1. ON a complaint instituted by Asha Rani Khanna, widow of Parminder Kumar Khanna, the District Forum-I, Union Territory, Chandigarh
ordered on 28.12.1999 that the Life Insurance Corporation of India shall pay a sum of Rs. 20,000/- for which the deceased was insured, with
interest @ 12% p.a. with effect from 2.12.1991, the date of death together with costs Rs. 1,000/-. Aggrieved against it, the present appeal has
been attempted by the Life Insurance Corporation of India.
2. BRIEFLY the facts are that Parminder Kumar Khanna, aged 36 who was an employee of Punjab Housing Board, got himself insured on
20.6.1989 for a period of 20 years. On 1.12.1991 he had fallen from stairs and suffered head injury. He was taken to P.G.I. Chandigarh where he
died the next day. Asha Rani Khanna, the widow moved a complaint when her claim was repudiated by the Life Insurance Corporation on
7.4.1993. Mainly on behalf of the appellant it was averred that the repudiation was bona fide and after considering all the facts it was not a case of
deficiency. It was further averred that when the investigation was got conducted by the Life Insurance Corporation it revealed that it was an old
case of Rheumatic Heart Disease and Mitral Stenosis. It was further averred that on several occasions the employee remained on leave.
The fact that the age of Parminder Kumar was 36 years at the time of insurance for a sum of Rs. 20,000/- and that the period of term of insurance
was 20 years and premium was paid and receipt issued had not been controverted at any stage. On behalf of the appellant it has been pointed out
that Parminder Kumar had been a heart patient and on several occasions he proceeded on leave. At the same time it is a case where the assured
was examined by a Medical Officer of the choice of Life Insurance Corporation and the cause of death was head injury on account of fall from
staircase and that too after a period of two years from the commencement of policy. All these facts clearly go in favour of the deceased and his
widow and the repudiation in such a case was not justified and it amounted to deficiency. Any active ailment of the heart was not noticed by the
Medical Officer of the Life Insurance Corporation. In fact Section 45 of the Insurance Act forbids the LIC that a statement made in the proposal
for insurance or any report of the Medical Officer was inaccurate or false, unless the insurer shows that such statement or material was suppressed.
Here the plea that Parminder Kumar had a fall from the staircase and it resulted in an head injury has been well-established and death was clearly
on account of the aforesaid reason.
On behalf of the appellant our attention has been drawn to Ajay Prakash Mittal v. Life Insurance Corporation of India, I (1998) CPJ 2
(NC)=1997 (2) CPR 233 (NC), wherein the fact that the insured was pregnant was kept concealed. In the aforesaid case there was violation of
specific instructions contained in the Manual. Besides it was a Jeevan Sathi Policy and terms and conditions were different. On the contrary,
learned Counsel for the respondent has referred to Smt. Nirmal Rani v. The Divisional Manager, Divisional Office, LIC of India, 1996 (1) CPC
122, where considerable weight was given to the authenticity of the medical examination conducted by the approved doctor of the Corporation. In
the case now in hand there was no active ailment of the heart of the assured employee at the time of the commencement of the insurance policy and
the death occurred entirely on account of differnt reason, i.e. fall in the staircase resulting in head injury. After considering all these facts we affirm
the decision of the District Forum-I and dismiss the appeal with costs Rs. 10,000/-. Appeal dismissed with costs.