JUSTICE V.K. JAIN, PRESIDING MEMBER (ORAL) IA/15979/2018 (Impleadment of legal heirs) The learned counsel appearing for the son of the respondent states that Prateek is the only surviving legal heir of the deceased insured. He is, therefore, impleaded as a respondent in this petition. The amended memo of parties is taken on record. RP/1785/2011 Late Shriram Jadhav husband of the complainant / respondent obtained a New Bima Gold Policy for a period of 20 years from the petitioner Corporation, for a sum assured of Rs.3.00 lacs. He having died in a road accident, a claim for payment in terms of the insurance policy was submitted by the complainant with the petitioner Corporation. The claim was repudiated by the petitioner Corporation on ground that the deceased had suffered from viral Hepatitis before taking the insurance policy and the said ailment was concealed by him while obtaining the insurance policy. Being aggrieved, the complainant approached the concerned District Forum by way of a consumer complaint, seeking payment in terms of the insurance policy taken by her husband. 2. The complaint was resisted by the petitioner primarily on the ground on which the claim had been repudiated vide letter dated 28.2.2009. It was alleged that the deceased was suffering from Viral Hepatitis for the period from 1.11.2007 to 03.12.2007 and the said ailment was concealed by him while applying for the insurance policy. 3. The District Forum having ruled in favour of the complainant, the petitioner Corporation approached the concerned State Commission by way of an appeal. The said appeal also having been dismissed, the Corporation is before this Commission by way of this revision petition. 4. In Sulbha Prakash Motegaonkar & Ors. Vs. LIC of India [Civil Appeal No.8245 of 2015] decided by the Hon’ble Supreme Court on 5.10.2015, the husband of the complainant had, at the time of taking the policy from LIC of India, concealed the fact that he was suffering from Lumbar Spondylitis with PID with Sciatica for which he was taking medical treatment and had also availed medical leave. He suffered myocardial infarction and succumbed to the said ailment. The claim lodged by the complainant, however, was repudiated on the ground that the deceased had not disclosed the ailment of Lumbar Spondylitis with PID with Sciatica at the time of submitting the proposal. Allowing the complaint, the Hon’ble Supreme Court interalia held as under:- “It is not the case of the Insurance Company that the ailment that the deceased was suffering from was a life threatening disease which could or did cause the death of the insured. In fact, the clear case is that the deceased died due to ischaemic heart disease and also because of myocardial infarction. The concealment of lumbar spondilitis with PID with sciatica persuaded the respondent not to grant the insurance claim. We are of the opinion that the National Commission was in error in denying to the appellants the insurance claim and accepting the repudiation of the claim by the respondent. The death of the insured due to ischaemic heart disease and myocardial infarction had nothing to do with his lumbar spondilitis with PID with sciatica. In our considered opinion, since the alleged concealment was not of such a nature as would disentitle the deceased from getting his life insured, the repudiation of the claim was incorrect and not justified.” 5. In the present case, the deceased died in a road accident. Therefore, his death had not happened on account of the ailment from which he had suffered sometime before taking the insurance policy. The insurance policy was taken on 11.2.2008, whereas the deceased allegedly suffered from Viral Hepatitis during the period from 1.11.2007 to 03.12.2007. No expert evidence such as opinion of a doctor has been led by the petitioner to prove that Viral Hepatitis is a life threatening disease which could cause the death of the insured. No Medical Literature has been filed to show that the Viral Hepatitis was in itself a life threatening disease. Thus the decision of the Hon’ble Supreme Court in Sulbha Prakash Motegaonkar (supra) squarely applies to the facts of this case. 6. The learned counsel for the petitioner states that there are previous decisions allowing repudiation of the claims on account of concealment of a material fact and the judgment relied upon by the learned counsel in Satwant Kaur Sandhu Vs. New India Assurance Co. Ltd., IV (2009) CPJ 8 (SC). However, as far as this case is concerned on facts, it is squarely covered by the decision of the Hon’ble Supreme Court in Sulbha Prakash (supra) and no subsequent decision, to the contrary, has been brought to my notice. 7. For the reasons stated hereinabove, I find no merit in the revision petition, which is accordingly dismissed, with no order as to costs. |