Page 61 - Suri’s - NCDRC ON LIFE INSURANCE 2017 V1.3

Suri’s - NCDRC ON LIFE INSURANCE 2017 61

unjust. Therefore she filed a complaint with the following prayer:
(i) To pay an amount of Rs,2,25,000/- due under the above said policy with in-
terest @ 24% per annum from the date till the date of realisation;
(ii) Pay an amount of Rs.5,000/- towards mental agony and physical strain;
(iii) To pay Rs.5,000/- towards expenses and costs of the complaint;
(iv) And pass such other necessary orders as the Hon‘ble Forum deems fit and
proper in the circumstances of the case.
3. Respondent no.1/ OP no. 1 filed memo adopting the version of respondent
no. 2/ OP no. 2 and their contention in brief are as under:
The insured died within five months after taking the policy. The insured ob-
tained the policy suppressing his pre-existing disease to extract money for unjust en-
richment. The petitioner failed to submit either the case history or post mortem report
or claim form in the prescribed form. As the insured Ramaiah suppressed his pre-
existing ailments while taking the policy, the policy was void-ab-initio. The petitioner
kept silent till 19.05.2011 and then got issued a legal notice. The petitioner even in
her notice dated 19.05.2011 was silent with regard to the certificate issued by the doc-
tor to the respondents herein. The procurement of the letter by influencing the doctor
through local prominent persons revealed the attitude and conduct of the petitioner.
The respondents did not commit any deficiency of service. Therefore, the complaint
should be dismissed.
4. The District Consumer Disputes Redressal Forum, Guntur (‗the District Fo-
rum‘) vide its order dated 11.05.2012 while allowing the complaint passed the follow-
ing order:
“In view of the above findings, in the result the complaint is allowed partly as
indicated below:
The opposite parties are directed to pay Rs.2,25,000/- @ 9% per annum from
the date of complaint till the date of realisation;
The opposite parties are directed to pay Rs.5,000/- as damages;
The opposite parties are directed to pay Rs.2,000/- towards cost of the com-
plaint;
The amounts ordered above shall be paid within a period of six weeks from the
date of the complaint till the date of realisation”.
5. Aggrieved by the order of the District Forum, the respondents/ opposite
parties filed an appeal. The State Commission while allowing the appeal observed
as under:
“12. The medical certificate issued by Dr Venkataswara Rao of Venkates-
wara Nursing Home is not believed by the District Forum on the premises that the
doctor did not maintain records. However, the laboratory report dated 04.05.2009
issued by Sri Sai Srinivasa Laboratory would establish that the insured had un-
dergone pathological examination and his urine examination value has shown
sugar (++) and Albumin (+). The laboratory report coupled with evidence of the
doctor indicates the insured was suffering from diabetes and he did not disclose
the fact in the proposal form.
13. Dr Venkateswara Rao deposed that he issued Ex A1 and B 1. Ex A1 re-
veals that he did not treat the insured whereas Ex B 1 would show that he treated

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