LIFE INSURANCE CORPORATION OF INDIA v. POONAM SHARMA
2006-05-25
A.K.GOEL, NARINDER SINGH THAKUR, SAROJ SHARMA
body2006
DigiLaw.ai
ORDER: Justice Arun Kumar Goel (Retd.) President. Respondents No.1 is the widow and 2 & 3 are the son and daughter of late Sh. Deepak Kumar Sharma. He was admittedly insured with the appellant in the sum of Rs. 1 lac. This insurance was done on 28.3.2003. Monthly premium was Rs. 1005/-. Insured died on 6.12.2003. Respondents preferred claim for payment of the sum insured. It was repudiated on 31.3.2004. For repudiation of the claim as well as in reply to the complaint before Forum below stand of the appellant was that the deceased had obtained policy fraudulently by intentionally withholding the material information \ regarding his state of health in the proposal from. Because at that time he was | suffering from chronic alcoholic liver disease and was also admitted in De-addiction Centre at Dharamshala, besides having remained on medical leave w.e.f. 25.11.2003 to 6.12.2003. Therefore, respondents were not entitled for any claim whatsoever. 2. After the conclusion of the trial, District Forum below directed the appellant to pay Rs. 1 lac alongwith accrued benefit and also interest on the said amount @ 12% per annum w.e.f filing of the complaint, i.e. 12.8.2004 till the date of actual payment. In addition to this litigation cost ofrs.2500/- has also been allowed. 3. In the aforesaid background Mr. Sharma learned counsel for the. appellant urged that the Forum below fell into error in passing the impugned order against his client. As according to him his client accepted the accepted the statement made in the proposal form particularly regarding the State of health at that time in Col. No. 10 and 11 of the said form. Further according to him contract of insurance is based on utmost good faith and bonafide. In addition to this he also submitted that his client insures a standard life, whereas deceased being a chronic case of alcoholic liver disease was a non standard life and thus he prayed for allowing this appeal. All these pleas have been controverted by Sh. Verma learned counsel for the respondent. Per him there was no purposeful muchless either intentional or fraudulent withholding of any material as well as relevant information by the deceased in the proposal form as alleged by the appellant. And unless it is established that the withholding of information and or mis-statement was fraudulent, mere mis-statement is of no consequence as alleged. 4.
Per him there was no purposeful muchless either intentional or fraudulent withholding of any material as well as relevant information by the deceased in the proposal form as alleged by the appellant. And unless it is established that the withholding of information and or mis-statement was fraudulent, mere mis-statement is of no consequence as alleged. 4. Deceased having been insured for Rs. 1 lac and having died during the validity of the policy is not in dispute. Therefore, in order to succeed, it was incumbent upon the appellant u/s 45 of the Insurance Act, 193,8 to have placed on record martial to show that the facts disclosed by the deceased were fraudulent and the policy holder knew at the time of making such a statement those to be false. In this behalf by referring to fax copy of form on 3816 Annexure R-6 and leave record the deceased D.K. Sharma Annexure R-V and certificate issued by Superintendent of Police Annexure R-IV and certificate issued by Superintendent of Polfce Annexure R-IV, Sh. Sharma submitted and these documents are enough for rejecting the claim by the appellant. In order to succeed on all these documents, it was necessary for the appellant to have placed on record the! Affidavits of the Superintendent of Police and as well as of the Doctor who had filed! in the original form No. 3816. So far as leave record is concerned, great emphasis1 was laid by Mr. Sharma on the medical/commutted leave during the period I 25.11.2003 to 6.12.2003 as according to this Annexure was on medical leave. It [I does not spell the nature of disease. 5. So far plea of the deceased having remained at De-Addiction Centre Dharamshala is concerned, in this behalf suffice it to say, that Superintendent of Police observed deceased to be taking excess liquor," for the last 3 months." Date of death was 6.1.2.2003. Thus in terms of this document deceased was observed taking excess liquor 3 months some where in August, 2003. With a view to take benefit of form No. 3816, affidavit of the Doctor who had issued it should have been placed on record, admittedly that is not produced. Why learned counsel for the appellant had no answer. In addition to this it also not the case of the appellant that the Doctor either has been transferred and or when approached he refused to do the needful.
Why learned counsel for the appellant had no answer. In addition to this it also not the case of the appellant that the Doctor either has been transferred and or when approached he refused to do the needful. In such the latter situation, the appellant could and in fact should have summoned the doctor u/s 13 of the Consumer Protection Act, 1986. For taking this view we reply on a decision of this Commission in Life Insurance Corporation of India V/S Kamla Devi, 11 (2006) CPJ 308. 6.Another ground urged by Mr. Sharma was that interest allowed is @ 12% per annum form the date of filing of complaint on the sum of Rs. 1 lac as such it was liable to be reduced. This plea was resisted by Mr. Peeyush Verma, learned counsel for the respondents. Per him since the amount was wrongly withheld by the appellant, therefore rate of interest calls for no interference. We feel that grant of interest on the sum of Rs. 1 lac @ 9% per annum form the date of complaint i.e. 12.8.2004, till the date of deposit/payment, whichever is earlier besides cost of Rs. 2500/- allowed by District Forum below will meet the ends of justice, and it would also bring the interest in consonance with the decisions of the Supreme Court and National Commission. Therefore the interest needs to be reduced from 12% to 9%. Ordered accordingly. No other point was urged. This appeal is partly allowed subject to above the modification while upholding the rest of the order and leaving the parties to bear their own cost. All interim orders shall stand vacated forthwith. Office will make available copy of this order to the parties free of cost as per Rules.