SENIOR BRANCH MANAGER, LIC OF INDIA vs BODDEPALLI RAMARAO

THE complainant''s father took a LIC policy on 28.3.1989 for a sum of Rs. 50,000/-. He died on 10.11.1989 due to heart attack. In the policy the complainant, that is, the son of the assured was nominated. THE complainant informed the death of his father and claimed the amount. But according to the complainant, the Opp. Parties went on informing him that his claim was under consideration. Even after long period the claim was not settled, the complainant on 12.9.1991 filed this complaint, claiming the amount under policy with interest etc. After filing of the complaint, the complainant received a letter of repudiation, which was dated 26.9.1991 but posted on 8.10.1991. In the said letter of repudiation, the Insurance Company took a stand that the deceased withheld material information regarding his health, at the time of effecting the insurance policy with them. According to them in the proposal form dated 28.3.1989 and signed by the deceased on the same day, at the time of his medical examination he gave false answers to questions 17(a), 18(a) and 20. THE Opp. Party had indispensable proof to show, he had suffered from Tuberculosis, for which he has consulted a medical man and had taken treatment, since he did not disclose this at the time of the proposal the Insurance Company repudiated their liability. THE District Forum on a consideration of the material, held that except the allegation in the repudiation letter dt. 26.9.1991, the Opp. Party had not produced any documentary evidence or Doctors, who examined the deceased within a period of one year prior to the proposal and who certified that he suffered from Tuberculosis and also treated him. THE Opp. Party filed the Affidavit of Senior Branch Manager, LIC of India, Srikakulam one Mr. O. Venkateswara Rao. He stated in the affidavit that the complainant is not entitled, as his father was suffering from Tuberculosis from the date of proposal for LIC for his life. It was not stated whether Mr. O. Venkateswara Rao had personal knowledge or whether he was aware that the complainant''s father was treated for any such disease prior to his death. THE District Forum also noticed that the Opp. Party summoned one B. Satyanarayana to prove that the deceased was suffering from Tuberculosis, that the said Doctor was present before the Forum, the LIC has not choosen to put him in the witness box. As there is no evidence produced by the Opp. Party to prove that the complainant''s father was at any time suffered from Tuberculosis and was treated for the same, and such burden of proof is on the Opp. Party to establish that the deceased has suffered from Tuberculosis and was treated. THE District Forum rejected the contention of the Opp. Party and allowed the claim. It is clear from the evidence on record, that the Opp. Party except writing a letter repudiating the liability alleging that they are in possession of indisputable proof that the complainant has suffered with some disease prior to proposal and that he suppressed the same, no material was produced either oral or documentary to show that the complainant had suffered with Tuberculosis and that he was also given treatment under any Doctor.

BUT the appellant filed separate documents stating that there are some statements given by E. Appalasuri and Ramachandra Rao. BUT these statements were not filed before the District Forum and he has also not filed any application to receive the documents as additional evidence. It is well settled that the Insurance Company cannot repudiate policy without holding enquiry and without gathering material to show that the complainant''s father had actually suffered with Tuberculosis as held by them. In the instant case, there was no enquiry, no investigation and there is no material to show that the complainant''s father suffered with Tuberculosis. We are therefore not inclined to interfere with the order of the District Forum. The appeal is dismissed. No costs. Appeal dismissed.