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NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
V.K. Jain, Presiding Member
L.I.C. of India and Ors. —Appellants
versus
Deep Chand Sood and Ors. —Respondents
First Appeal No.318 of 2008 and 53 of 2009
Decided on 17.3.2020
Counsel for the Parties:
For the Appellants:Ms. Shomona Khanna, Advocate & Ms. Khushboo Prateek, Advocate
For the Respondents:Mr. Ashok Kashyap, Advocate
IMPORTANT POINT
Repudiation of Life Insurance claims on ground of suppression of material facts held justified.
Headnote:
Consumer Protection Act, 1986 – Section 19 – Consumer Protection Act, 2019 – Section 41 – Life Insurance – Policy claim – Repudiation of claim – Same policy claimed have been repudiated on ground that deceased having withheld material information regarding her health at the time of effecting the assurance with us – As per materials on record, deceased found to have suppressed material facts regarding her health – Deceased insured being an educated person and a nurse by profession cannot claim that the proposal form was submitted by her without giving through its contents through even such a defence is otherwise not legally sustainable – Thus, consumer complaint dismissed – Impugned order set aside. (Paras 6 to 15)
Result: Order accordingly.
ORDER
V.K. Jain, Presiding Member—Late Smt. Rama Sood, who was employed as a Staff Nurse in a School obtained as many as 19 insurance policies from the petitioner LIC of India. The details of the said policies, as noted in the written version to the complaint and in the order of the State Commission were as follows:
| Sr. No. | Policy No. | Table & Term | Sum Assured | Proposal Date | Remarks | Status at Death | Last Premia paid on |
| 1 | 130403584 | 75-20 | 25,000 | 22.12.86 | Revived on 30.9.03 | Death | 19.10.04 |
| 2 | 130405172 | 75-20 | 10,000 | 28.12.87 | Revived on 30.3.02 | In force | 19.10.04 |
| 3 | 150100344 | 74-15 | 50,000 | 28.7.90 | Revived on 30.9.03 | In force | 30.9.2003 |
| 4 | 152336677 | 14-20 | 1,00,000 | 15.2.96 | Not revived | In force | 28.04.05 |
| 5 | 152372724 | 89-15 | 1,00,000 | 28.3.99 | Not revived | In force | 28.04.05 |
| 6 | 150798290 | 14-15 | 1,00,000 | 28.03.2K | Revived on 19.10.04 & Repudiated | In force | 19.10.04 |
| 7 | 152400755 | 14-14 | 2,00,000 | 28.03.02 | Not revived | In force | 28.04.05 |
| 8 | 151280124 | 14-16 | 1,00,000 | 28.10.02 | Not revived | Lapsed | 31.10.02 |
| 9 | 151321656 | 151-15 | 5,00,000 | 15.02.03 | Not revived | Lapsed | 28.02.03 |
| 10 | 151329959 | 159-11 | 2,00,000 | 22.10.03 | Not revived | Lapsed | 17.11.03 |
| 11 | 151329994 | 14-06 | 1,00,000 | 22.10.03 | Not revived | Lapsed | 17.11.03 |
| 12 | 151460678 | 102-33 | 5,00,000 | 07.12.03 | Not revived | Lapsed | 08.12.03 |
| 13 | 152429832 | 14-27 | 5,00,000 | 15.02.04 | Repudiated | In force | 28.04.05 |
| 14 | 152411383 | 149-27 | 3,00,000 | 28.02.04 | 10 Gaps | Lapsed | 28.04.05 |
| 15 | 151612717 | 149-27 | 18,00,000 | 18.08.04 | Repudiated | In force | 16.02.05 |
| 16 | 152365382 | 14-06 | 50,000 | 28.03.97 |
| Matured |
|
| 17 | 130405909 | 90-15 | 30,000 | 12.05.88 |
| Matured |
|
| 18 | 150876629 | 90-15 | 1,00,000 | 28.11.00 | Not revived | Matured |
|
2. Late Smt. Rama Sood having died on 20.4.2005, claims for payment in terms of the aforesaid policies were preferred by the complainants, they being her legal representatives. The claim against the following eight policies stand duly paid:
| Sl. No. | Policy No. | Date on which admitted | Amount paid |
| 1. | 130405172 | 14.01.2001 | 12095.00 |
| 2. | 130403584 | 14.1.2006 | 25404.00 |
| 3. | 150100344 | 14.1.2006 | 87951.00 |
| 4. | 130405909 | 28.6.2003 | 34818.00 |
| 5. | 152365382 | 28.3.2003 | 66449.00 |
| 6. | 152372724 | 13.7.2005 | 130306.00 |
| 7. | 152336677 | 28.6.2005 | 123393.00 |
| 8. | 152400755 | 28.6.2005 | 224203.00 |
3. It would also be seen from Chart-A that policies No. 151280124, 51321656, 51329959, 151329994, 151460678 and 152411383 had lapsed on account of the premium having not been paid. The policies having lapsed within less than two years, no claim for the aforesaid lapsed policies was payable. As far as policy No. 150876629 at Sl. No. 18 is concerned, there is no evidence of any premium having been paid after taking the policy and therefore, the aforesaid policy had also lapsed. It was informed by the learned counsel for the Corporation during the course of hearing that the aforesaid policy was taken under Marriage / Education Endowment Plan and the amount which was payable under the said policy, despite its having lapsed stand duly paid. Therefore, the dispute between the parties is confined to payment in terms of three insurance policies bearing No. 150798290, 152429832, 151612717.
4. The insurer repudiated the claim against policy No. 150798290, 152429832, 152411383, vide letters dated 06.1.2006, which to the extent they are relevant read as under:
“Reg: Death claim Policy No. 150798290 in the name of late Shri Bal Smt. Rama Sood Sum Assured Rs. 1,00,000-Plan & Term 14-15 (DAB)
With reference to you claim under the above po
