PYARI DEVI vs LIC OF INDIA

S. M. Kantikar, Member

[1] Smt. Pyari Devi is the complainant in this case. The complainant''s husband, Shri Rajbir Singh( since deceased) took insurance policy for a sum of Rs.50,000/- from opposite party on 28.2.2001. The insured died on 8.1.2002. Therefore, complainant made a claim before the Insurance Company, which was repudiated by OP on the ground that the insured-(deceased) suppressed the material fact regarding his health at the time of filling up the proposal form. Therefore, alleging that it was a deficiency in service on the part of OP, the complainant filed a complaint before the District Forum, Hisar.

[2] The District Forum allowed the complaint and directed the OP to pay Rs.50,000/- along with interest @ 10% p.a. from 8.4.2002. The decision of District Forum was challenged before Haryana State Consumer Disputes Redressal Commission, Panchkula by the OP. The appeal was allowed and the complaint was dismissed. Hence, this revision petition has been filed by widow of Shri Rajbir Singh, insured.

[3] We have heard the learned counsel for both the parties.

[4] There is a delay of 110 days in filing this revision petition. An application for condonation of delay has been filed by the petitioner/complainant. The reason stated therein is that she is the only adult member in the family.No adult male in her house to take up the matter. Hence, there was a delay. We are satisfied with the reasons, accordingly we hereby condone the delay.

[5] The counsel for the petitioner submitted that, the deceased was not suffering from any pre-existing disorder. The insured died due to breathlessness and respiratory difficulties. He brought our attention to the fact that the insured was serving the army. As per his medical category, he was found to be disabled to the extent of 20%. This disability certificate is only concerned with fitness in the army and has nothing to do with his civil life or civil employment. The death of insured was not on account of this disability. The deceased suffered breathlessness and cough, and after 10 months of taking the policy, he was admitted to PGI Rohtak, which diagnosed him with cancer by lung. Therefore, he was not aware of the disease.

[6] The rival argument by the counsel for the OP is that insured suppressed the disability and has brought our attention to the proposal form. In para 11(f), the insured answered the question ''do you have any bodily defect or deformity'' as ''No''. This answer is in contrary to the disqualification of the insured from the Army due to disability. The second limb of argument from the counsel for OP is that the patient was suffering from breathlessness for past 2 years. It was mentioned in the LIC form, filled by medical officer where the patient died. He has brought our attention to para 4, in which it is mentioned that the patient was suffering from breathlessness. What was the exact history? It is answered as ''Two Years''. We are not convinced with those entries . We have perused medical records on file from the PGI, Rohtak where he was admitted on 4.10.2001 and investigated by X-ray Chest and other tests. He was diagnosed as brain metastasis from the bronchogenic Carcinoma lung and he was subjected for radiotherapy.

[7] It is quite surprising that, the hospital medical record did not spell a single line or history that he was suffering from cough and breathlessness for last two years. Learned counsel for the OP further vehemently argued that insured clearly violated the terms of contract. The insurance policy is a contract of good faith.

[8] It is very strange that insurance company, being is a dominant position, tries to harass the illiterate and helpless consumers. The OP should into look such cases, in a different angle. The complainant is a widow of an army man, who served for the nation, despite all odds. The policy''s sum assured was just a meager amount of Rs.50,000/-. It is very disgusting that the life insurance companies earn huge amount by way of lapsed policies, unclaimed policies, discontinued policies etc, but indulge into the litigation, for a meager amount. We really feel sorry for such inhuman attitude of the insurance company. 7. This case is hanging fire since 15 years. It is a dream of a person, who insures himself that after his death, the family left behind him, should not suffer due to his death. The deceased army man, if made known that, after his death, his nominees would have to struggle for the genuine claim, then he would have not taken such a policy. In the instant case, the sum insured was just Rs. 50,000/- for which the LIC dragged the helpless widow into the litigation, for more than 15 years. Hon''ble Supreme Court in many cases, made its yeomen observations regarding the petty claims where, unnecessarily, the matters are being dragged for decades. Hon''ble Supreme Court in Gurgaon Gramin Bank vs. Smt. Khazani & ANR. [Civil Appeal No. 6261 of 2012 @ Special Leave Petition (C) No. 8875/2010] by a bench of Hon''ble Justices K S Radhakrishnan and Dipak Misra, while expressing disapproval at the tendency to drag every small matter, up to the Supreme Court, the bench observed :-

"Unless serious questions of law of general importance arise for consideration or a question which affects a large number of persons or the stakes are very high, court''s jurisdiction cannot be invoked for resolution of small and trivial matters. We are really disturbed at the manner in which those types of matters are being brought to courts, even at the level of the Supreme Court."

We do not think that, in the instant case, it was not a material non-disclosure. The disability word has several meanings. The OP has not clarified about which disability. Disability is quite obvious and judged by naked eye. Thus, it is apparent that OP issued the policy to the insured with closed eyes.

Therefore, we are of the considered view that the OP failed to prove its case that the disability was a material non-disclosure. It''s just a technical one. Also from the medical record of PGI Rohatak, it is crystal clear that, patient suffered breathlessness after 10 months of taking policy.

[9] On the basis of the above discussion, we allow this revision petition, set aside the order of State Commission and restore the order of District Forum, Hisar.