Life Insurance Corporation Of India vs Prem Devi

This revision petition has been filed by the petitioner Life Insurance Corporation of India against the order dated 20.9.2016 of the State Consumer Disputes Redressal Commission, Rajasthan, (in short 'the State Commission') passed in First Appeal No.953 of 2014.

Brief facts of the case are that the husband of the complainant was insured under Money Plus Plan bearing No.195663483 on 26.03.2007. The husband of complainant/applicant was depositing the insurance premium regularly without any break. The last instalment of the premium was paid on 07.03.2008 and the next date of depositing was falling due on March, 2009 but prior to this date the husband of the complainant/applicant suddenly died on 25.01.2009. The complainant/applicant filed death claim with the opposite party. The claim was repudiated vide letter dated 13.03.2009 on the ground that the Deceased Life Assured (DLA) suppressed the material information at the time of filing of the proposal that he was suffering from tuberculosis and had taken the treatment in a Government hospital. The complainant then filed a consumer complaint No.1253 of 2012 (old no.111/2010) before the District Consumer Disputes Redressal Forum, Jaipur-III (in short 'the District Forum'). The complaint was resisted by the opposite party on the same ground as mentioned in the repudiation letter. The opposite party filed a certificate from Primary Health Centre Divrala signed by the Medical officer certifying that Shri Banshi Dhar, the insured was treated of tuberculosis from 27.10.2006 to May 2007 and from 16.1.2008 to 30.11.2008. The District Forum allowed the complaint and directed the opposite party to pay Rs.1,00,000/- along with 15% p.a. interest from the date of filing of the claim till the actual payment in addition to a compensation of Rs.11,000/- for mental agony and cost of litigation. The petitioner/opposite party preferred appeal before the State Commission being Appeal No.953 of 2014. The State Commission dismissed the appeal vide its order dated 20.09.2016.

Hence the present revision petition.

Heard the learned counsel for the petitioner Insurance Company. The respondent/complainant was proceeded ex-parte vide order dated 01.8.2019 as none turned up even after service of notice.

Learned counsel for the petitioner stated that the husband of the complainant i.e. DLA was suffering from tuberculosis at the time of filing of proposal form as is clear from the certificate given by the Primary Health Centre Divrala, wherein the Medical Officer has certified that the husband of the complainant Shri Banshi Dhar was suffering from tuberculosis and took treatment at the Primary Health Centre from 27.10.2006 to 5.2007 and from 16.1.2008 to 30.11.2008. The District Forum allowed the complaint on the ground that the DLA was an illiterate person, therefore, he could not know what was filled in the proposal form. By giving advantage of this fact to the DLA, the complaint was allowed. The State Commission dismissed the appeal on the ground that the certificate submitted by the Insurance Company did not have any serial number and date. Learned counsel asserted that the certificate has been issued by a competent authority of Government Primary Health, Centre therefore, it cannot be disbelieved. Both the fora below have erred in appreciating the certificate in its proper prospective. Accordingly, it was prayed that the order of the fora below be set aside and revision petition may be accepted.

I have carefully gone through the record of the case and have considered the arguments advanced by the learned counsel for the petitioner. First of all, both the fora below have given concurrent finding of fact that the certificate submitted by the Insurance Company is not believable. Against the concurrent finding of fact, this Commission has limited jurisdiction in the revision petition as held by Hon'ble Supreme Court in Mrs. Rubi (Chandra) Dutta vs. United India Insurance Company, 2011 (3) Scale 654, wherein the following has been observed:-

"Also, it is to be noted that the revisional powers of the National Commission are derived from Section 21 (b) of the Act, under which the said power can be exercised only if there is some prima facie jurisdictional error appearing in the impugned order, and only then, may the same be set aside. In our considered opinion there was no jurisdictional error or miscarriage of justice, which could have warranted the National Commission to have taken a different view that what was taken by the two Forums. The decision of the National Commission rests not on the basis of some legal principle that was ignored by the Courts below, but on a different (and in our opinion, an erroneous) interpretation of the same set of facts. This is not the manner in which revisional powers should be invoked. In this view of the matter, we are of the considered opinion that that the jurisdiction conferred on the National Commission under Section 21(b) of the Act has been transgressed. It was not a case where such a view could have been taken, by setting aside the concurrent finding of two fora."

From the above it is clear that the facts cannot be reassessed by this Commission at the stage of revision petition against the concurrent finding given by both the fora below. Moreover, the authenticity of the certificate becomes doubtful as it does not carry any serial number or the date when it has been issued. The certificate has not been proved by the Insurance Company before the District Forum by filing the affidavit of the concerned doctor or any other officer from Primary Health Centre Divrala. In such circumstances, fault cannot be found with the order of the State Commission.

Based on the above discussion, I do not find any illegality, material irregularity or jurisdictional error in the order dated 20.09.2016 of the State Commission which calls for any interference from this Commission. Consequently, the revision petition No.3513 of 2016 is dismissed.