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2011 DIGILAW 631 (MP)

Pushpa Chandrakar v. Branch Manager, LIC of India

2011-05-20

S.C.VYAS, V.K.PATIL

body2011
JUDGMENT : As per S.C. Vyas, J. (President) : - This appeal is directed against ex pane order dated 24-2-2011 of District Consumer Disputes Redressal Forum, Raipur (C.G.) (hereinafter called "District Forum" for short) in Complaint Case No. 377/2010, whereby the complaint of the appellant herein, has been dismissed on the ground that material facts regarding previous illness, were suppressed by the insured at the time of making proposal for the insurance and so, the amount of insurance, is not payable to the nominee on the death of the insured. 2. Briefly stated, the facts of the case are that son of the appellant herein, namely, Sandeep purchased an insurance policy of Rs. 1,50,000/- from the respondent-Life Insurance Corporation of India (hereinafter called "Insurance Corporation" for short) on 10-6-2004, in which the appellant herein, was his nominee. He was continuously paying premium of the insurance policy for next few years and on 24-3-2007, he died. Then, a claim for sum assured was preferred by the complainant before the respondent-Insurance Corporation, which was repudiated by the Insurance Corporation, on the ground of suppression of material facts by the insured at the time of making proposal for the insurance policy. 3. When complaint was filed before District Forum by the complainant/appellant, then none appeared for the respondent-Insurance Corporation, in spite of service of notice by Regd. Post and no document was filed in support of Letter of Repudiation, dated 30-11-2009. 4. Learned District Forum, after having considered the material available on record, dismissed the complaint on the ground that material facts, were suppressed by the insured at the time of making proposal for insurance. 5. We have heard the arguments advanced by both parties and perused the record of the District Forum. 6. From the record of the District Forum, we find that Death Certificate of the deceased insured, has been filed by the appellant/complainant before District Forum as Annexure 2, which shows that he died on 24-3-2007. Status Report of Policy No. 383401319, Annexure 1, has also been filed, which shows that premium of the insurance policy, was paid by the deceased insured timely and sum assured was Rs. 1,50,000/-. In this document, the age of deceased insured and name of his nominee Pushpa' being mother of the insured, are mentioned. These documents show that insurance policy, was duly purchased by the deceased insured and he died on 24-3-2007. 1,50,000/-. In this document, the age of deceased insured and name of his nominee Pushpa' being mother of the insured, are mentioned. These documents show that insurance policy, was duly purchased by the deceased insured and he died on 24-3-2007. The appellant herein sent a letter dated 5-9-2009, Annexure 3, to the Insurance Corporation, by way of claim for sum assured and as intimation of death of the deceased insured. Respondent-Insurance Corporation, then repudiated her claim by sending Letter of Repudiation, dated 30-11-2009, Annexure 4, wherein it was stated by the Insurance Corporation that it was having material and evidence to show that deceased suffered a road accident on 17-1-2004 and was admitted in MMI Hospital from 17-1-2004 to 24-1-2004 and was discharged from the Hospital in unstable condition and these facts were not mentioned by the deceased insured in the proposal form. 7. We find from the record of the District Forum that notice of consumer complaint was duly served in the office of respondent Insurance Corporation. Acknowledgment containing seal impression of office of Insurance Corporation, along with signature of a person, is available the record of the District Forum. From the record, it further appears that in spite of service of this notice, none appeared on behalf of respondent-Insurance Corporation before the District Forum, and, therefore, the matter was proceeded ex-parte against the respondent-Insurance Corporation and it was decided as such. 8. Though, respondent-Insurance Corporation had claimed in its Letter of Repudiation dated 30-11-2009 that it was having material to prove that some material facts have been suppressed by the insured at the time of making proposal, but neither the proposal form of the deceased insured nor such evidence, was produced by the Insurance Corporation before the District Forum in spite, of having opportunity for producing the same. 9. Counsel for the respondent-Insurance Corporation submitted that the matter be remanded back to the District Forum, so that such material can be placed before the District Forum now, but he is not in a position to Say that in what circumstances, in spite of service of notice to the respondent-Insurance Corporation, none appeared before District Forum on it's behalf. 9. Counsel for the respondent-Insurance Corporation submitted that the matter be remanded back to the District Forum, so that such material can be placed before the District Forum now, but he is not in a position to Say that in what circumstances, in spite of service of notice to the respondent-Insurance Corporation, none appeared before District Forum on it's behalf. If the respondent-Insurance Corporation has chosen not to oppose the complaint of the appellant herein, then there appears no reason for providing another chance to the respondent-Insurance Corporation for taking it's defence now to dislodge the claim of the complainant/appellant, when nothing has been stated as to why none appeared before District Forum on behalf of Insurance Corporation, in spite of service of notice and when no material has been produced even before us to show that some material facts, were suppressed by the deceased insured at the time of making proposal for the insurance, then we do not see any reason to remand the matter back to the District Forum for any further inquiry or trial. 10. We find that deceased insured Sandeep Chandrakar was insured for his life by the respondent-Insurance Corporation and he has died. The Insurance Corporation was having no reason to repudiate the claim of the complainant/appellant and the sum assured was required to be paid to the appellant by the Insurance Corporation. The District Forum has committed mistake in dismissing complaint of the appellant herein, without any material on record to establish the facts stated in the Letter of Repudiation of the Insurance Corporation, dated 30-11-2009. 11. Therefore, the appeal succeeds and is allowed. The respondent-Insurance Corporation, is directed to pay a sum of Rs. 1,50,000/- to the complainant/appellant within a period of one month, otherwise the amount, will carry interest @ 6% p.a. The cost of litigation is quantified as Rs. 1,000/-, and respondent-Insurance Corporation, is directed to pay this amount also to the complainant/appellant. With these directions, the appeal is disposed of.