DIVISIONAL MANAGER, LIFE INSURANCE CORPN. OF INDIA vs PRATIMA MANSINGH

THIS appeal is by the Life Insurance Corporation of India (''LIC'', for short) against the order of the District Forum directing them to pay a sum of Rs. 1,10,000/- with interest at the rate of 12 per cent per annum under Life Insurance Policies under the Salary Savings Scheme and also to pay a sum of Rs. 500/- as cost.

ADMITTEDLY the deceased Abhimanyu Mansingh while serving as a Teacher under the Block Development Officer, Tangi took out two life insurance policies, one on 27.2.1993 for Rs. 30,000/- and the other on 24.11.1994 for Rs. 50,000/-. They were under the Salary Savings Scheme and the premiums were being deducted from his salary. Since he was ailing for sometime past, the premiums for the months of January to March, 1995 were deducted in the month of August, 1995. A claim was made by the complainant, as the nominee under the policies, which was repudiated by the LIC on the ground that prior to his death the deceased was suffering from cancer and this fact was suppressed from the LIC and the policies were issued in good faith. Once there was a suppression of material fact, they pleaded, the repudiation was justified. The District Forum held that the complainant was entitled to the amount in question under the policies, since there was no material placed from the side of the LIC that the deceased was under treatment for cancer in between the dates from 29.3.1994 to 10.5.1994.

We have heard Mr. Samantray, learned Counsel for the LIC and Mr. R.K. Mohanty, learned Counsel for the complainant. We have perused the impugned order and also materials on record. The LIC took the plea that the deceased was suffering from cancer and was undergoing Radio Therapy during the period from 29.3.1994 to 10.5.1994. The District Forum has rightly held that there was lack of materials on record to support the case of the LIC that the deceased was undergoing Radio Therapy at Acharya Harihar Regional Cancer Centre, Cuttack, from 29.3.1994 to 10.5.1994, because in the written version the LIC have taken the ground that this information was given to them by the Director of the Cancer Centre in his letter dated 13.10.1998. But we may point out that the treatment was from 29.3.1994 to 10.5.1994, the 1st policy was taken on 27.2.1993 and the 2nd one on 24.11.1994. At least by 27.2.1993 when the proposal for the first policy for Rs. 30,000/- was accepted, there was no case of suppression of the disease of cancer. The duplicate Xerox copy of the certificate from the Cancer Centre, Cuttack is on record and we accept the case of the LIC that the deceased took 43 days of Radio Therapy treatment between 29.3.1994 and 10.5.1994 for Carcinoma of Trachea. Thus admittedly on the date of proposal in respect of the second policy, i.e. 24.11.1994 the deceased was already under treatment for cancer till 10.5.1994 as stated above. Therefore, in the case of the second proposal, that is relating to policy No. 581170861 dated 24.11.1994 for Rs. 50,000/-, there was suppression of the fact that the deceased had undergone Radio Therapy. Therefore, we are of the view that the complainant cannot avail the benefit under that policy. But so far as the first policy is concerned there was total lack of material to hold that as on 27.2.1993 he was suffering from this ailment and that he suppressed this.

IN the result, we confirm the findings of the District Forum and the decision thereof with the modification that the complainant shall be entitled to get Rs. 30,000/- (Rupees thirty thousand) with interest, bonus, etc. under the first policy. Her claim in respect of the second policy for Rs. 50,000/- rejected. The appeal is partly allowed with the modification. No cost of this Commission. Appeal partly allowed.