Neetu Namdhari vs LIFE INSURANCE CORPORATION OF INDIA

BOTH these revision petitions have been filed by the same petitioner, who was the original complainant before the District Forum and the respondents in both these cases were the opposite parties. It is seen from the record that this complainant had filed five separate complaints under Section 12 of the Consumer Protection Act, 1986 before the District Forum, Mandi in respect of her claim under each of the five insurance policies purchased by her deceased husband Shri Malwinder Singh whose life was insured with the opposite parties for varying amounts of money, particulars whereof, are as under: In all the aforesaid five consumer complaints, the District Forum vide its similar orders passed on 29.2.2008 had held that the respondent Insurance Company had been right in repudiating the claim of the complainant. However, keeping in view the facts and circumstances of the complaint, the District Forum had directed the OP Insurance Company to pay the amount of insurance premium realized by it to the complainant along with interest @ 9% p.a. from the date of receipt of the premium till payment. All the five complaints were disposed of with this direction by the District Forum. BOTH the complainant and the opposite parties, aggrieved by the orders of the District. Forum, filed separate appeals against each of the five orders of the District Forum. While the opposite parties sought dismissal of the complaints in their entirety, the complainant sought direction from the State Commission to the opposite parties to pay the sum assured with interest.

THE present two revision petitions emanate from the common order dated 9.4.2012 passed by the HP. State Consumer Disputes Redressal Commission, Shimla in First Appeal Nos. 83, 84 of 2008. We may note that the State Commission vide its common impugned order had accepted the appeals filed by the OP Insurance Company and dismissed the appeals filed by the petitioner while setting aside the orders of the District Forum and dismissed the complaints. Since both these revision petitions involve similar question of law based on identical facts, they are being disposed of by this common order. As stated above, the husband of the petitioner had purchased five insurance policies from the OP Insurance Company on different dates within a short period of two and a half years for a total sum of Rs. 24 lakh. As per the allegations, the husband of the complainant had been having a mild problem of indigestion and when he visited a Doctor at Mandi for treatment of this problem, that Doctor referred him to Sir Ganga Ram Hospital at New Delhi where it was detected that he was suffering from lever cirrhosis which required transplantation of lever. The husband of the complainant was operated upon but the operation was not successful and eventually he died on 29.12.2005. The complainant informed the opposite parties about the death of her husband and submitted five claims in respect of each policy to the opposite parties which came to be repudiated on the ground that the life assured was not enjoying good health, had been suffering from diabetes mellitus and several other ailments which he had concealed/suppressed while answering various parts of the question No. 11. Alleging deficiency on the part of the OP Insurance Company while repudiating her claims, the complainant filed five separate complaints before the District Forum which came to be disposed of with partial relief of refund of the premium in each case to the complainant with interest. However, as stated above, these orders of the District Forum were set aside by the State Commission vide its common impugned order which is now under challenge before us through these two revision petitions. The only issue for our consideration in these revision petitions is whether or not while taking the insurance policies, the husband of the petitioner had concealed the material fact about his treatment at PGI, Chandigarh in the year 1999.

WE have heard Mr. Mohinder Pal Thakur, Advocate for the petitioner and Mrs. Jaya Tomer, Advocate for the respondents and perused the record. Broad facts regarding the issuance of policies, sum assured and the cover provided are not under dispute. Learned Counsel has contended that the impugned order passed by the State Commission is not correct since the State Commission has failed to appreciate the evidence as a whole which has been produced before the District Forum. The State Commission has also overlooked the fact that the Development Officer obtained the signatures of the life assured on blank proposal form without informing the contents to the life assured. It was also argued on behalf of the petitioner that the State Commission committed material irregularity while considering the evidence produced that the cause of the death is diabetes whereas, as mentioned in the death certificate, the cause of death is due to intra abdominal bleeding after the lever transplantation operation. He submitted that the respondents had issued the policies after satisfying about the health of the insured and the life assured was having good health and healthy life as examined by the panel Doctor of the respondent Insurance Company. Learned Counsel further argued that the findings of the District Forum which were upheld by the State Commission are based upon simple conjectures and surmises and hence the impugned order based upon such findings is liable to be set aside. He also submitted that respondent Insurance Company did not produce any record of PGI, Chandigarh to substantiate the allegation of treatment at PGI, Chandigarh. Keeping in view the submissions of learned Counsel for the petitioner and the only issue involved in these revision petitions, we sought clarification in this regard by directing the petitioner to file an affidavit specifying whether her husband was treated at PGI, Chandigarh for the disease mentioned in the report of the Local Commissioner submitted before the District Forum, Mandi. However, in spite of the opportunity given, no affidavit was filed by the petitioner. Learned Counsel for the petitioner, however, clarified that there has been no denial about this treatment of the life assured at PGI, Chandigarh by the petitioner either in the consumer complaint before the District Forum or the State Commission. In fact during the course of arguments, he fairly admitted that the life assured had taken treatment at PGI, Chandigarh. In view of the above, no fault could be found with the concurrent finding of fact returned by both the Fora below while non -suiting the claim of the complainant. It is established beyond doubt from the facts and circumstances of this case that there was suppression of material information in respect of the health condition of the life assured and hence the State Commission was right in upholding the order of the District Forum and dismissing the complaint. We agree with the view taken by the State Commission and the same is in line with the view taken by Their Lordships of the Supreme Court in the celebrated judgment of Satwant Kaur Sandhu v. New India Assurance Co. Ltd., (2009) SLT 338 : IV (2009) CPJ 8 (SC) : (2009) 8 SCC 319. In the circumstances, we do, not find any merit in these revision petitions and the same stand dismissed with no order as to costs.