the permission of the forum no payment will be made before the time without the permission of the Forum”.
5. Being aggrieved, respondents filed appeal before Chhattisgarh, State Consumer Disputes Redressal Commission, Raipur (for short,‘State Commission’) which allowed the same, vide impugned order dated 27.01.2011 and set aside the order of the District Forum. Consequently, complaint of the petitioner was dismissed.
6. Hence, the present revision.
7. We have heard the learned counsel for the parties and gone through the record.
8. It has been contended by the learned counsel for the petitioner that deceased was having almost normal blood pressure all the time and there was no treatment with regard to the problem of liver or kidney, prior to the date of making proposal form for insurance policy. As such, there was no reason so as to suppress the material facts from the respondents
9. Further, it is contended that no affidavit of the concerned doctor was filed. Thus, petitioner was deprived the right to cross examine the doctor. Hence, impugned order is liable to be set aside.
10. On the other hand, it has been argued by the learned counsel for the respondent that contract of insurance is based on principle of utmost good faith. Any deviation from this principle entitles the insurer to cancel the insurance policy. In the present case, this principle has been violated at the time of filing the proposal form. The deceased deliberately concealed the fact that he was suffering from hypertension since 2000. Further, deceased was having Cirrhosis of liver since 2005 and was also on Hemodialysis since one year but this fact was deliberately concealed at the time of filing of proposal form in 2006. Under these circumstances, State