BEFORE THE KARNATAKA STATE CONSUMER DISPUTES REDRESSAL COMMISSION, BANGALORE.
DATED THIS THE 26TH DAY OF MAY 2022
PRESENT
MR. RAVISHANKAR : JUDICIAL MEMBER
MRS. SUNITA CHANNABASAPPA BAGEWADI : MEMBER
APPEAL NO. 860/2015
The Divisional Manager– I, LIC of India, D.A. Branch, J.P. Building, 1st Floor, J.C. Road, Bangalore 560 002. Represented by its Manager ( L & HPF ), LIC of India, D.O. – I, Jeevan Prakash, JC Road, Bangalore 560 002. (By Sri Rajesh Shetty) | ……Appellant/s |
V/s
Smt. Saraswathi, W/o Late L.R. Munirajappa, Aged about 35 years, R/at 270/6, 6th Cross, Krishnappa Building, Bagalakunte, Bangalore 560 073. (By Sri Imran Pasha) | ..…Respondent/s |
ORDER
MR. RAVISHANKAR, JUDICIAL MEMBER
1. The appellant/Opposite Party has preferred this appeal being aggrieved by the Order dt.23.07.2015 passed in CC.No.1086/2011 on the file of 3rd Additional District Consumer Disputes Redressal Commission, Bangalore.
2. The brief facts of the case are as hereunder;
It is the case of the complainant that her husband late Mr.L.R. Munirajappa during his lifetime had obtained Anmol Jeevan-1 policy bearing No.615393142 by paying a premium of Rs.8,306/-. After receipt of the premium, this Opposite Party had issued a policy which effect from 04.02.2008. The complainant was made a nominee to the said policy. After issuance of the policy, being a nominee, the complainant issued a legal notice on 06.03.2010 and reminder notice on 27.03.2010 and called upon the Opposite Party to pay policy amount as the policy holder died during the policy is in force. For the non-payment of the policy amount, the complainant filed a complaint before the District Commission. After trial, the District Commission allowed the complaint directing the Opposite Party to pay Rs.10 lakhs with interest at 8% p.a. from 15.05.2008, till realization along with compensation and costs.
3. Aggrieved by the said order, the appellant/ Opposite Party is in appeal.
4. On going through the memorandum of appeal, certified copy of the order of the District Commission, we noticed that one Mr. L.R. Munirajappa had obtained Anmol Jeevan-1 policy bearing No.615393142 on 04.02.2008 by paying a premium of Rs.8,306/-. We noticed here that the policy holder died on 15.05.2008 within a span of four months after obtaining the policy. The appellant had investigated the matter and noticed that prior to obtaining the policy, the husband of the complainant/deceased was suffering from diabetes since four years and alcoholic since 13 years and he was admitted to the hospital on 21.05.2001 and discharged on 28.05.2001, but, the said facts were not disclosed by the policy holder at the time taking the policy and suppressed the material facts with respect to the health condition. Hence, the appellant was unable to pay the assured amount to the complainant.
5. On perusal of the discharge summary, we noticed that Late Mr. L.R. Munirajappa was diagnosed alcohol dependence syndrome and he was admitted to the hospital on 21.05.2001 and discharged on 28.05.2001, but, the policy holder had not reflected the same at the time of taking the policy. It is a clear case of suppression of material facts. The policy holder ought to disclose the health condition at the time of taking the proposal of the policy. The policy holder has to take the policy in utmost good faith. He has to express detailed report with respect to the health condition as reflected in the proposal form, but, when the health condition was not disclosed, it is a clear case of non-disclosure of material facts for wrongful gain. The District Commission below had not appreciated the documents produced by the Opposite Party with respect to the health condition of the insured. Inspite of that, allowed the complaint and made an error in directing the appellant/Opposite Party to pay the insured amount, hence, interference is required. The complainant is not entitled to any insurance amount. Accordingly, we proceed to pass the following,
ORDER
The appeal is allowed. Consequently, the complaint is dismissed.
The amount in deposit shall be refunded to the appellant under proper ID.
Forward free copies to both parties.
Sd/- Sd/-
MEMBER JUDICIAL MEMBER
KCS*
