BEFORE A.P STATE CONSUMER DISPUTES REDRESSAL COMMISSION AT HYDERABAD

F.A.No.40 OF 2011 AGAINST C.C.NO.52  OF 2010 DISTRICT FORUM ANANTHAPUR

Between:

Smt J.Nagaratna W/o late J.Bayanna Gowd
D.No.22-216, Kuruba Street, Old Town,
Anantapur, Anantapur Dist.

                                                        Appellant/complainant

                A N D

The Branch Manager,
Shriram Life Insurance Co.Ltd.,
Subash Road, Anantapur

                                                        Respondent/opposite party

Counsel for the Appellant                      M/s I.Venkata Prasad

Counsel for the Respondent                   M/s K.R.R.Associates

          QUORUM:   SRI R.LAKSHMINARASIMHA RAO, HON’BLE MEMBER

                                                AND

SRI THOTA ASHOK KUMAR, HON’BLE MEMBER

TUESDAY THE ELEVANTH DAY OF SEPTEMBER

                                TWO THOUSAND TWELVE

Oral Order (As per Sri R.Lakshminarasimha Rao, Hon’ble Member)

                                        ***

1.             The unsuccessful complainant has filed the appeal contending that the District Forum has not considered her claim, in correct perspective and that it had committed a grave error in not considering ExB7, the letter dated 21.01.2010 sent by the zonal office of the respondent-insurance company to its claim department.

2.             The facts leading to the filing of the appeal are that the appellant’s husband obtained Life Insurance Policy bearing no. LN080800077792 dated 24.04.2008 with the risk commencing from 24.04.2008 for a sum assured amount of `1.5 lakh. He paid premium of `20,000/- and was examined by the panel doctor of the respondent-insurance company before the proposal submitted by him was accepted .He died on 10-11-2009. After the death of her husband, the appellant filed claim with the respondent -insurance company. The appellant got issued notice dated 5-03-2010 with request to pay the sum assured.

3.             The respondent resisted the claim contending that the appellant’s husband had knowledge of his ill-health and suppressed his health history. The respondent conducted investigation which revealed that the insured was a known case of bronchial asthma since his childhood, having history of Old Koch’s Cor Pulmonale. He suppressed the pre-existing disease in the proposal form dated 31.03.2008.Had he informed the respondent-insurance company about his health history, the respondent would not have issued the insurance policy. The respondent collected the medical records of the insured from the NIMS and Pavani Multi Speciality Hospital, Hyderabad.

4.             The  appellant  has filed her affidavit and the documents, Exs.A1 to A9.  On behalf of the respondent, its Assistant General Manager, E.Sridhar and its Assistant Manager, B.Venugopal Rao  had filed his affidavit and the documents,ExB1 to B9. 

5.             The District Forum has dismissed the complaint on the premise that the appellant’s husband  suppressed his previous ailments such as asthma, Old Koch’s disease and Cor pulonale etc.,

6.             The learned counsel for the respondent- insurance company has filed written arguments.

7.             The points for consideration are:

1)           Whether the appellant’s husband has suppressed any material fact at the time of submitting the proposal?

2)           To what relief?

8.             POINTS NO.1:  The respon