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Judgment
This revision is directed against the order of the State Commission Maharashtra dated 01.02.2016 in Appeal no. 728/14 whereby the State Commission reversed the order passed by the District Forum Jalna and dismissed the complaint.
The facts relevant for the disposal of the revision petition are that Ramesh Gaikwad, husband of the respondent complainant had purchased two life insurance policies from the opposite party for rs.5,00,000/- each. Ramesh Gaikwad died of heart attack on 04.09.2005. The insurance claim filed by the petitioner complainant was repudiated by the insurance company on the ground that Sh. Ramesh Gaikwad deceased had obtained the insurance policies by concealing the material particulars about his health condition.
The District Forum on consideration of pleadings and evidence allowed the complaint and directed the respondent insurance company to pay to the petitioner sum of Rs.10,00,000/- with 8% interest thereon from the date of filing of complaint i.e. 06.12.2013.
Opposite party insurance company being aggrieved of the order of the District Forum preferred an appeal. State Commission on re-appreciation of evidence allowed the appeal, set aside the order of the District Forum and dismissed the complaint. The basis of the order of the State Commission is letter dated 14.11.2014 written by Dr. M L Mote to the Manager, LIC of India, Jalna, which is reproduced as under:
"To
The Manager
Life Insurance Corporation of India Jalna
I, Dr. M L Mote aged 46 years Occupation Taluka Medical Officer resident at Jafrabad Tq.jafrabad Dist. Jalna do hereby state on oath as under:
That I know deceased Ramesh Pandurang Gaikwad as he was taking the treatment from me for Rehumatic heart diseased with valvular heart diseases from July 2003.
That I have diagnosed the illness of Ramesh Panurang Gaikwad as Rheumatic heat disease with valvular heart disease first time in July 2003 itself. I have also informed about this illness to patient Ramesh Pandurang Gaikwad and his family in July 2003.
That I have issued medical attendant certificate and certificate of treatment for primary cause of death of deceased life assured that is Ramesh Pandurang Gaikwad that is Rheumatic heart disease with valvular heart disease. Both are issued by me. However regarding this I want to explain that medical attendance certificate given on 29.09.2005 has been issued by me in respect of treatment of fever, cough, dyspepsia etc and period of one and half month mentioned by me in respect of period of suffering of illness of fever, cough, dyspepsia etc by the deceased Ramesh Pandurang Gaikwad. In the same way the certificate of treatment of Ramesh Pandurang Gaikwad dated 02.12.2005. It is also true and by this certificate I want to reiterate and state that deceased Ramesh Pandurang Gaikwad was suffering from Reheumatic Heart disease with valvular heart disease since July 2003 and he and his family was having full knowledge regarding this.
That the contents of this affidavit are true and correct to the best of my knowledge."
Counsel for the petitioner has contended that State Commission has erred in relying upon the said letter ignoring the fact that Dr. M L Mote has also answered the questionnaire of LIC of India dated 02.12.2005, according to which the insured consulted him during his illness in July 2008 and nature of disease was RHD with Valvular Heart Disease. The doctor in the said questionnaire in response to the question as to how long the patient had been suffering from said disease has answered ''not known to me''. It is submitted that as Dr. M L Mote has given contradictory opinion, he cannot be relied upon. Therefore, there is no basis to substantiate the plea of the opposite party that deceased obtained life insurance policies by concealing material facts.
We do not find merit in the contention of learned counsel for the petitioner. The questionnaire allegedly answered by Dr. Mote is dated 02.12.2015. Therefore, it is an impossibility that in the said questionnaire, Dr. Mote could have mentioned that the deceased insured first consulted him in July 2008. Thus, it is obvious that the petitioner with a view to practice fraud on the insurance company as also the consumer Fora has forged copy of the questionnaire dt. 02.12.2005 by converting the figure ''3'' of July 2003 into ''8'' and filing the photocopy on the record. Thus, it is clear that Dr. M L Mote was first consulted by deceased sometimes in July 2003. This conclusion finds support from the letter dated 14.11.2014 relied upon by the respondent insurance company, wherein Dr. M L Mote has stated that the deceased insured consulted him in July 2003 and he was told that he was suffering from Rheumatic Heart Disease. However, the deceased in the proposal form did not disclose this fact and on the contrary answered the relevant question in the proposal form in the negative. Thus, it is clear case of obtaining insurance policies by concealing the material fact. Therefore, we do not find any fault with the order of the State Commission which is based upon the law laid by the Supreme Court in the matters of P.C. Chacko & Anr. Vs. Chairman, LIC of India (2008) 1 SCC 321 and Satwant Kaur Sandhu Vs. New India Assurance Company (2009) 8 SCC 316.
In view of the discussion above, we find no merit in the revision petition. Revision Petition is accordingly dismissed. From the facts discussed above, it is evident that the petitioner has tried to practice fraud by submitting a forged document. Therefore, penal cost of Rs.50,000/- is imposed on the petitioner, who is directed to deposit the amount in Consumer Legal Aid Account-NCDRC within four weeks. List on 25.05.2017 for compliance report.