Union of India vs HANIFABEN

THIS appeal is filed by the Union of India against the order of the City District Forum, Ahmedabad wherein the District Forum has accepted the complaint of the complainant and has passed an order to pay Rs. 60,000/- to the widow of the complainant with interest and cost.

THE complaint is filed by the widow of the deceased Bhikhubhai Vora for herself and as guardian of nunor children. THE deceased Bhikhubhai was serving as Medical Officer in the Community Health Center at Dhandhuka, District Ahmedabad. He had taken endowment Insurance policy for Rs. 60,000/- after submitting his proposal on 16.9.87. THE proposal was accepted on 19.10.87 after going through all the formalities necessary under the rules and regulations of the Posta1 Departments, in the nomination column name of the complainant has been stated. Mr. Vohra paid first premium of Rs. 315/- and died on 19.11.87. THE widow on her be half and on behalf of the minor children made a claim which was rejected by the Postal Department. There is no dispute that the proposal of the insured was accepted and the policy was issued on 22.9.87. However, it was disputed that when the insured was on duty from 8.00 hrs. to 20.00 hrs. how he can be examined by the Civil Surgeon, Ahmedabad on 22.9.87 when he was 110 kms. away from Ahmedabad. The insured died on account of ''acute left ventricular failure''. It is stated that if the; insured had been medically examined, he could not have been found medically fit and the medical examination by the Civil Surgeon was mandatory requirement. The complainant was orally examined. Bhikhubhai died at 3 a.m. on 19.11.87. Bhikhubhai was Medical Officer and was in service for last 11 years. He had attended the medical camp at Bharwada and after reaching home at 8 to 9 p.m. He performed one operation at 10 p.m. He got up at 3 a.m. and complained of chest pain. Doctors were called and injections were given but he died. In cross-examination she had stated that Bhikhubhai was not ill. Her husband was aged about 42-43 at the time of his death. She had stated that her husband had no sickness of blood pressure. It appeared that he was not suffering from any disease and so-much-so that even two days'' sick leave was not taken by him in his lifetime. It therefore appeared to the District Forum that Bhikhubhai kept good health to such an extent that even two days'' leave was not taken by him. With regard to verification before Medical Officer, the District Forum has observed that the opposite party has not laid any evidence to prove that such verification was not true. The signature of the Civil Surgeon on proposal form was not disputed by the opponents. That how the insured could go to Ahmedabad from Dhandhuka on the day in question is concerned, according to our opinion, it is possible that after getting the signature of the Civil Surgeon the deceased might have gone to Dhandhuka and the time of attendance entry at Dhandhuka might not be correctly made and it is not for the complainant to explain as to how the signature of the Civil Surgeon on the proposal form was obtained.

Now, it has been settled law that the burden to prove that there is a mis-statement in the proposal form or that some material omission has been found in the proposal form lies on the Insurance Company. We are convinced that the insured was possessing sound health so-much-so that he had never taken two days'' sick leave for number of years and that he has been medically examined and has died on account of what is commonly known as heart attack which was not known to him and it was not proved that the insured knew that he was suffering from any disease. The opponents have not examined any witness and has not proved by cogent evidence that the declaration was wrong or fraudulent and when the District Forum has arrived at the conclusion that there was legal and valid insurance and the opponents have failed to prove any mis-statement regarding the health, the Postal Department was under legal obligation to pay the insured amount. Alter all, the insured was a Medical Officer and was in the age group of 42-43 years and there are no reasons to suspect that he was suffering from any disease especially when on the day of his death he had gone for his duties and on coming back from duties, performed one operation. There is no doubt that the insured was possessing good health. We, therefore, find no error committed by the District Forum in arriving at the above said conclusion. We agree with the findings of the District Forum and affirm their judgment. There is no merits in the appeal and the same is liable to be dismissed. ORDER The appeal is dismissed with cost. The cost is quantified at Rs. 200/-. Appeal dismissed with costs.