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2004 DIGILAW 139 (HP)

LIFE INSURANCE CORPORATION OF INDIA v. KIRAN KEHERA

2004-06-30

ONKAR CHAND THAKUR, PREM CHAUHAN, SURINDER SARUP

body2004
ORDER Mr. Surinder Sarup, J. (Retd.) President: This appeal is against the order of the learned District Forum, Shimla, Camp at Nahan, dated 14.3.2002, whereby the appellant has been directed to indemnify the complainants/respondents to the extent of Rs. 1,00,000/- alongwith interest of 9% per annum from the date of the complaint i.e. 20.7.2001 plus litigation cost of Rs. 500/-. 2. The late Daulat Ram Khera was insured by the appellant for an amount of Rs. 1,00,000/-. After he had paid two installments of the premium, in respect of his insurance policy, he died on 14.12.1999. The respondents, being his legal heirs, field a claim for payment of the insured amount which was rejected and resulted in filing of the complaint by them. In the reply, the only defence was that the insured had pre-insurance medical history, being a chronic alcoholic which caused his premature death also, and this significant fact had been withheld by him at the time of filing of the proposal from for getting himself insured with the appellant. 3. The learned Forum below relied on a decision of the Supreme Court referred to in para-4 of the impugned order and also recorded a finding that once the appellant had issued the insurance policy in favour of the deceased, after issuing the report of the doctor on its approved panel who had medically examined the deceased before he was insured, it cannot escape its liability from indemnifying the complaints being his legal heirs. 4. The learned Counsel for the appellant has placed strong reliance on the document, Annexure R-111, which was filed alongwith the reply to the complaint and is a piece of evidence on the record. The same has been issued by the Divisional Office, Chandigarh of the appellant-Life Insurance Corporation of India (L.I.C.) on the basis of the Hospital record vide C.R. No. 215306 regarding the treatment of the deceased in the Department of Gastroenterology, P.G.I. According to the same, the deceased was a heavy alcohol consumer and chain smoker. He was suffering from hypertension also. During the pendency of the appeal, an opportunity was given to the learned Counsel for the appellant to file the affidavit of a concerned Official explaining the circumstances of the source from which the said document Annexure R-111, was obtained by the complainant Smt. Kiran Khera, widow of the deceased. He was suffering from hypertension also. During the pendency of the appeal, an opportunity was given to the learned Counsel for the appellant to file the affidavit of a concerned Official explaining the circumstances of the source from which the said document Annexure R-111, was obtained by the complainant Smt. Kiran Khera, widow of the deceased. Consequently, affidavit of one Shri S.C. Dhingra, Manager (L&H PF), L.I.C, Divisional Office, Kasumpti, Shimla, was filed in which it was deposed that the record of medical history vide Annexure R-111 was submitted by the claimant Smt. Kiran Khera after getting the same filled from P.G.I., Chandigarh and the same was submitted by her to the L.I.C. Branch Office, Nahan, for consideration of her claim. As against this a counter-affidavit of the said Smt. Kiran Khera has also been filed in which it has been deposed specifically denying that the medical history as mentioned in Form No. 3816, Annexure R-111 was submitted by her as alleged and that the allegations to this effect are false and concocted. It has also been deposed that it is common knowledge that information regards a patient with the P.G.I., Chandigarh being of a confidential nature, no person, not even the patient is supplied the same by the Hospital authorities. Moreover, the documents, Annexure R-111, was not issued from the Divisional Office of the appellant-L.I.C. at Kasumpti, Shimla, but from the Divisional Office, Chandigarh, as stated therein. Therefore, it has also been deposed by Smt. Kiran Khera in her affidavit that the person swearing the affidavit i.e. Sh. S.C. Dhingra is not competent to depose as regards its origin or the source from which it surfaced. 5. In the above situation, we are confronted with two affidavits, both stating absolutely divergent facts as regards the source of production of Annexure R-111. Therefore, the appellant has not been able to satisfactorily show as to how the same was obtained by its Divisional Office, Chandigarh as regards the treatment of the deceased by the concerned doctor of the P.G.I., at Chandigarh. Moreover, the said document has not been proved as per the law of evidence. Therefore, the appellant has not been able to satisfactorily show as to how the same was obtained by its Divisional Office, Chandigarh as regards the treatment of the deceased by the concerned doctor of the P.G.I., at Chandigarh. Moreover, the said document has not been proved as per the law of evidence. As neither the affidavit of the doctor who has given the medical history of the deceased as regards his addiction to alcohol and smoking has been produced in evidence nor the said doctor was examined to state that he had issued that certificate of the medical history of the deceased. 6. In order to go to the root of the matter, we had also called for the original record relating to the insurance case of the deceased and the same has been produced today by the learned Counsel for the appellant. On a perusal of the same, it transpires that the doctor of the L.I.C. who had examined the deceased before he was insured, has categorically opined in the relevant column that there was no enlargement of his liver. This contradicts the document, Annexure R-1, which is a letter from the Divisional Manager of the L.I.C. Office at Shimla to the address of complainant-Smt. Kiran Khera, wherein it is indicated that the L.I.C. holds indisputable proof to show that before he proposed for the above policy, her husband had suffered from alcoholic liver disease cirrhosis, with hypertension and a history of heavy alcohol drinking for 30 years and claim smoking for the last 20 years. 7. As a result of the above discussion, there is no option but to hold that the defence as regards the suppression of facts of the medical history of the deceased prior to the insurance on account of his alleged chronic drinking and smoking habits, has not been proved by the appellant. In these circumstances, we uphold the direction in the impugned order to pay the insured amount of Rs. 1,00,000/- by the appellants to the respondents as his legal heirs as well as the litigation cost of Rs. 500/-. We, however, reduce the rate of interest from 9% to 6% per annum on the amount of Rs. 1,00,000/- from the date of the complaint in the peculiar facts and circumstances of the case. The appeal is disposed of accordingly.