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Cause Title/Judgement-Entry
IN THE STATE CONSUMER DISPUTES REDRESSAL COMMISSION
ODISHA, CUTTACK
 
First Appeal No. A/183/2018
( Date of Filing : 11 Apr 2018 )
(Arisen out of Order Dated 05/02/2018 in Case No. Complaint Case No. CC/45/2017 of District Balangir)
 
1. Life Insurance Corporation of India
represented Manager, Legal & HPF Department, Life Insurance Corporation of India, Sambalpur Division Office, Jeevan Prakash, Post Box No. 04, Ainthapali, Sambalpur.
...........Appellant(s)
Versus
1. Baidyanath Agrawal
S/o- Fatechand Agrawal,R/o- Vill/Po- Bhaler,Ps- Puintala, Dist-Bolangir.
...........Respondent(s)
 
BEFORE: 
 HON'BLE MR. JUSTICE Dr. D.P. Choudhury PRESIDENT
 
PRESENT:Mr. S.K. Mohanty, Advocate for the Appellant 1
 M/s. B.N. Bhol & Assoc., Advocate for the Respondent 1
Dated : 25 Nov 2021
Final Order / Judgement

                       Heard the learned counsel for both the parties.

2.              This appeal is  filed  U/S-15 of erstwhile  Consumer Protection Act,1986(herein-after called the Act). Hereinafter, the parties to this appeal shall be referred to  with reference to their respective status before the learned District Forum.

3.               The factual  matrix  leading to the case of the complainant is that the complainant’s brother  Bishnulal Agrawal  has purchased   three insurance policy vide policy No.594932423,594938279 and 594944509 from OP  on 23.2013,28.10.2014 and  21.11.2015 respectively.  It is alleged inter-alia that brother  Bishnulal Agrawal expired on 14.12.2015. Thereafter the claim was made but it was repudiated by the OP stating that the policy holder has suppressed his pre-existing disease  challenging the repudiation by erring  same as deficiency of service on the part of the OP, complaint was filed.

4.          Per Contra,the OP filed written version stating that they have sold three policies to the complainant. They have also admitted that the policy holder died on 14.12.2015 leaving complainant as nominee but they averred that the policy holder has suppressed his pre-existing disease namely old Cardiac RHD and doctor has served same. As the policy holder suppressed the material facts there is violation of Section-45 of the Insurance Act(herein-after called the  Insurance Act. So, they have discharge the duty by not allowing the claim.

5.              After hearing both the parties, learned District Forum has passed the following order:-

    “  The O.Ps are directed to pay Rs.5,00,000/-,Rs.5,50,550/- and Rs.5,00,000/- vide Policy No. 594932423,594938279 and 594944509 respectively, totaling a sum of Rs.15,50,550/-(Rupees Fifteen lakhs fifty thousand five hundred fifty) to the complainant within one month from the date of receipt of this order alongwith interest @ 10% P.A. from the date of repudiation i.e. 25.03.2017 till payment. The O.Ps are further directed to pay Rs.5,000/-(Rupees Five thousand)only towards litigation expenses to the complainant within the aforesaid period.”

6.             Learned counsel for the appellant submitted that learned District Forum has committed error in law by allowing the complaint without going through the written version filed by the OP with all perspective. According to him U/S-45 of the Insurance Act, OP has proved the  report of doctor showing the policy holder as old  Cardiac RHD  patient but learned District  has not accepted the same. On the otherhand learned District Forum has not applied judicial mind to the fact and circumstances of the case. He further submitted that since the policy holder has filled up the proposal form denying all the diseases but the  OP has adduced the  medical opinion of doctor. Learned District Forum ought to have dismissed the case of the complainant. Hence  he submitted to set-aside the impugned order by allowing the appeal.

7.           Learned counsel for the respondent  submitted that the OP has utterly failed to prove their plea.  Learned District Forum has rightly decided the case in favour of the complainant. On the


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