Life Insurance Corporation of India v. Sudesh Kumari
2005-07-13
LUXMI SINGH, SURENDRA KUMAR
body2005
DigiLaw.ai
JUDGMENT Sri Surendra Kumar, Acting President This is an appeal against the order dated 22.9.2004 passed by the District Forum Udham Singh Nagar where by the complaint of the complainant was allowed for a sum of Rs. 1,50,000/- along with interest @ 8% and costs of Rs. 1,000/-. 2. The brief facts of the case are that the husband of the complainant namely Sri Amarnath Kamra had got three policies. Policy No. 240142536 for Rs. 50,000/- policy No. 240520528 for Rs. 1,00,000/- and policy No. 220022913 for Rs. 25,000/-. It is alleged that the husband of the complainant died on 5th April 2001. The payment of policy No. 220022913 of Rs. 25,000/- was made by the opposite party. The opposite party gave consent for Rs. 17,000/- for policy No. 240142536 and the claim of policy No. 240520528 was repudiated on the ground that the insured was suffering from diabetes. It is alleged that the claim of the two policies has been repudiated without any reason. Therefore the complaint filed the complaint. 3. The appellant filed written statement and admitted that the insured had taken three policies. The payment of Rs. 25,000/- has been made. In additional pleas, it is pleaded that the insurance is a contract of utmost good faith. The insured took treatment in Tomar Hospital Bareilly, which was not disclosed at the time of insurance. The payment of policy No. 220022913 was made because the said policy had run for 3 year while the other two policies were done before 2 years 9 months 7 days & 1 year 3 months 20 days respectively. 4. The complainant filed her affidavit and alleged that before insurance, the insured was medically examined by the doctor of the insurance company and the doctor found that the insured was not suffering from any disease. The Learned Forum after taking the evidence of the parties and hearing them allowed the complaint against which order the presser appeal has been Shed. 5. We have heard the Learned Counsel for the parties and gone through the records. The complainant in para 5 of her complaint stated that the claim was repudiated on the ground that the insured was suffering from Diabetes Mellitus.
5. We have heard the Learned Counsel for the parties and gone through the records. The complainant in para 5 of her complaint stated that the claim was repudiated on the ground that the insured was suffering from Diabetes Mellitus. The appellant in para 17 1 of the written statement has alleged that the insured took treatment in Tomar Hospital, Bareilly and according to the certificate issued by the doctor, he was suffering from diabetes mellitus since 25 years. The insured has given his status of health at the time of insurance and there is no mention in this form of any disease. The claim form is also available on record. In this claim from the cause of death of the insured has been mentioned as heart failure. Policy numbers have also been mentioned in this claim form and it has been signed by the complainant. The medical certificate of insured has also been filed, which is signed by Dr. Sharad Aggarwal. In this certificate the cause of death has been mentioned as cardio respiratory arrest. In column 4, it is written that the insured was suffering from diabetes mellitus from last 25 years. It is also written that renal failure detected recently. Then there is letter of the appellant to the complainant dated 29.1.2002, in which it is written that the insured was suffering from diabetes mellitus from last 10 years and he has also taken treatment and he has suppressed this fact in the proposal form. There is no evidence available on record to prove that the insured was ever treated in Tomar Hospital, Bareilly. There are two contradictory allegations of the appellant. In the medical certificate issued by Dr. Sharad Aggarwal, it is written that the insured was suffering from diabetes mellitus from last 25 years while in the letter dated 29.1.2002, it is mentioned that the insured was suffering from this disease from last 10 years. 6. There is no evidence available on record to prove that the insured ever ... took treatment at Tomar Hospital, Bareilly. There is no prescription slip of Tomar Hospital, Bareilly. No other paper whatsoever has been filed by the appellant to prove that the insured was actually suffering from any disease. In absence of any evidence, the Learned Forum was perfectly justified in allowing the complaint.
took treatment at Tomar Hospital, Bareilly. There is no prescription slip of Tomar Hospital, Bareilly. No other paper whatsoever has been filed by the appellant to prove that the insured was actually suffering from any disease. In absence of any evidence, the Learned Forum was perfectly justified in allowing the complaint. We do not find any force in this appeal and the appeal is liable to the dismissed. ORDER The appeal is hereby dismissed. Costs shall be easy.