PATANGI SENAPATI vs Life Insurance Corporation of India

THE complainant in C.D. Case No. 66 of 1994 is the appellant. THE complainant is the widow of late M.C. Senapati, who was a Life Insurance Policy holder of two policies. THE policy holder died on 20.6.1992 and the complainant approached the Life Insurance Corporation of India several times for settlement of her claim. She claims to have complied with all the requirements for settlement of her claim. But the same was not settled in respect of the Policy No. S-581226350. THE reason for repudiation was that according to the Life Insurance Corporation of India there was suppression of material facts which vitiated the contract of policy. It was asserted that the policy holder was suffering from chronic peptic ulcer, for which he had taken leave from office on medical ground from 1.8.1988 to 31.8.1988. Being fully aware of such ailment, the policy holder in answering the questions in the proposal form did not disclose his previous ailment which according to the Life Insurance Corporation are relevant for the purpose of acceptance of the policy. After examination of all the papers submitted, the District Forum came to the conclusion that in fact the policy holder was suffering from chronic peptic ulcer and was on medical leave from 1.8.1988 to 31.8.1988. THE District Forum thus came to a conclusion that the policy holder having suppressed the material facts misled the Life Insurance Corporation who accepted the proposal and issued a policy of insurance. Having thus rejected the claim of the complainant, she has filed this challenging the aforesaid findings.

APART from the merits of the case, one more aspect also is to be decided alongwith the appeal. The impugned order is dated 23.7.1994. This appeal having been filed on 3.7.1995 there has been a delay of nearly little less than eleven months. The appellant has filed an application praying for condonation of delay on the ground that she was suffering from Arthritis from 27.7.1994 till 12.6.1995 and was being treated in the District Headquarters Hospital, Sambalpur for which the appeal could not be filed in time. A certificate in support of her allegation has been issued by Dr. R.K. Hota describing himself to be a Medicine Specialist of District Headquarters Hospital, Sambalpur. This obviously is not a certificate issued by the hospital itself. The said certificate has been issued on 27.6.1995 and the date has been overwritten. The doctor has attested the signature of the complainant, but what he attested is a thumb impression. From the complaint petition we find that the complainant had put her thumb impression and he may be an illiterate. The fact that the thumb impression was there or was presented in presence of the doctor, he cannot write that the signature attested. In the aforesaid circumstances, we have reservation about the certificate given by the doctor in support of her alleged illness. From the documents filed before the District Forum and scrutinised by the said Forum, it is apparent that the policy holder was suffering from chronic peptic ulcer for which he had undergone treatment. Peptic ulcer is a disease which causes disastrous consequences and is therefore a material fact which should have been disclosed in the proposal form in answering to the appropriate question. The policy holder having suppressed the said fact at the time of proposal, the conclusion is irresistible that there was suppression of material facts vitiating the policy itself. In the aforesaid circumstances, we find no merit in this appeal and hence dismissed. Appeal dismissed.