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Sonu v/s Birla Sun Life Insurance Company Limited & Others

Company & Directors' Information:- BIRLA CORPORATION LIMITED [Active] CIN = L01132WB1919PLC003334

Company & Directors' Information:- SUN PVT LTD [Active] CIN = U24246RJ1984PTC003093

Company & Directors' Information:- G SUN INDIA PRIVATE LIMITED [Strike Off] CIN = U74899DL1995PTC071425

Company & Directors' Information:- SONU AND COMPANY PRIVATE LIMITED [Strike Off] CIN = U70101DL1992PTC050211

Company & Directors' Information:- SUN INDIA CORPORATION PRIVATE LIMITED [Strike Off] CIN = U65991TN1943PTC000994

    Revision Petition No. 533 of 2017

    Decided On, 18 May 2017

    At, National Consumer Disputes Redressal Commission NCDRC

    By, MEMBER

    For the Petitioner: Bharat Swaroop Sharma, Advocate. For the Respondents: ---------

Judgment Text

This revision is directed against the order of the State Commission Haryana, Panchkula dated 11.11.2016 in first appeal No.FA/170/2015 whereby the State Commission allowed the appeal preferred by the respondent/opposite party, set aside the order of the District Forum and dismissed the complaint.

2. Briefly stated facts relevant for the disposal of the revision petition are that the father of the petitioner/complainant had purchased an insurance policy for Rs.10 lakhs from the opposite party. The policy was valid w.e.f. 30.9.2012. Father of the petitioner during the subsistence of the insurance policy died on 17.7.2013. The petitioner being the legal heir filed the insurance claim. The opposite party repudiated the claim on the plea that the insured had obtained the insurance policy by concealing the material fact that he was suffering from Diabetes Mellitus and Palloor. Being aggrieved of the repudiation of the insurance claim the petitioner filed consumer complaint in District Forum, Fatehabad.

3. The opposite party on being served resisted the consumer complaint and justified the repudiation for the reason noted above.

4. The District Forum, Fatehabad on appreciation of the evidence allowed the complaint and directed the respondent/opposite party as under: -

'Keeping in view the facts and circumstances of the case we allow the present complaint directing the OPs to pay a sum of Rs.10 lacs to the complainant with interest @ 6% per annum from the date of filing of complaint till realization of the amount within one month. The OPs are further directed to pay a sum of Rs.5,000/- as litigation expenses, harassment and mental agony etc. Order be complied within one month failing which the complainant is at liberty to initiate proceeding against the OPs under Section 25/27 of the C.P. Act. A copy of this order be supplied to both the parties free of costs. File be consigned after due compliance.'

5. The opposite party insurance company being aggrieved approached the State Commission, Haryana in appeal. The State Commission on re-appreciation of evidence vide impugned order came to the conclusion that the insurance policy was obtained by the insured by concealing material fact regarding his previous ailments. Accordingly, it was held that the repudiation was justified and the appeal was allowed. The relevant observations of the State Commission are reproduced as under: -

'This argument is devoid of any force. It is well settled that Evidence Act, 1872 (in short 'Evidence Act) is not strictly applicable in consumer complaints as per view of Hon’ble National Commission in first appeal No.512 of 2013 titled as Sheela R. Ohri vs. Bajaj Allianz General Insurance decided on 11.11.2014. Documents are not to be proved as in the civil cases. Es.R-14 is the application submitted by wife of deceased before Deputy Commissioner, Fatehabad and it is obtained from the office. Ex. R-5 is the copy of the treatment received at General Hospital, Fatehabad which is also attested by the doctor. This is public document and there is no necessity to call the doctor to prove the same. Complainant has nowhere alleged that this application was not moved by the wife of the deceased or that Bedhead ticket Ex.R-5 is not pertaining to his father. Learned District Forum fell in error while ignoring these documents. As per these documents it is clear that DLA was suffering from this ailment since 11.7.2012 and concealed this fact when proposal form was submitted on 29.9.2012. When complainant concealed this fact, he is not titled for claim.'

6. On reading of the above, it is clear that motivating factor for the State Commission to conclude that insured had obtained insurance policy by concealment of his previous ailment i.e. diabetes mellitus and Palloor on the basis of the information contained in the documents marked as Ex. R-4 & R-5 on the record, namely, the application submitted by wife of the deceased insured to the Deputy Commissioner Fatehabad and the attested copy of the record of the treatment of the deceased at General Hospital Fatehabad duly attested by the doctor. The only contention of learned counsel for the petitioner is that State Commission has committed a grave error on relying upon the information contained in the aforesaid documents ignoring the fact that copies placed on record were not properly proved.

7. We do not find merit in the above contention for the reason that as per the scheme of the Consumer Protection Act, the consumer disputes are to be decided summarily. Therefore, technical rules of CPC and Evidence Act are not applicable to the consumer cases provided the principles of natural justice are followed. Otherwise also, original of Ex. R-4 was submitted by wife of the deceased to the Deputy Commissioner Fatehabad. Therefore, the State Commission cannot be faulted for relying upon the same.

8. Learned Shri B.S. Sharma, Advocate for the petitioner has furthe

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r contended that the State Commission has failed to appreciate that even if the insured was suffering from Diabetes Mellitus, it had no nexus with the heart problem which was cause of the death. We do not find merit in this contention. As per medical science, Diabetes is a killer disease and if not properly controlled and cured it can result in hyper tension as also lead to heart problem or failure of other organs. 9. In view of the discussion above, we do not find merit in the revision petition. Revision petition is accordingly dismissed.