(Per: Justice B.S. Verma, President): This appeal under Section 15 of the Consumer Protection Act, 1986 is directed against the order dated 31.07.2009 passed by the District Forum, Dehradun in consumer complaint No. 108 of 2004.
2. Briefly stated the facts giving rise to the appeal are that late Sh. Rupesh Gupta, the son of the complainant Sh. Ramesh Chandra Kansodan (who had also expired during the pendency of this appeal), during his lifetime, had obtained a life insurance policy bearing No. 271202382 for assured sum of Rs. 2,00,000/-. In addition to the said policy, the life assured also had three other life insurance policies for assured sum of Rs. 50,000/-; Rs. 3,00,000/- and Rs. 25,000/- respectively. The complainant was the nominee in the three life insurance policies obtained by the life assured. The life assured died on 24.02.2003, intimation whereof was given by the complainant to the insurance company through his letter dated 29.06.2003. The insurance company made payment in respect of two insurance policies, but denied the payment of policy No. 271202382 and the claim in regard to the said policy was repudiated by the insurance company on the ground that at the time of taking the insurance policy in question, the life assured had withheld the information regarding his previous policies. Thus, alleging deficiency in service on the part of the insurance company, the complainant filed a consumer complaint before the District Forum, Dehradun.
3. The insurance company filed written statement before the District Forum and pleaded that prior to taking the insurance policy in question, the deceased life assured had taken policy No. 271141896 for assured sum of Rs. 3,00,000/-, which fact was not disclosed by the life assured at the time of taking the insurance policy No. 271202382 in question; that the life assured had died on account of suicide within a period of about three months from taking the policy in question; that the claim of the complainant was rightly repudiated by the insurance company and that there is no deficiency in service on their part.
4. The District Forum after perusal of the evidence on record, allowed the consumer complaint vide impugned order dated 31.07.2009 and directed the insurance company to pay the insured amount of Rs. 2,00,000/- to the complainant together with interest @7% p.a. from the date of repudiation of the claim till payment. Aggrieved by the said order, the insurance company has filed the present appeal.
5. During the pendency of the appeal, the complainant Sh. Ramesh Chandra Kansodan expired on 13.11.2013 and, as such, his legal heirs were substituted in his place as respondent Nos. 1/1 and 1/2. We have heard the learned counsel for the parties and gone through the record.
6. So far as the plea taken by the insurance company that since the life assured had not disclosed the earlier insurance policy No. 271141896 at the time of submitting the proposal for the insurance policy in question and, as such, the claim was rightly turned down by the insurance company is concerned, it need to be stated that all the insurance policies were taken by the life assured from the appellant Life Insurance Corporation of India and the appellant insurance company had all the information with regard to the insurance policies obtained by the life assured during his lifetime. The insurance company has not put forward any satisfactory reason on the part of the life assured in suppressing the earlier insurance policy obtained by him and in not disclosing the same in the proposal form. The proposal form is always filled in by the agent of the insurance company. When in the proposal form, the life assured had mentioned his earlier policy No. 270912182 for assured sum of Rs. 50,000/-, there was no occasion for the life assured to withheld information with regard to his other insurance policy. Thus, we are of the view that the repudiation of the claim by the insurance company on the ground that in the proposal form, the life assured had withheld information with regard to his earlier insurance policy, was not justified and there was clearly deficiency in service on the part of the insurance company in denying the claim of the complainant. It is also important to mention here that it is not the case of the insurance company that the life assured was suffering from any disease and in order to get unlawful gain / benefit, he obtained the insurance policy in question, so that on his death, his nominee may be benefitted with the assured sum under the policy. Even otherwise, there is nothing on record to show that the life assured was suffering from any disease / ailment at the time of submitting the proposal form for the policy in question. Thus, we do not find any force in the stand of the insurance company that if the life assured would have disclosed his earlier policy No. 271141896 at the time of submitting the proposal for the policy in question, he would have been subjected to medical examination, which could have affected the decision of the insurance company regarding issuance of the insurance policy in question in favour of the life assured deceased.
7. So far as the another plea taken by the insurance company that since the life assured had died on account of suicide and hence the claim is not payable is concerned, it need to be stated that the insurance company has not filed any plausible / cogent evidence to show that the life assured had committed suicide. This apart, it is also important to mention here that the insurance company has not repudiated the claim on the ground that the life assured had committed suicide. However, since the insurance company has failed to prove that the life assured had died on account of committing suicide and there is nothing on record to prove the said fact and hence the insurance company can not deny the claim on the ground that the life assured had committed suicide. It is pertinent to mention here that in respect of other policies of the life assured also, same pleas were raised by the insurance company, but the insurance company has paid the insured amount under the said policies without any objection. Therefore, the insurance company is estopped from raising these pleas in the present case.
8. The District Forum has considered all the facts and circumstances of the case and has rightly allowed the consumer complaint per impugned order, which does not call for any interference and is fit to be maintained. The appeal lacks merit and is liable to be dismissed.
9. Appeal is dismissed. No order as to costs. (D.K. TYAGI) (JUSTICE B.S. VERMA)