Kerala

StateCommission

A/14/400

THE BRANCH MANAGER, LIC OF INDIA - Complainant(s)

Versus

SEBASTIAN - Opp.Party(s)

S SREEKUMAR

04 Sep 2015

ORDER

KERALA STATE CONSUMER DISPUTES REDRESSAL

COMMISSION  VAZHUTHACAUD, THIRUVANANTHAPURAM

APPEAL NO.400/14

JUDGMENT DATED: 04.09.2015

 

PRESENT : 

JUSTICE SHRI. P.Q. BARKATHALI                         :  PRESIDENT

SHRI.V.V. JOSE                                                          : MEMBER

The Branch Manager,

Life Insurance Corporation of India,

Thodupuzha Branch,                                                        : APPELLANT

Thodupuzha.P.O, Idukki.

 

(By Adv: Dr. S. Sreekumar)

 

            Vs.

 

Sebastian K.V,

Vyapana House,

Perumpillichira .P.O,

Thodupuzha, Idukki,                                                         : RESPONDENT

PIN – 685 500.

 

 

JUDGMENT

JUSTICE SHRI. P.Q. BARKATHALI:  PRESIDENT

 

This is an appeal filed by the complainant in CC.267/13 on the file of Consumer Disputes Redressal Forum, Idukki challenging the order of the Forum dated, April 29, 2014 directing the opposite party to disburse the policy amount due to the complainant under Ext.P1 policy with a cost of Rs.1000/-.  

2.      The case of the complainant as detailed in the complaint before the Forum in brief is this:-

The wife of the complainant died on January 12, 2012. She had availed an insurance policy from the opposite party for Rs.1,00,000/- in the year 1994 which will mature on 2019.  Due to non payment of premium the policy was lapsed from September 2010 to March 2011.  Thereafter on March 31, 2011 the policy was revived by paying 3 quarterly instalments.  Till her death the wife of the complainant was paying the premium regularly.  The opposite party, Insurance Company repudiated the claim stating that before the revival of the policy she was suffering from several ailments which she has suppressed at the time of revival of the policy.  Therefore complainant filed this complaint for getting the amount due under the policy.

3.      The opposite party is Life Insurance Corporation of India, represented by its Branch Manger, Thodupuzhba.  He in his version contended thus before the Forum:-  Issuance of the policy to the wife of the complainant is admitted.  It is not disputed that policy was lapsed due to non payment of premium from September 10 to March 2011 and that it was revived on March 31, 2011.  On enquiry it was revealed that she was undergoing treatment at Lakeshore Hospital, Kochi and was suffering from cirrhosis of liver for a period of 3 years prior to the death.  She has suppressed the said fact while reviving the claim.  Therefore the claim of the complainant was repudiated.

4.      On the side of the complainant Exts.P1 and P2 were marked and the opposite party was examined as DW1 and he produced Exts.R1 to R11 before the Forum.  On an appreciation of evidence the Forum found that complainant is entitled to the amount due under the policy and allowed the complaint.  Opposite party has now come up in appeal challenging the said order of the Forum.

5.      Heard both the counsels.

6.      The following points arise for consideration:-

1. Whether the opposite party is justified in repudiating the claim of the complainant?
2. Whether the impugned order of the Forum can be sustained?

7.      It is not disputed that the wife of the complainant availed Ext.P1 policy from the opposite party while she was working as a school teacher in 1994 that the policy was lapsed due to non payment of premium and that it was revived on March 31, 2011 and thereafter she was paying the premium amount till her death.  The opposite party repudiated the claim of the complainant on the ground that at the time of revival of the policy the fact that she was suffering from cirrhosis of liver and was treatment for 3 years was suppressed.

8.      For several reasons we agree with the finding of the Forum that opposite party is not justified in repudiating the claim of the complainant.  In Ext.R2 the copy of the policy with conditions it is seen that after the lapsing of the policy it should be revived only after the production of evidence of health and habits of life assured including a medical report on her life at her own expense to the satisfaction of the Corporation and evidence to show that there has been no adverse change in the personal or the family history or occupation.  In the present case opposite party revived the policy without insisting on the above documents and thereafter the deceased was paying the premium regularly.  Therefore opposite party cannot now contend that deceased had suppressed the fact that she was suffering from illness at the time of revival of the policy.  Further after revival it has to be treated as an original policy taken during 1994.  Opposite party has no case that at that time the deceased was suffering from any disease.  For all these reasons we are of the view that opposite party is not justified in repudiating the claim of the complainant.  The finding of the Forum on this point is confirmed.

9.      Forum has ordered to disburse the policy amount the complainant with interest and a cost of Rs.1000/-.  We find no reason to interfere with the said finding of the Forum.

In the result we find no merit in this appeal and the same is hereby dismissed with a cost of Rs.5000/-.

 

JUSTICE P.Q. BARKATHALI       :  PRESIDENT

 

 

V.V. JOSE : MEMBER

 

VL.