DHARAM PAL vs Life Insurance Corporation of India

AFTER hearing the learned Counsel for the appellant Mr. Arvind Kashyap, Advocate and going through the impugned order dated 1.5.2003, we find that the District Consumer Disputes Redressal Forum-II (for short hereinafter referred to as the District Forum) has rightly recorded a finding that there has been no deficiency in service or unfair trade practice on the part of the respondent and ultimately in dismissing the complaint. Our reasons stated briefly are as under.

THE case of the appellant/complainant as set out in the complaint case was that Shri Sis Pal Singh (since deceased) son of the appellant/complainant Shri Dharam Pal took a policy of insurance regarding his life and was issued insurance policy covering the risk of the life of the insured w.e.f. 28.2.1995. THE insured Shri Sis Pal Singh mentioned the name of his father Shri Dharam Pal as his nominee in the insurance policy. Shri Sis Pal Singh died as a bachelor on 16.9.1997 and was issueless. THE complainant alleged that Shri Sis Pal Singh was not suffering from any disease either at the time of taking of the policy or even at the time of his death. THE complainant filed his claim with the LIC of India under the said policy being the nominee of the deceased - insured but his claim was repudiated by the LIC vide letter dated 28.6.1999. THE ground on which the claim was repudiated was that the insured at the time of revival of the policy, suppressed and concealed material facts relating to his state of health and stated ''No'' to the question about ever suffering from any illness or disease for a week or more and ''Yes'' to the question ''Are you at present in sound health?''. Annexure RF-4 is the copy of the statement of the deceased - insured Shri Sis Pal Singh regarding the state of health and it showed that he gave his answer ''No'' to the three questions (a), (b) and (c) which related to his suffering from any illness/disease, requiring treatment for a week or more, about his having any operation, accident or injury and about his undergoing ECG, X-ray, Screening, Blood, Urine or Stool Examination. The deceased insured was working as a Junior Technician in Government service vide entry filled against Column 4(a) of Proposal Form (Annexure R-5). Annexure R-6 was the certificate of an employer which was filed by the complainant with the claim. In Column No. 1 of this Form, the deceased was shown as Junior Technician. In Column No. 3, it was stated that there was daily wager only and leave rules are not applicable to him. The certificate was issued by Sub-Divisional Engineer (Electrical) Sub-Division No. 3, Chandigarh Housing Board, Chandigarh. According to the special non-medical LIC insurance scheme, which was placed on record, the employee of the Government, quasi-Government, municipal bodies, school, hospital, State corporations, Government industrial undertakings, reputed commercial firms, private schools, colleges were eligible to take out such a non-medical special policy.

The O.Ps. contended that the deceased-insured was not a permanent Government employee at the time when he took the insurance policy and particularly when its revival was sought. It was further contended that he wrongly mentioned in the Proposal Form that he was a Government servant as Junior Technician. The District Forum held that the policy due to the wrong information regarding the employee became void. The District Forum held that there was suppression of material information regarding the health of the insured inasmuch as the insured gave wrong answers regarding his state of health because it had been proved rather admitted that the insured was suffering from epilepsy and convulsions before taking of the policy and its revival. The insured died in the hospital and the primary cause of his death was Aspiration Pneumonia while the secondary cause of death was epilepsy. The District Forum held that there was a clear nexus between the suppression of material information relating to the state of health i.e. about suffering from epilepsy with the cause of death as well.

THE District Forum, in our considered opinion, has rightly held that the respondent/LIC of India considered the claim and repudiated it for valid ground and reasons and consequently there is no deficiency in service on the part of the LIC of India. Resultantly, the appeal lacks merit and is dismissed in limine. Copies of this order be sent to the parties free of charge. Appeal dismissed.