Kalla Anna Purna vs LIFE INSURANCE CORPORATION OF INDIA

THE complainant is the wife of late K. Venkateswara Rao. He obtained five insurance policies from the opposite party. THE details of which are furnished below : S.No. Date Policy No. Sum Assured 1. 10.10.1976 37219453 Rs. 30,000/ - 2. 10.8.1979 37272271 Rs. 25,000/ - 3. 28.3.1982 64519466 Rs. 50,000/ - 4. 19.3.1988 670117730 Rs. 2,00,000/ - 5. 28.3.1990 670128690 Rs. 2,00,000/ - All the policies were in force. While so he died on 3.7.1990 due to cardiac arrest. THE complainant addressed a letter dated 22.8.1990 to the opposite party informing the sudden demise of her husband and demanded for payment of the sum assured under those policies enclosing the necessary records like all the policies, medical attendance certificate, certificate of identity or burial or cremation, etc. It is also stated that in the first two policies her husband was shown as minor and, therefore, no nomination was made. But in the third policy he nominated his father while in the last two policies he nominated the complainant as nominee. THE Branch Manager of opposite party, Vijayawada enquired about the death of late Venkateswara Rao and submitted a report. After considering the report the opposite party settled the claim of the complainant in respect of first three policies. However they repudiated the claim in respect of the last two policies by their communication dated 14.12.1991 stating that her husband made incorrect statements withholding correct information regarding his death at the time of submitting the proposals. Hence the complainant approached this Commission claiming the sum due under those policies in addition to damages of Rs. 25,000/ -.

IN the counter filed by the opposite party it is stated that the complainants husband suppressed the material facts at the time of the proposals, the certificate issued by the National Institute of Mental Health and Neuro Sciences, Bangalore, shows that the assured was admitted in the said hospital on 11.5.1988 for problems arising out of excess alcoholic consumption having been addicted to the same for five years prior to 1988. They also show that the assured was addicted to drinking for four years prior to 1988 and day drinking for two years. The assured had stated while answering questions 17A, 20 and 23 that he never used alcohol and was never admitted into the hospital. As the husband of the complainant had given false declaration which is the basis for the policy the claim of the complainant was repudiated. On the side of the complainant Exs. A -1 to A -11 were marked and the opposite party marked Exs. B -1 to B -6.

THE point that arises for consideration is whether the repudiation of the claim of the complainant as per the communication dated 14.12.1991 is bad and illegal ?

THERE is no dispute that the complainants husband took five policies out of which first two policies were taken while he was a minor and the other three policies were taken after he became major. The last two policies were taken on 19.3.1988 and 28.3.1990 and he died on 3.7.1990. The first three policies were for a sum of Rs. 30,000/ -, Rs. 25,000/ - and Rs. 50,000/ - respectively. The last two policies were for Rs. 2,00,000/ - each. There is no evidence to show why the complainants husband suddenly took huge policies of Rs. 2,00,000/ - each in 1988 and 1990 even though he was having three policies by then. That apart he has made statements while answering questions 17(a), 20 and 23 while submitting the proposals that he was never admitted into the hospital for any ailment and for treatment for more than a week and that he never used alcohol. The certificate issued by Dr. Mathew Varghese, M.D., Assistant Professor of Psychiatry, Nimhans, Bangalore (marked Ex. B -2) dated 2.12.1991 shows that the assured was admitted into the hospital on 11.5.1988 for problems arising out of excess alcohol consumption since he was addicted to the same for five years prior to 1988. So also Ex. B -3 letter shows that the complainants husband was a chronic alcoholic. Under Ex. B -3 he was referred by Dr. N.V. Ramana Rao, Professor of Psychiatry, Guntur Medical College to Prof. Chennabasavanna stating that he is referring the complainants husband aged 26 years who is chronic alcoholic for favour of management. Ex. B -2 also shows that the complainants husband was daily drinking for four years prior to 1988 and day drinking two years prior to 1988. This also shows that the complainants husband was admitted on 11.5.1988 in the hospital and discharged only on 9.6.1988. Therefore, we are of the view that the husband of the complainant did not make true and correct statements about his health and treatment in the hospital at the time of submitting the proposals. Condition No. 5 of the policy clearly states that in case any incorrect statement is contained in the proposal or declaration and any material information is withheld subject to the provisions of Section 45 of the Insurance Act the policy shall be void and all claims shall cease. In view of this condition we cannot find fault with the opposite party Insurance Company when they repudiated the claim of the complainant. This condition is based on uberima -fides. Therefore, we do not find that there is any deficiency in service in repudiating the claim of the complainant by the opposite party. If there is a breach of violation of the trust or faith it is open to the opposite party to terminate the contract.

THE complaint, therefore, fails and is accordingly dismissed. No costs. Complaint dismissed.