Life Insurance Corporation of India vs RUKMANI DHARAMSHAKTU

THIS is an appeal against the judgment and order dated 1.6.1995 passed by the District Forum, Pitthoragarh in Complaint No. 137/1993, Smt. Rukmani Dharamshaktu v. Life Insurance Corporation of India, whereby the complaint of the claimant was allowed by the District Forum for recovery of the insured amount on the death of the husband of the complainant.

THE brief facts of the case are that Sh. Jeevan Singh Dharamshaktu, the husband of the complainant submitted the proposal form for Life Insurance Policy on 30.12.1985 for a sum of Rs. 50,000/- (Rupees fifty thousand only). THE policy was given with risk commencing from 28.12.1985. THE premium was not regularly paid, therefore, for non-payment of premium in December, 1987 the policy lapsed. On 7.3.1992 the insured again submitted proposal along with arrears of premium for the revival of the policy. THE Insurance Company accepted the proposal and premium and revived the policy. Sh. Jeevan Singh Dharamshaktu was posted in Pitthoragarh as Junior Engineer and during his service on 16.10.1990 by an accident he died. The post-mortem report is on the record showing multiple injuries present. There was depression present over occipital region and there was also blood clots in the chest and the post-mortem report shows that the victim died only because of A.M. injuries. The post-mortem report showed that the victim had got well built muscular body. No other abnormality was found in this post-mortem report.

In spite of completion of all the formalities the Insurance Company repudiated the claim and only informed to pay paid-up value of Rs. 10,501/- (Rupees ten thousand five hundred one only). The complainant being the widow and nominee filed the complaint in the District Forum. In the District Forum it was alleged that the policy has lapsed and when the new proposal was given the insured had suppressed material facts regarding his health and there was specific declaration that if there was anything incorrect in the declaration form the policy can be cancelled. After hearing the learned Counsels for the parties, the learned Forum allowed the complaint against which order the present appeal has been filed.

SH. M.M. Verma, the Senior Branch Manager has been examined in the Forum and he has specifically admitted that during investigation he did not enquire from doctors who conducted the post-mortem. It could alone have disclosed whether the alleged illness has got any nexus with the death of the victim or not. He has further specifically admitted that epilepsy has not been shown as ground of death of the victim. He has further admitted that at the time of the earlier proposal Dr. A.B. Ojha has examined the victim and he has found that the victim was healthy. SH. Verma has ruled out about any toxicant in his statement. We have heard the learned Counsels for the parties and gone through the records. The policy is admitted. It is also admitted that the insured had got the policy in 1987 lapsed. Again he go revived it in 1990 and on 16.10.1990 he died. The Insurance Company argued that the true facts were suppressed in so far so that the victim was ill by epilepsy and he has got several medical leaves on the ground of illness. The insured has got medical leave from 6.11.1988 to 15.11.1988 due to viral fever. Fever is not such a disease, which should be ordinarily disclosed for taking the insurance policy. It is again said that Sh. Jeevan Singh Dharamshaktu was a patient of epilepsy and fits. Epilepsy and fits are also not such diseases, which could cause death. At least it is not said that he suffered the accident due to epilepsy and fits rather argument was advanced that at the time of accident the victim was drunk. The doctor conducting the post-mortem did not find any alcohol in the stomach of the victim. We have also said above that the post-mortem report itself shows that the victim has got well built body and there is nothing on record to show that the disease, if any, has got any nexus with the death of the victim. It is said that at the time of getting the original policy, the victim was not having any illness and it is settled principle of law as pronounced by the Hon''ble Supreme Court in the ruling reported in AIR 1991 Supreme Court 392, Life Insurance Corporation of India v. G.M. Channabasemma, that the evidence of the Corporation''s doctors who have certified the good health of the insured at time of taking of the policy was believed in the case of revival as well. It was held by the Hon''ble Supreme Court that the terms and conditions of the agreement shall remain the same.

THE learned Counsel for the Insurance Company referred a number of rulings to show that if true facts are not being disclosed, the Insurance Company has got a right to repudiate the claim but the present trend of decisions given by the National Commission and the Hon''ble Supreme Court show that every disease is not material and even if it has not been disclosed the claim cannot be rejected. Secondly also it is clear the death of the victim has got no nexus with any earlier ailment. We have gone through the judgment given by the learned Forum and we find that the judgment and order passed is on proper appreciation of facts and law. We did not find anything for which the judgment may be interfered with in the appeal. Therefore, this appeal has got no force and is to be dismissed. ORDER The appeal is hereby dismissed. Cost of the appeal shall be easy. Appeal dismissed.