STATE CONSUMER DISPUTES REDRESSAL COMMISSION, PUNJAB, S.C.O. NO , SECTOR 22-D, CHANDIGARH. First Appeal No.285 of 2003

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1 STATE CONSUMER DISPUTES REDRESSAL COMMISSION, PUNJAB, S.C.O. NO , SECTOR 22-D, CHANDIGARH. First Appeal No.285 of Kasturi Lal Khurana, son of Ram Lal, Date of institution : Date of decision : Sheela Wanti, wife of Kasturi Lal Khurana Both residents of W.E.100, Chota Ali Mohalla, JALANDHAR CITY. Versus.Appellants Life Insurance Corporation of India, Divisional Office, Jeevan Parkash Bldg., Model Town Road, Jalandhar through its Senior Divisional Manager. Respondent Before :- First Appeal against the order dated of the District Consumer Disputes Redressal Forum, Jalandhar. Present :- Hon ble Mr. Justice S.N. Aggarwal President. Lt. Col. Darshan Singh (Retd.), Member. Shri Piare Lal Garg, Member. For the appellants : Shri K.C. Malhotra, Advocate. For the respondents : Shri Paramjit Batta, Advocate. JUSTICE S.N. AGGARWAL, PRESIDENT: Harjit Kaur daughter of the appellants had taken the life insurance policy from the respondents by filling the proposal form on for an amount of Rs.25,000/-. The date of commencement was She was 17 years old at that time. Unfortunately she died on She was unmarried at the time of her death. The appellants being the legal heirs of their daughter Harjit Kaur lodged the insurance claim with the respondents. It was repudiated by the respondents vide letter dated Alleging deficiency in service on the part of the respondents, the appellants filed the complaint against them in the District Consumer Disputes Redressal Forum, Jalandhar (in short District

2 First Appeal No.285 of Forum ) for insurance claim. Compensation, interest and costs were also claimed. 2. The respondents filed the written reply. It was admitted that Harjit Kaur had taken the life insurance policy by filling the proposal form on for a sum of Rs.25,000/- and the date of commencement was It was also not disputed that Harjit Kaur had died on It was also admitted that the insurance claim was repudiated on It was pleaded that Harjit Kaur was suffering from diabetes mellitus for the last 7 years prior to her death. She had concealed these facts while filling the proposal form. Therefore the repudiation was legal and valid. Hence dismissal of the complaint was prayed. 4. Kasturi Lal Khurana appellant filed his own affidavit Ex.C1 and additional affidavit Ex.C2. The appellants also filed the affidavit of Satish Kumar as Ex.C3, affidavit of Rajesh Kumar as Ex.C4 and the affidavit of Khazan Singh as Ex.C5. The appellants also proved documents Ex.C6 to Ex.C On the other hand, the respondents filed the affidavit of Amarjit Singh Sood, Manager, Claims as Ex.O1 and the additional affidavit of Amarjit Singh Sood as Ex.O2. They also filed the affidavit of Hem Raj Garg, Chief Medical Officer as Ex.O3. The respondents also proved documents as Ex.O4 to Ex.O After considering the pleadings of the parties and the affidavits/documents placed on file by them, the learned District Forum dismissed the complaint vide impugned judgment dated Hence the appeal. 8. The submission of the learned counsel for the appellants was that the appeal be accepted and the impugned judgment dated be set aside. 9. On the other hand, the submission of the learned counsel for the respondents was that there was no merit in the present appeal and the same be dismissed. 10. Record has been perused. Submissions have been considered.

3 First Appeal No.285 of Admittedly Harjit Kaur daughter of the appellants had taken the life insurance policy from the appellants by filling the proposal form on for an amount of Rs.25,000/-. It is also not disputed that she was died on The insurance claim was filed by the appellants. It was repudiated by the respondents vide letter dated (Ex.C6). 12. The proposal form filled by Harjit Kaur life assured has been proved as Ex.O-11. She had answered questions 12(a) and 14 as under:- 12.(a) What has been your usual state of health? Good 14. Have you been suspected of diabetes or are you suffering from diabetes or have you ever passed sugar, albumin, pus or blood in urine? No. 13. In order to prove that Harjit Kaur was suffering from illness, the respondents have proved the certificate of hospital treatment in Form No.3816 as Ex.O4. As per this certificate, Harjit Kaur was admitted in Civil Hospital, Jalandhar on This document also reveals that she was a patient of diabetes for the last 7 years prior to the date of her admission in this hospital. 14. The respondents have also proved the affidavit of Dr. Hem Raj Garg, Chief Medical Officer, Civil Hospital, Jalandhar (Ex.O3). This witness has also deposed that Harjit Kaur was a diabetic for the last 7 to 8 years. 15. It has been held in a number of judgments that diabetes is not a disease fatal in itself. It has also been held that the suppression of these facts does not authorize the insurance companies to repudiate the insurance claim. 16. It has been held by this Commission in the judgment reported as LIFE INSURANCE CORPORATION OF INDIA v. SUSHMA SHARMA II(2008) CPJ 213 as under:- 18. So far as hypertension is concerned. No doubt, it is a disease but it is not a material disease. In these days of fast life, majority of the people suffer from hypertension. It may be only the labour class who work

4 First Appeal No.285 of manually and take the food without caring for its calories that they do not suffer from hypertension or diabetes. Out of the literate and educated people particularly who have the white collar jobs, majority of them suffer from hypertension or diabetes or both. If the Life Insurance Companies are so sensitive that they consider hypertension and diabetes as material diseases then they should wind up their business and stop accepting premium. If these diseases had been material Nand Lal insured would not have survived for 10 years after he started suffering from these medical problems. Like hypertension, diabetes has also infected a majority of the Indian population but the people who suffer from diabetes and continue managing it under the medical advise, they survive for number of years and none of these diseases is fatal and as discussed above, if these diseases had been material diseases Nand Lal insured would not have survived for 10 years. 17. In the present case also Harjit Kaur had survived for 7 to 8 years after suffering the disease of diabetes. Therefore the ratio of law laid down in Sushma Sharma s case (supra) is applicable to the facts of this case also. 18. Similar view was taken by the Hon ble U.T. State Consumer Disputes Redressal Commission, Chandigarh in the judgment reported as LIFE INSURANCE CORPORATION OF INDIA & ANR. v. SARABJIT KAUR III(2008) CPJ 120 in which it was held that diabetes and hypertension are not serious diseases. They were part and parcel of ordinary strain and stress of life. Therefore the Insurance Companies do not have the right to repudiate the claim on its basis alone.

5 First Appeal No.285 of Moreover the Zonal Office, New Delhi of the appellants had issued Instructions No. Legal/99/470 dated to all the Divisional Offices of the Life Insurance Corporation of India in which one of the instruction (Instruction No.5) was that utmost restraint should be exercised at the time of repudiation particularly where the sum assured is less than Rs.50,000/-. In the present case, the amount assured is only Rs.25,000/-, therefore, the appellants should have followed the instructions issued by their head office. 20. This Commission had observed about these instructions in the judgment dated passed in First Appeal No.1264 of 2001 Life Insurance Corporation of India v. Kamlesh Rani as under:- 11. The Zonal Office, New Delhi of the appellants had issued Instructions No. Legal/99/470 dated to all the Divisional Offices of the Life Insurance Corporation of India in which one of the instruction (Instruction No.5) was that utmost restraint should be exercised at the time of repudiation particularly where the sum assured is less than Rs.50,000/-. In the present case, the amount assured is only Rs.25,000/-, therefore, the appellants should have followed the instructions issued by their head office. In the present case, these instructions were more justified when Ram Saran Sehgal had got the insurance policy in the year 1986 for a sum of Rs.25,000/-. Although it had lapsed in 1994, but the appellants themselves had initiated the special campaign for revival of lapsed policies and this policy was also revived on The insured had died more than 22 months after the revival of the insurance policy. The repudiation of such small claim, particularly when

6 First Appeal No.285 of the appellants have accepted the premium for more than 12 years was not at all justified. Such approach on the part of the appellants was deprecated by this Commission in another judgment in First Appeal No.1467 of 2006 titled as Life Insurance Corporation of India versus Angrej Singh. The appeal filed by the appellants deserves to be dismissed on this ground alone. 21. Keeping in view the discussion held above, the respondents were not justified in repudiating the insurance claim. 22. This appeal is accordingly accepted with costs of Rs.5,000/- and the impugned judgment dated is set aside. 23. The respondents are directed to pay the insurance claim admissible under the life insurance policy taken by Harjit Kaur. 24. The respondents are also directed to pay interest at the rate of 7.5% per annum from the date of repudiation i.e till the date of payment. 25. The appeal could not be decided within the statutory period due to heavy pendency of court cases. (JUSTICE S.N. AGGARWAL) PRESIDENT (LT. COL. DARSHAN SINGH [RETD.]) MEMBER November 19, Bansal (PIARE LAL GARG) MEMBER

7 First Appeal No.285 of

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