BEFORE STATE CONSUMER DISPUTES REDRESSAL COMMISSION, CIRCUIT BENCH, RAJASTHAN, JAIPUR


APPEAL No. 2237/2006


06.03.2009


LIC of India vs Om Prakash Sharma


Before:

Mr. G.S. Hora, Presiding Member

Mr. Sikandar Punjabi, Member


Present:

Mr. Vizzy Agarwal, counsel for the Appellant

Mr. Alok Chaturvedi, counsel for the Respondent


Heard.


This appeal arises out of the order dated 3.11.2006 passed by the learned District Forum, Bharatpur whereby the Appellant Insurance Corporation has been directed to pay to the Complainant a sum assured of Rs. 50,000/- along with interest @ 9% per annum from the date of the presentation of the complaint till the date of payment as well as a sum of Rs. 2,000/- towards compensation for mental agony and sum of Rs. 1,000/- towards litigation expenses within a period of one month.


Late Shri Chandra Bhan Sharma had obtained a new Janraksha Policy with profits + accident benefit for a sum assured of Rs. 50,000/-. The proposal was submitted on 31.3.2003 and the policy was issued on 1.5.2003. Nearly 44 days thereafter, the Life Assured (LA) died. The Complainant who is the Brother of LA, being the nominee, lodged the claim with the Insurance Corporation but the claim was repudiated vide letter dated 31.12.2003 on the ground that the LA had been suffering from Tuberculosis (TB) at the time when the proposal was submitted but he did not disclose this fact in his proposal, rather gave a false answer therein. The Insurance Corporation in its reply took the same stand as was taken in the letter of repudiation. The Appellant also filed a letter of the District TB Officer, Bharatpur which indicates that Chando S/o Mooli Ram Sharma, aged 20 years, R/o Dhormoi had taken the treatment of TB from 3.2.2003 to 25.4.2003. His TB No. was 59/2003. The learned District Forum did not place reliance on this document on the ground that the primary evidence has not been produced nor the affidavit of District TB Officer, Bharatpur was filed. Consequently, the complaint was allowed as indicated above.


2


The Appellant at this stage has filed the original certificate of District TB Officer, Bharatpur which goes to show that the LA had tested positive for TB and had taken the treatment also from Prasavika deputed at village Dhormoi. His TB Card No. was 59/2003. This certificate of the District TB Officer, Bharatpur is very important from this point of view whether the LA had been suffering from TB at the time when the proposal for insurance policy was submitted. The treatment for TB was started on 3.2.2003 which continued till 25.4.2003 whereas proposal was submitted on 31.3.2003. The treatment continued even during the period the proposal was pending consideration for issuance of policy. This document should not have been thrown away lightly by the learned District Forum. Rather the learned District Forum should have taken steps to call for relevant record, particulars of which are mentioned in the letter itself. We would like to send the matter back to the learned District Forum with the directions to give an opportunity to the Insurance Corporation for producing the relevant record and an opportunity should also be given to the Complainant to rebut the evidence produced by the Insurance Corporation.


Consequently, while setting aside the impugned order of the learned District Forum, we remand the case back to the learned District Forum, Bharatpur to proceed as per the aforesaid directions and after hearing both the parties, pass a fresh order.


Both the parties are directed to appear before the learned District Forum, Bharatpur on 30.4.2009.



Member Presiding Member



Hira Lal