Consumer Complaint No: 113/2007

Date of presentation: 19.04.2007

Date of decision: 06/01/2010.

Sh. Vikram Chandel,

S/o Sh. Karamveer Chandel,

R/o Sant Merry Cottage Behind SBI Shimla.

… Complainant.
Versus
The Shimla Urban Co-operative Bank Ltd. Shimla,

78, The Mall, Shimla,

Through its Manager.
… Opposite Party.

For the complainant: Mr. Naresh Sharma, Advocate.

For the Opposite Party: Mr. Vivek Chauhan, Advocate.
Vice Mr. D.P. Chauhan,Advocate.
O R D E R:

Sureshwar Thakur (District Judge) President:- This instant complaint, has been filed by the complainant, by invoking the provisions of Section 12, of the Consumer Protection Act, 1986. The complainant avers that her husband late Shri Bhagat Ram, during his life time, purchased three policies from the OP-LIC, bearing No.151245975, 151246793 & 152456062, for an amount of Rs.1,30,000/-, Rs.50,000/- and Rs.50,000/- respectively. She further contends that her husband was employed as driver with HP Forest Corporation, Solan Division, H.P., who unfortunately met with an accidental death on 22.01.2006 and after his death, the claim was lodged with the OP-LIC, for indemnification, but the OP-LIC, instead of settling her claim, rejected the same on false ground. Hence, it is averred that there is apparent deficiency in service on the part of the OP-LIC and accordingly relief to the extent as detailed in the relief clause be awarded in favour of the complainant.

2. The OP-LIC, in its written version to the complaint, raised various preliminary objections, vis-à-vis maintainability of the complaint, inasmuch, as, the life assured was guilty of deliberate misstatements and fraudulent suppression of material information. On merits, it is admitted that the life assured had purchased the policies referred to above, but, prior to the purchase of the policies, he was suffering from vertigo with hypertension with fracture of skull due to which he was found to be chronically ill at the time of proposal and his life span was likely to be reduced. Hence, it is denied that there was any deficiency in service on their part or that.

3. Thereafter the parties led evidence by way of affidavits and documents in support of their respective rival contentions.

4. We have heard the learned counsel for the parties at length and, have, also, thoroughly scanned the entire record of the case meticulously.

5. It is not in dispute that the life assured late Shri Bhagat Ram, was the holder of life insurance policies bearing Nos.151245975, 151246793 and 152456062, for an amount of Rs.1,30,000/-, Rs.50,000/- and Rs.50,000/- respectively. The parties also do not wrangle over the fact that the life assured, met his end, during the currency of the aforesaid policies. The lodging of the claim by the complainant with the OP-LIC and its repudiation is, also not in dispute.

6. The OP-LIC, resists the claim of the complainant on the score that, on, the date of the purchase of the insurance policies by life assured, from the OP-LIC, their was, an, active concealment by the complainant of an pre existing ailment, inasmuch, as, he having availed leave on medical grounds for the periods, 15.10.2001 to 11.12.2001 for head injury and fracture of skull and 08.02.2002 to 18.02.2002 for vertigo with HTN, hence, the non-disclosure or suppression of the above vital information, by the life assured, at, the time of purchase of the aforesaid insurance policies, is, contended to be infracting the principle of uberrimae fidei, on, which principle all contracts of insurance are anchored and which principle, gets, vitiated by suggestio falsi which, in, turn also, vitiates, the, insurance policies purchased by the life assured from the insurer, consequently, making the repudiation of the claim of the complainant, to, be tenable.

7. The OPs-Company, in, canvassing the above contention has not adduced cogent and satisfactory evidence to establish that the demise of the life assured, is, the result of his having been afflicted with any of the preexisting ailments, which, he, had sustained prior to the accident, in which he died, whereas, the deceased met his end in the motor accident. Since, the establishment of a nexus between the demise of the deceased undisputedly in a motor vehicle accident and the pre existing ailment was necessary to be substantiated by the OP-LIC, it is not open for the later to, canvass that, hence, with uberrimae fidei having come to be infracted its liability stands exculpated. Since, the above fact has not been established by the OP-LIC, by adduction of cogent evidence, therefore, the, mere fact that the complainant was afflicted with a preexisting ailment and when the said ailment had no nexus or did not contribute to the demise of the deceased, therefore, the OP-LIC, was not legally competent to repudiate the claim of the complainant, for, the reasons aforesaid.

8. The upshot of the above discussion, is, that the contention as canvassed before us by the OP-LC in seeking to repudiate the claim of the complainant are wholly unfounded and untenable and amounts to deficiency in service

9. Now it is to be determined as to what amount of indemnification, is payable by the OP-LIC to the complainant. The life assured has admittedly purchased three insurance policies, from the OP-LIC, for an amount of Rs,1,30,000/-, Rs.50,000/- and Rs.50,000/- respectively, and on death of its holder, owing to accidental death, double the amount of sum assured, is payable to the nominee. Hence, the OP-LIC, is, liable to indemnify the complainant to the extent of Rs.4,60,000/-.

10. Consequently, we allow this complaint and direct the OP-LIC, to indemnify the complainant to the extent of Rs.4,60,000/-, along with interest at the rate of 9% per annum, with effect from the date of filing of the complaint, i.e. 20.09.2007, till actual payment is made. In addition to this, the OP-LIC, shall also pay litigation cost, which in the given facts and circumstances of the case is quantified at Rs.3500/-. This order shall be complied with by the OP-LIC, within a period of forty five days after the date of receipt of copy of this order. The learned counsel for the parties undertook to collect the certified copy of this order from the office, free of cost, as per rules. The file after due completion, be consigned to record room.