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NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
Prem Narain, Presiding Member
M/s. Reliance Nippon Life Insurance Co. Ltd. —Petitioner
versus
Yeellapu Venkata Adibabu —Respondent
Revision Petition No.3502 of 2017
(Against the Order dated 04/09/2017 in Appeal No. 439/2015 of the State Commission Andhra Pradesh)
Decided on 3.12.2018
Counsel for the Parties:
For the Petitioner:Mr. Kaustubh Prakash , Advocate with Mr. Piyush Singh, Advocate
IMPORTANT POINT
When there is no illegality, material irregularity or jurisdictional error in the order of the lower fora, revisional jurisdiction cannot be invoked.
Headnote:Consumer Protection Act, 1986—Section 21—Revision—The father of the complainant/respondent Appa Rao obtained a Life Insurance Policy during his life time from the opposite party/petitioner for a sum of Rs. 5,00,000/-—Complainant/Respondent was appointed as the nominee under the said policy—On 10.3.2011, insured suffered from Diarrhea—He was shifted in a hospital in Visakhapatnam—He was treated by Dr. B.D Naidu and while undergoing treatment, the insured died on the same day—Insurance company was informed about the death who repudiated the claim on the ground that material facts were suppressed—Hence, complaint was filed who allowed the same—Appeal filed by the appellant/Insurance Company was also dismissed—Hence, the present revision—Heard the counsel, perused the documents and the record—It can be seen from the record that the cause of death had no relation with the alleged pre-existing disease of paralysis and hence, the claim cannot be repudiated—There is no illegality, material irregularity or jurisdictional error in the order of the State Commission which calls for interference from this Commission—The revision petition is dismissed at the admission stage.
Result: Revision Petition is dismissed at admission state.
This revision petition has been filed by the petitioner M/s. Reliance Nippon Life Insurance Co. Ltd. against the order dated 04.09.2017 of the State Consumer Disputes Redressal Commission, (in short ‘the State Commission’) passed in FA No.439 of 2015.
2. Briefly put, facts relevant for the disposal of the present revision petition are that the father of the complainant/respondent Appa Rao obtained a Life Insurance Policy during his life time from the opposite party/petitioner for a sum of Rs.5, 00, 000/-. Complainant/Respondent was appointed as the nominee under the said policy. On 10.3.2011, insured suffered from Diarrhea. He was shifted in a hospital in Visakhapatnam. Therein, Dr. BD Naidu prescribed some medicines to him. On the same night, insured died and intimation of his death was given to the opposite party/petitioner. Complainant/respondent submitted the claim with necessary documents. However, opposite party/petitioner repudiated the claim on the ground of non-disclosure of material facts about the health. Complainant filed a consumer complaint CC/374/2012 in the District Forum, Visakhapatnam against the Opposite Parties for directing them to pay an amount of Rs.5,00, 000/- along with interest from the date of claiming the amount till its payment and Rs.50, 000/- towards compensation with costs.
3. Opposite parties submitted their written statement and denied the material averments in the complaint. Though it has been admitted that the deceased Appa Rao has obtained Life Insurance Policy for Rs.5,00,000/- and that he died on 10.03.2011 the claim was received by the Insurance Company on 17.02.2012. Opposite party justified repudiation of the claim on the ground that Insurance Policy was obtained by concealing the material fact that the deceased life assured (DLA) was hospitalized much prior to the signing of the proposal form.
4. District Forum vide its order dated 02.07.2015 held that the OP has repudiated the claim of the complainant on the ground that insurance was obtained by the deceased by concealing the fact that he was hospitalized and treated for Cerebrovascular accident. Onus of proving the above ground of repudiation of insurance claim lies with the OP but they failed to prove the same. As OP has failed to prove its part of the case there has been clear deficiency of services on the part of the OP. Therefore, complainant is entitled for the relief for an amount of Rs.5,00,000/- with interest @ 9% pa from the date of May, 2012 i.e. after receiving the repudiation letter from OP, compensation of Rs.25, 000/- and costs of Rs.2500/-.
5. Aggrieved by the order of the District Forum, opposite party preferred an appeal before the State Commission. The appeal was dismissed by the State Commission. OP heavily relied on the report of the investigator but State Commission found that there was nothing on record to prove about the said report and no credibility can be attached to it. State Commission agreed with the reasoning put forward by the District Forum that the appellant utterly failed to prove that the insured was suffering from ailment and that he suppressed any information in the proposal form. State Commission did not find any valid reason to reject the claim of the complainant. Order of the District Forum was upheld by the State Commission.
6. Hence this Revision Petition.
7. It has been argued that during the course of investigation it came to knowledge of the petitioner through the hospital treatment records (i.e. prior to the signing of the proposal form) that Life Assured was a known case of Cerebrovascular Accident and was treated for Cerebrovascular accident since 2009 in Krishi Trust Hospital, Sheelanagar, Visakhapatnam-12. The deceased was hospitalized for the above said disease during the month of January, 2009 i.e. much before taking up the policy. The petitioner has produced the original hospital records, which clearly establishes that the DLA had a pre-medical history which was intentionally suppr
