NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
Anup K Thakur, Presiding Member and C. Viswanath, Member
Life Insurance Corporation of India—Petitioner
versus
Jaswinder Kaur—Respondent
Revision Petition No.587 of 2018
(Against the Order dated 28/11/2017 in Appeal No. 286/2017 of the State Commission Chandigarh)
Decided on 5.4.2019
The contention of the complainant was that the appellant only asked to sign the form and the rest of the contents were filled by the agent of the appellant – The entire proposal form was in the handwriting of the agent – Section 45 of the Insurance Act mandated that the policy should not be questioned on any grounds after two years.
Held, since no policy can be questioned, after two years, the grounds for repudiation is not justified.
Further Held, The District Forum directed the Petitioner to pay Rs.5,00,000/- being death claim of the deceased to the Complainant and Rs.25,000/- as Compensation for deficiency in service, unfair trade practice and mental agony suffered by the Respondent alongwith Rs.10,000/- towards cost of litigation. The above order was to be complied within 30 days of its receipt by the Petitioner. Thereafter, they shall be liable for an interest @12% p.a. from the date of institution of this Complaint, till it is paid, apart from cost of litigation. (Para 7)
Result: Revision dismissed.
C. Viswanath, Member—The present Revision Petition is filed by the Petitioner under Section21(b) of the Consumer Protection Act, 1986 against Order passed by the State Consumer Disputes Redressal Commission, U.T. Chandigarh (hereinafter referred to as the “State Commission”) in F.A. No. 286/2017 dated 28.11.2017.
2. In the Complaint, it was stated that in the year 2012 Respondent’s husband Late Sh. Gurbir Singh Riar was issued a Life Insurance ‘Jeevan Anand’ Policy No.165405996 with death sum assured of Rs.5,00,000/-.Under the said Policy, the Respondent was a nominee. The date of commencement of the Policy was 4.12.2012. Unfortunately, on 26.9.2015, due to unknown reasons the husband of the Respondent committed suicide. The Respondent lodged a claim with the Divisional Manager of LIC, but the same was erroneously rejected by the Petitioner, vide letter dated 24.06.2016, on the ground that the deceased concealed material facts at the time of buying the insurance policy. It was further stated that against order of the Divisional Manager of LIC, appeal was filed by the Respondent before the Zonal Manager, LIC of India, Zonal Office, New Delhi. The Zonal Office upheld the repudiation decision of the Divisional Office and dismissed the Appeal, vide order dated 9.11.2016. Respondent then filed an Appeal before the Claims Disputes Redressal Committee, LIC of India, but till date no decision has been taken by the aforesaid Committee. Hence Complaint was filed by the Respondent.
3. The Complaint was contested by the Petitioner stating that after the death of the deceased life assured (for brevity ‘DLA’), a claim was lodged which was immediately examined and it was found that the DLA was suffering from Bipolar Disorder (a mental illness) and had taken treatment from different places and this material information had been deliberately suppressed by him while taking the Policy. In the proposal form made on 2.2.2012, while filling the questionnaire regarding his medical condition, he answered in the negative. However, the deceased remained hospitalised at Neuro Psychiatry and Drug Deaddiction Rehabilitation Centre during 2008 to 2009 and later in 2015. Hence, the claim of the Respondent was repudiated, vide letter dated 24.6.2016, pleading that there was no deficiency in service or unfair trade practice on the part of the Petitioner and prayed for dismissal of the Complaint. Petitioner further stated that the Fora below erred in interpreting Section 45 of the Insurance Act, 1938. According to Section 45 of the Act, which has been amended w.e.f. 26.12.2014, Policy is not to be questioned on ground of misstatement after three years. It was further stated that the State Commission and District Forum failed to appreciate the law laid down by this Commission in RP No.1987 of 2006, Kokilaben Narendrabhai Patel vs. LIC of India dated 5.4.2010. Both the Fora below further failed to appreciate the law laid down by this Commission in RP No.991 of 2010, LIC of India vs. Chhaya Hanmayya Ghante, dated 15.10.2014. In the said case, the Policy was questioned after two years and the Hon’ble Commission had observed that as the insured made untrue declaration, as such the orders of the Fora below were set aside and the Consumer Complaint was dismissed. In the present case, the Hon’ble Commission has referred the case of Mithoo Lal vs. LIC, AIR 1962 SC 814, Life Insurance Corporation of India vs. Asha Goel (2001) 2 SCC 160: (2000) 8 Supreme 521., PC Chacko & Anr. vs. Chairman of LIC of India & Anr. 2008 (1) SCC 321: (2007) 7 Supreme 311. and Satwant Kaur Sandhu vs. New India Assurance Co. Ltd. (2009) 8SCC 16, wherein it was held that the insured was under solemn obligation to make true and full disclosure of information which was within his knowledge, in the proposal form and withholding of such information or making misstatement was a fraudulent act and breach of principle of utmost good faith and the insurer was justified in repudiating the claim unde
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