MANJIBHAI NAGJIBHAI GOHEL vs Life Insurance Corpn. of India

THE appellant is the original complainant who is working as peon in Bank of Maharashtra. He had taken a joint policy with double cover popularly known as "Jeevan Sathi" policy. That the wife of the appellant died on account of fire accident. THE scheme of the policy which is produced, in Gujarati clearly states that a woman who is earning is placed in category 3 and the woman who is selling vegetable, milk or fish is also entitled for the benefits under this policy. THE medical examination of both husband and wife was compulsory.

THAT the summons was served to the LIC. The advocate has also appeared but the LIC has not thought it fit to file its version. The complainant has filed the complaint and has also filed a separate affidavit. The wife of the complainant has died in the hospital and post mortem has also been done. The proposal form filled In by deceased Leelaben is also on record. In the column of present occupation it has been specifically stated that the occupation is plying vegetable lari. In the column of type of duty it is further mentioned that the duty is plying vegetable lari. The learned advocate of the appellant states that though the proposal was taken in September, 1987 the policy has not been issued till the date of complaint. The learned advocate for the appellant made the following submissions: (1) That the respondent has not filed any version. (2) That the respondent has not even produced the policy. (3) The policy was not sent to the complainant or his wife. (4) That the proposal form itself shows the occupation of the deceased.

Inspite of all these facts on record and in absence of any written statement, the District Forum has permitted the learned advocate of the opposite party to raise a contention of Clause 4(b). Had this contention been raised earlier, the complainant could have brought number of witnesses who have purchased vegetables from the deceased so that the question of application of Clause 4(b) was not applicable to the complainant. She has further submitted that the LIC has not even cared to send the policy to the complainant nor have they produced it before District Forum to show that there was any application of Clause 4(b) rightly or wrongly. In absence of total evidence against the complainant and inspite of the complaint filed with the affidavit, the District Forum committed a serious error both of law and facts in arriving at a conclusion that the complainant was not entitled for the insured amount since Clause 4(b) was applicable to the complainant''s wife.

We shall have to accept the argument. The LIC has failed to file the version and the District Forum had no jurisdiction to raise such question. Whether Clause 4(b) is applicable or not cannot be decided without the facts since the proposal form in terms states that she was doing the business of selling vegetables and was a earning woman. Hence the order of the District Forum is not based upon any facts, is erroneous and liable to be set aside. The LIC is liable to pay the benefits of the policy available to the complainant. ORDER The appeal is allowed. The order of the Distrrict Forum is set aside and the LIC is directed to give all the benefits available under the policy to the complainant and whatever amount payable shall be payable with interest @ 18% from the date when the amount became due and will pay total cost of Rs. 1,000/-. Appeal allowed with costs.