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Swadesh Pal Singh v/s HDFC Standard Life Insurance Company Ltd. & Another

    Revision Petition No. 1992 of 2016

    Decided On, 09 August 2016

    At, National Consumer Disputes Redressal Commission NCDRC

    By, MEMBER

    For the Petitioner: Govind Narayan, Advocate. For the Respondents: ---------

Judgment Text

Dr. S.M. Kantikar, Member

1. There is a delay of 19 days in filing this revision petition. For the reasons mentioned in the application for condonation of delay, the short delay is hereby condoned.

2. Smt. Krishna Chaudhary (since deceased), wife of the complainant/petitioner, Shri Swadesh Pal Singh, took housing loan for a sum of Rs.3,18,877/- from HDFC Ltd., OP 2, on 23.12.2004. For the security of said loan, HDFC loan cover term insurance policy for Rs.2,83,190/- was purchased from HDFC Standard Life Insurance Limited, OP 1. Smt. Krishna Chaudhary submitted the proposal form on 29.12.2004 by paying premium of Rs.11,234/-. Accordingly, OP 1 issued a letter that the date of commencement of the policy is 20.1.2005. The policy was issued after conducting medical examination of the insured and no disease was found with the insured and OP 1 accepted the policy. Thereafter, on 3.2.2005, OP 1 made a demand of Rs.4041/- as extra premium, it was paid by wife of petitioner. The insurance policy was assigned to OP 2 as a security for housing loan obtained by wife of petitioner. Unfortunately, the insured died because of Cancer in May, 2005. The complainant as a nominee of the insured filed a claim before OP 1, which claim was repudiated by the insurance company without any justification. Therefore, in the year 2006, the complainant filed a complaint before the District Forum, Alwar, Rajasthan.

3. The District Forum allowed the complaint and directed the OP 1 to pay a sum of Rs.2,83,191/- alongwith interest @ 9% per annum from the date of presentation of the complaint. Aggrieved by the order of District Forum, OP 1 filed first appeal before the State Commission, Rajasthan. The State Commission allowed the appeal and dismissed the complaint.

4. Therefore, against the impugned order, this revision petition aroused.

5. At the admission stage, we have heard Mr. Govind Narayan, learned counsel for the petitioner. He vehemently argued that the OP 1 had issued the policy, it was commenced from 20.1.2005. He further submitted that, the policy was issued on the basis of medical examination. There was no disease at the time of submitting the proposal form. She was not diagnosed of Cancer till May, 2005 and has not concealed any material fact from the insurance company.

6. We have perused the impugned order in which the State Commission held that no legal contract will come into force unless the offer and acceptance of proposal is made. In the instant case, the complainant’s wife submitted the proposal form on 29.12.2004 by remitting premium of Rs.11,234/- on 21.1.2005 but, the insurance company did not accept proposal in view of medical condition of the wife of the complainant. She was under weight. Therefore, additional premium of Rs.4041/- was charged and offer was accepted after paying additional premium on 28.3.2005. Therefore, the insured risk was started from 28.3.2005.

7. It is more pertinent to quote the relevant observation made by the State Commission, it is reproduced as hereunder:-

'14. xxxxx

'After submitting the proposal on 29.12.2004 she was bound to communicate any change in her health condition. There is an application ex. R-25 on record which was written by the wife of the complainant informing the block education officer, Tijara that she has been suffering from Cancer and was absent from her duty for 29 days. She rejoined her duty through this letter on 12-3-2005. This letter is sufficient to believe that she had knowledge of her disease, as she was suffering from Cancer and was absent for 29 days. This fact is further strengthened by her leave record, she was on long leave for 14 days from 26-2-2005 to 11-4-2005 then leave for 29 days from 14-3-2005 to 11-4-2005 and leave for 28 days from 13-4-2005 to 10-5-2005.

15. It is evident from the medical record produced by the insurance company that she had knowledge of the disease. On 16-3-2005 she was diagnosed positive for malignant cells-metastatic. The prescription of the doctor Rajesh Kapoor Ex R-15 also mentioned results FNAC Test. The prescription of the Dr. GP Elhence Ex. R-14 dated 7-3-2005 shows that she had been advised FNAC on 7-3-2005. There is sufficient evidence on record to prove that between December 2004 to 28-3-2005 her medical condition has changed and she was under obligation to inform the company the subsequent developments in her health. Thus it is apparent that she concealed the material facts from the Insurance Company.'

8. On the basis of forgoing discussion, it is clear that she underwent FNAC on 7.3.2005 and diagnosed as malignancy (Metastatic Carcinoma). S

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he paid extra premium of Rs. 4041/- on 28.3.2005, thus, the proposal was accepted on 28.3.2005. Thus, the instant case is a clear case of concealment of material facts by the insured (deceased) person. It was the duty of the proposer, that she should have communicated the change in her health condition, after submitting proposal form on 29.12.2004.9. We do not find any reason to interfere with the order of State Commission. The revision petition is without merits, therefore, the same is hereby dismissed.