IN THE NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION AT NEW DELHI

01.07.2025 RESERVED ON:

PRONOUNCED ON: 08.09.2025 CONSUMER COMPLAINT NO. 2015 OF 2019 Smt. Kanta W/o Late Sh. Yogesh Kumar R/o Block -A, Flat No.904, Manglam, the Grand Residence, Vaishali Nagar, Jaipur, Rajasthan - 3020120 … Complainant Versus

1. Life Insurance Corporation Through its Manager (Claims)

Jaipur Division Il Plot No. A-20, Nangi Plaza, Opp Gandhi Nagar Railway Station, Anita Colony, Jaipur, Rajasthan - 302015.

2. Life Insurance Corporation of India Through its Managing Director Central Office, Yogakshema Building, Jeevan Bima Marg, Mumbai, Maharashtra -40021 …Opposite Parties BEFORE:

HON’BLE AVM J RAJENDRA AVSM VSM (Retd) PRESIDING MEMBER HONBLE MR. JUSTICE ANOOP KUMAR MENDIRATTA, MEMBER For Complainant : Mr. Karthik Yadav, Advocate (VC)

For Opposite Parties : Mr. Sanjay K. Chadda and Mr. Amiditya Sharma, Advocates

JUDGMENT

Air Vice Marshal J. RAJENDRA, AVSM VSM (Retd.), 1. The present Consumer Complaint has been filed under Section 21 of the Consumer Protection Act, 1986 (for short “the Act”) against the Opposite Parties seeking to direct the OPs:

“a) The Opposite Parties be directed to pay a total sum of Rs. 1 crore along with Interest @18% pa on the said amount from the date of death till actual realization to the Complainants on account of unfair trade practice and deficiency in service, b) Rs. 10 Lacs as compensation on account of mental harassment and agony suffered by the Complainants, -

c) Rs. 50,000/ as litigation costs.”

2. Brief facts, as per the complaint, are that on 16.04.2017, the Complainant’s husband (Life Assured) submitted a Proposal Form to the OP, Insurer seeking a Life Insurance Policy for Rs. 1 Crore on an annual premium @ Rs. 18,400/- for a period of 20 years. The risk under the policy commenced from 18.05.2017. As per the Proposal Form, he maintained good health with sober habits (non-smoker and non- alcoholic). On 29.04.2017, The OP’s empanelled doctors conducted ECG and Treadmill Tests at Jaipur, and all parameters were reported to be normal. Later, a Medical Examiner’s Confidential Report dated 29.04.2017 was issued by the OP stating that all the health parameters were normal, except for imperfect eyesight. Based on its medical evaluation, OP issued Policy No. 895830099 dated 18.05.2017 in his favour. On 23.12.2017 at 12:22 PM, the Life Assured died of sudden cardiac arrest at Jaipur. The Complainant submitted the death claim under the policy to the OP on 20.01.2018 in the prescribed format, along with a Medical Attendant’s Certificate dated 11.01.2018 which recorded in column 5(a) that the habits of the Life Assured were sober, and in column 5(b) that the attack was not caused or aggravated by any intemperate habits. Surprisingly, vide letter dated 08.03.2018, the OP wrote to the concerned Police Station enquiring whether any FIR or complaint under the Domestic Violence Act had been lodged against the Deceased Life Assured (DLA). In response, it was confirmed that no such complaint or FIR was ever registered against him. Subsequently vide letter dated 12.07.2018, OP sought comments from Dr. Arun Mathur regarding the DLA’s treatment. In response, Dr. Mathur stated he treated the DLA with homeopathic medicine for chronic bronchitis, which relieved symptoms in 3 to 4 months. He clarified that such treatment, typically used for cough and flu-like symptoms, had no connection with the cause of death or any alleged suppression of material fact. He further stated that the said homeopathic treatment was undergone by the DLA. It is the case of the Complainant that despite the above, on 08.10.2018, the OP repudiated her claim on the ground that there was suppression of material facts in the Proposal Form, specifically the omission of disclosure regarding undergoing homeopathic treatment and availing sick leave by the DLA. Aggrieved by the said repudiation, she filed the present complaint.

3. Upon notice, the complaint was resisted by the OP