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NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
Prem Narain, Presiding Member and C. Viswanath, Member
Sunita and Anr. —Petitioners
versus
HDFC Standard Life Insurance
Co. Ltd. —Respondent
Revision Petition No.3178 of 2013
(Against the Order dated 27/05/2013 in Appeal No.1977/2007 of the State Commission Karnataka)
Decided on 9.11.2020
Counsel for the Parties:
For the Petitioners:Mr. Gurudatta Ankolekar, Advocate
For the Respondent:Mr. Joydeep Bhattacharya, Advocate
IMPORTANT POINT
For suppression of information regarding health of insured, complaints dismissed.
Headnote:
Consumer Protection Act, 1986—Section 21(b) : [Consumer Protection Act, 2019—Section 58]—Insurance Act, 1938—Section 45—Children’s Double Benefit Policy—Death claim—Repudiation—Legality of—Insured had taken aforesaid policy from 11.3.2003, however, she expired on 17.2.2006—Petitioners of children of the insured—No need to examine the authors of the documents i.e. claim form, death summary and doctor’s report, as produced by parties in such cases—As per death summary, inured was suffering from liver problem since 4 to 5 years—As per Hospital certificate, deceased was suffering from Hepatitis infection chronic with partial hypertension since January, 2003—However, Policies, were taken in March, 2003 i.e., 3 years before her death—Death of DLA was due to liver cirrhosis—DLA being aware of the ailment, but has not furnished incorrect information in the insurance policy proposal forms—Since information regarding medical condition of the issued was suppressed, petitioners cannot avail benefit of section 45, Insurance Act, 1938—Dismissal of complaint by state commission upheld. (Paras 8 to 13)
Result: Petition dismissed.
ORDER
C. Viswanath, Member.—The present Revision Petition is filed by the Petitioners under Section 21(b) of the Consumer Protection Act, 1986 against Order passed by the Karnataka State Consumer Disputes Redressal Commission, Bangalore (hereinafter referred to as the “State Commission”) in First Appeal No.1977/2007 dated 27.05.2013.
2. Petitioners are the children of the insured Tulsa Bai Kamalapur. The insured had taken HDFC Children’s Double Benefit Policy bearing Nos.143275 and 143262 for a sum of Rs.1,00,000/- each, Policies commencing from 11.03.2003. Tulsa Bai Kamalapur expired on 17.02.2006. Father/guardian of the Petitioners submitted insurance death claim with the Respondent/Insurance Company, which repudiated the claim on the ground that the insured had suppressed material facts in the proposal form. Aggrieved by repudiation of the claim, Complainants filed Consumer Complaint before the District Forum with the following prayer: -
“i). To pay Rs.2,00,000/- alongwith bonus and benefits and on that amount interest @ 18% from 17.02.2006 till the date of realization in respect of Petitioner No.2.
ii) To pay Rs.2,00,000/- alongwith bonus and benefits and on that amount of interest @ 18% from 17.02.2006 till the date of realization in respect of Petitioner No.2.
iii) To pay Rs.1,00,000/- towards mental agony to each petitioner.
iv) To pay the cost of the instant proceedings.”
3. Opposite Party/Insurance Company resisted the claim on the ground that the insured Tulsa Bai Kamalapur suppressed the material fact that she was suffering from diseases relating to “disorder of liver.” It was further submitted that the insured had violated the doctrine of utmost good faith which would enable the Insurance Company to take decision about grant of insurance. Death certificate issued by Care Hospital, Hyderabad admitted the death to HBV related cirrhosis of liver with portal hypertension and Hepato Renal Syndrome. In addition, Department of Gastroenterology of Care Hospital had given the past history as “known case of HBV related cirrhosis of liver with portal hypertension since 4 to 5 years.” Tulsa Bai Kamalpur had taken the Policy in March 2003 and before that date she was suffering from cirrhosis of liver, which is a life threatening disease. The disease cirrhosis of liver is long drawn and is usually fatal. It was further submitted that the Policy had been obtained fraudulently with the intention to make undue pecuniary gain. The District Forum, after hearing both the parties and appreciating the evidence led by them as well as based the record of the case, rejected the contention of the Opposite Party/Insurance Company and allowed the Complaint as follows: -
“Complaint is allowed. Guardian of the complainants i.e. Subhashchandra Kamalapur is entitled to recover a sum of Rs.2,00,000/- towards payment of death claim with regard to the policy No.143262 pertaining to Sunita with interest @ 6% per annum from the date of filing of this complaint till the date of realization from O.P. Further he is also entitled to recover a sum of Rs.2,00,000/- towards payment of death claim with regard to the policy No.143275 pertaining to the Mahesh with interest @ 6% per annum from the date of filing of this complaint till the date of realization from O.P. Further he is also entitled to recover a sum of Rs.2,000/- towards mental agony and cost of this proceedings from O.P. Complainants’ father Subhashchandra who is natural guardian of complainant No.1 and 2 is directed to deposit the said amount in the name of complainant No.1 and 2 in any nationalized bank till they attain the majority since Tulasabai died leaving behind her children. However, Subhashchandra Kamalapur who is natural guardian of complainant No.1 and 2 is directed to withdraw the interest on the said amount for the purpose of their education etc. Further O.P. is directed to pay the said amount within one month from the date of this order.”
4. Aggrieved by the order passed by
