UTTAR PRADESH STATE CONSUMER DISPUTES REDRESSAL COMMISSION
Bhanwar Singh, President and Rachna, Member
LIFE INSURANCE CORPORATION OF INDIA AND ANR. - Appellants
Versus
SUBHASH - Respondent
Appeal No. 400 of 2006
Decided on : 17-03-2009
Material Concealment - Life Insurance - [Consumer Protection Act, 1986, Section 12(1)(b)] - The court discussed the provisions of the Consumer Protection Act, 1986, specifically Section 12(1)(b) which deals with unfair trade practices. The court highlighted the principle that the burden of proof lies on the insurer to establish material concealment by the insured. The court also referenced a previous decision by the National Consumer Disputes Redressal Commission to support its conclusion.
Fact of the Case:
The deceased had four life insurance policies with the Life Insurance Corporation of India. The insurer refused to pay the insured amounts, alleging material concealment of the deceased's kidney disease.
Finding of the Court:
The court found that there was no evidence to support the insurer's contention of material concealment by the deceased. The court dismissed the appeal and imposed costs on the appellant.
Issues: The main issue was whether the deceased had materially concealed his kidney disease, affecting the validity of the insurance policies.
Ratio Decidendi: The court held that the burden of proof lies on the insurer to establish material concealment by the insured. The court also relied on a previous decision to support its conclusion.
Final Decision: The appeal was dismissed, and costs were imposed on the appellant.
ORDER
Bhanwar Singh, President (Oral)- Case called out. Mr. Vineet Srivastava, learned Counsel for the appellants is present and he seeks adjournment to which Mr. S.K. Sharma does not agree in view of two earlier adjournments sought by Mr. Vineet Srivastava one on 12.12.2008 and the other on 5.1.2009. Therefore, the request for adjournment is declined.
2. We have heard Mr. S.K. Sharma, learned Counsel for the respondent and perused the record. By means of the impugned judgment dated 20.1.2006, the District Consumer Forum, Hardoi has allowed the respondent's complaint thereby directing the Life Insurance Corporation of India to pay to her the insured amounts of four life insurance policies of the deceased Mr. Ravindra Pal Singh. Mr. Singh had acquired four insurance policies during his life-time, the details of which may be furnished as follows:
| Policy No. | Amount | Date of risk |
|
| 220704760 | Rs. | 15,000.00 | 31.10.1992 |
| 221510761 | Rs. | 75,000.00 | 31.3.1999 |
| 221524221 | Rs. | 1,00,000.00 | 28.3.2001 |
| 221524224 | Rs. | 1,40,000.00 | 28.3.2001 |
3. It would be relevant to note that the first two policies lapsed but revived on 31.8.1998 and 25.9.2000 respectively. In other words, all the four polices were operational on the date on which Sri Ravindra Pal Singh died i.e., October 23, 2001. The Life Insurance Corporation did not honour its commitment as laid under the terms and conditions of the policies, rather kept the matter pending for four years altogether and pleaded in its written statement filed before the Forum below that the claim of the respondent on account of all the four policies could not be entertained as there was material concealment on the part of the deceased. Narrating the details of the alleged material concealment, the Life Insurance Corporation submitted that deceased suffered from the kidney disease prior to the date of revival of the two polices obtained in the years 1992 and 1999. However, the Life Insurance Corporation could not produce any evidence before the Forum below whereby it would have been established that the deceased was at any point of time suffering from the renal problem. Neither there was any medical prescription nor a certificate of any doctor relied, in support of its contention. The appellant has filed few documents along with affidavit of Sri B.P. Tewari clearly admitting therein that these documents could not be filed before the Forum below.
4. At this stage Mr. Vineet Srivastava has resumed his arguments and referred to the Medical Attendant's certificate paper No. 18, in column 6 of which two dates are mentioned. These are 15.5.2001 and 8.6.2001. Perhaps, recital of these dates referred to the history commencing from the first date of disease having struck to the deceased. Both these dates fall subsequent to the date of four policies having been revived and acquired. To be specific two policies of Rs. 15,000.00 and Rs. 75,000.00 were revived long before the date of commencement of the medical history and revival of the respective policies took place on 31.7.1998 and 25.9.2000. The other two policies of Rs. 1,00,000.00 and Rs. 1,40,000.00 had admittedly been acquired on 28.3.2001. Obviously, thus, this history cannot be referred to the pre-policy period. There is no other documentary evidence on record to show that the deceased was suffering from either kidney problem or liver problem.
5. Mr. Vineet Srivastava, who has appeared for the L.I.C., has also referred to the chart of the medical and sick leave pertaining to the deceased. This chart was issued on 6.9.2004 by the Avadh Gramin Bank wherein the deceased was serving prior to his death. No doubt this chart indicates that the deceased had availed of sick leave and other kind of leave some times for long intervals but this alone is not sufficient to prove that he was a patient of liver or renal failure. Mr. Vineet
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