1.      This revision petition under the Consumer Protection Act, 1986 (in short, the ‘Act’) assails the order dated 01.09.2017 in Appeal No. 341 of 2017 of the State Consumer Disputes Redressal Commission, Punjab, Chandigarh (in short, the ‘State Commission’) arising out of order dated 27.03.2017 in Consumer Complaint No. 320 of 2016 of the District Consumer Disputes Redressal Forum, Amritsar (in short, the ‘District Forum’). This order will also dispose of RP No. 3295 of 2017 which arises from the same order.

2.      The facts, in brief, according to the revision petitioner/opposite party, are that the late husband of the respondent/complainant had obtained a life insurance policy from the petitioner on 31.10.2012 for an assured sum of Rs 25,00,000/-. On 03.11.2012 the insured expired suddenly. A claim was preferred by the respondent on 23.04.2014 after which the petitioner investigated since the death of the insured had occurred within 2 years of the policy being taken. During investigations it came to notice that the Deceased Life Assured (DLA) had concealed material evidence at the time of filling the proposal form relating to his hospitalization in Sri Guru Ramdas Hospital, Amritsar from 06.09.2012 to 07.09.2012 for Diagnostic Laparoscopy Biopsy prior to the issuance of the policy. It was also ascertained that the DLA was diagnosed with Sub Acute Intestinal Obstruction and that he was a known case of Non-Hodgkin Lymphoma. The claim was therefore repudiated on 16.07.2014. The respondent filed a consumer complaint no. 320 of 2016 which came to be decided on contest on 27.03.2017 with the District Forum upholding the complaint. The appeal before the State Commission against this order in Appeal No. 341 of 2017 was dismissed on 01.09.2017. This order is challenged in the instant petition.

3.      The petitioner’s case is that the DLA had deliberately not disclosed the fact of his hospitalization prior to the taking of the policy as per the proposal form which constituted suppression of a material fact. It is argued that the report of the medical examination done prior to the policy cannot be accepted in view of suppression of material evidence. Therefore, the claim had been rightly repudiated. The respondent has contended that the proposal form relied upon was unsigned and, therefore, not reliable. The fact of hospitalization is not denied although it was for a minor reason and that no evidence of the doctor concerned had been brought on record. According to the respondent, the affidavit of Ms Sunita Yadav, Associate Manager (Legal) relied upon by the petitioner could not be considered since she did not have first-hand knowledge of the facts. It is also contended that the policy was approved after the conduct of a medical examination which did not reveal any pre-existing illness.

4.      The order of the District Forum noted that though the petitioner/opposite party brought the discharge summary of the DLA on record, they could not examine the doctor who treated him or of any doctor who treated the DLA prior to the taking of the policy. The District Forum order reads as under:

… we are of the opinion that the Opposite Party has wrongly repudiated the claim of the complainants. Consequently, we allow the complaint with costs and the Opposite Party is directed to pay the claim amount of Rs 20 lacs (twenty lacs) to the complainants in equal shares, within one month from the date of receipt of copy of this order failing which the complainants shall be entitled to interest @ 6% per annum on this amount from the date of filing of the complaint till the payment is made to the complainants. Opposite Party is also directed to pay litigation expenses to the complainant to the tune of Rs 2000/-.

5.      The State Commission, while dismissing the appeal, held that the solitary point for adjudication was whether the life assured suppressed the material information with regard to his pre-existing disease or his hospitalization by giving wrong answers in the proposal form thereby making the contract of insurance voidable. On the basis of evidence of the complainant and evidence affidavit of the Associate Manager (Legal) of the petitioner it was held that the photostat copy of the discharge summary, which was unsigned, was inconsequential in proving a pre-existing disorder which was a material fact to be disclosed in the proposal form. Based on judgments of the Hon’ble Supreme Court and this Commission, it was held that:

… we find no illegality or material infirmity in the order of the District Forum calling for any interference therein. We find no merit the appeal and the same is hereby dismissed.

6.      I have heard the learned counsel for the parties at length and perused the material on record.

7.      The petitioner relied upon the judgment of the Hon’ble Supreme Court in (a) Reliance Life Insurance Co. Ltd., and Ors. Vs Rekhaben Nareshbhai Rathod Civil Appeal no. 4261 of 2019 (arising out of SLP (C) no. 14312 of 2015) decided on 24.04.2019 which held that the agent of the insurance ceases to be its agent while filling up the proposal form of the insured; (b) Satwant Kaur Sandhu vs New India Assurance Company Ltd. in Civil Appeal no. 2776 of 2002 decided on 10.07.2009 which held that in view of suppression of material facts, insurer was fully justified in repudiating the insurance contract; (c) P C Chacko and Anr. Vs Chairman, LIC of India and Ors., Civil Appeal no.5322 of 2007 (arising out of SLP (c) no. 23951 of 2005) decided on 20.11.2007 wherein it was held that a contract of insurance is a contract of ubberima fidei (utmost good faith); (d) Mithoolal Nayak vs LIC of India, CA no. 224 of 1959 decided on 15.01.1962 which held that “in cases in which there is stipulation that by reasons of a breach of warranty by one of the parties to the contract, the other party shall be discharged from the performance of his part of the contract”; (e) In Suraj Mal Ram Niwas Oil Mills (P) Ltd., vs United India Insurance Co. Ltd., and Ors., in Civil Appeal no. 1375 of 2003 decided on 08.10.2010 wherein it was held that for insurable interest “……………It is a settled proposition of law that a stranger cannot alter the legal obligations of parties to the contract”.

8.     The petitioner also relied upon this Commission’s order regarding judicial nexus of existing illness with cause of death in (a) LIC of India vs Smt Kusum Patro, RP no.1585 of 2011 dated 19.03.2012 wherein it was held that: “ …………… the Insurer was within its rights to repudiate the insurance claim of his nominee subsequent to his death, even though the cause of the death had no medical nexus with the accident that he suffered or the consequential disability”; (b) Reliance Insurance Co. Ltd., and Anr. Vs Madhavacharya in RP no.211 of 2009 decided on 02.02.2010; and (c) Harish Kumar Chadha Vs The Manager, Bajaj Allianz Life Insurance Co. Ltd., and Ors., in RP No. 3271 of 2013 decided on 07.10.2013 wherein it was ordered that in view of failure to pay the instalment of the premium being aware of the terms and conditions of the policy issued to him, there is no jurisdictional error, illegality or infirmity in the order passed by the Consumer Fora.

9.      Per contra, the respondent placed reliance on the judgments of the Hon’ble Supreme Court in Rubi (Chandra) Dutta Vs. United India Insurance Co. Ltd., (2011) 11 SCC 269 to highlight the limitations on this Commission’s revisionary jurisdiction under section 21 of the Act and P. Venkat Naidu Vs. Life Insurance Corporation of India and Anr., 2001 (4) CPJ 6 which laid down that it is for the insurer to prove that the deceased did not disclose correct facts relating to his health and it is for the insurance company to produce cogent evidence to prove the said allegation without relying on hypothetical grounds. Reliance has also been placed on this Commission’s order in New India Assurance Co. Ltd. Vs. Surinder Singh 2020 (3) CPR 401 which held that “a perusal of the repudiation letter would show that the aforesaid concealment was not a ground for repudiation of the claim. As held by the Hon’ble Supreme Court in Galada Power and Telecommunication Ltd., vs United India Insurance Co. Ltd., and Another IV (2016) CPJ 5 (SC) “the insurer cannot be allowed to travel beyond the ground taken in the repudiation letter issued by it while rejecting the claim. Therefore, the aforesaid concealment cannot be a ground for dismissing the complaint, the same not being one of the grounds for repudiating the claim”.

10.    From the records it is apparent that the petitioner has challenged the impugned order on the very same grounds which were raised before the District Forum as well as the State Commission in appeal. The concurrent findings on facts of these two foras are based on evidences led by the parties and documents on record. The present revision petition is therefore an attempt by the petitioner to urge this Commission to re-assess and re-appreciate the evidence which cannot be done in revisional jurisdiction. Learned counsel for the petitioner has failed to show that the findings in the impugned order are perverse due to jurisdictional error or material irregularities.  

11.    This Commission, in exercise of its revisional jurisdiction, is not required to re-assess and re-appreciate the evidence on record when the findings of the lower fora are concurrent on facts. It can interfere with the concurrent findings of the fora below only on the grounds that the findings are either perverse or that the fora below have acted without jurisdiction. Findings can be concluded to be perverse only when they are based on either evidence that have not been produced or based on conjecture or surmises i.e. evidence which are either not part of the record or when material evidence on record is not considered. The power of this Commission to review under section 21 of the Act is therefore, limited to cases where some prima facie error appears in the impugned order. Different interpretation of same sets of facts has been held to be not permissible by the Hon’ble Supreme Court.

12.   The Hon’ble Supreme Court in Rubi Chandra Dutta Vs. United India Insurance Co. Ltd., (2011) 11 SCC 269 dated 18.03.2011 has held that:

“23. Also, it is to be noted that the revisional powers of the National Commission are derived from Section 21 (b) of the Act, under which the said power can be exercised only if there is some prima facie jurisdictional error appearing in the impugned order, and only then, may the same be set aside. In our considered opinion there was no jurisdictional error or miscarriage of justice, which could have warranted the National Commission to have taken a different view than what was taken by the two Forums. The decision of the National Commission rests not on the basis of some legal principle that was ignored by the Courts below, but on a different (and in our opinion, an erroneous) interpretation of the same set of facts. This is not the manner in which revisional powers should be invoked. In this view of the matter, we are of the considered opinion that the jurisdiction conferred on the National Commission under Section 21 (b) of the Act has been transgressed. It was not a case where such a view could have been taken by setting aside the concurrent findings of two Fora.”

13.    Reiterating this principle, the Hon’ble Supreme Court in Lourdes Society Snehanjali Girls Hostel and Ors vs H & R Johnson (India) Ltd., and Ors  (2016) 8 SCC 286 dated 02.08.2016 held:

“17. The National Commission has to exercise the jurisdiction vested in it only if the State Commission or the District Forum has either failed to exercise their jurisdiction or exercised when the same was not vested in them or exceeded their jurisdiction by acting illegally or with material irregularity. In the instant case, the National Commission has certainly exceeded its jurisdiction by setting aside the concurrent finding of fact recorded in the order passed by the State Commission which is based upon valid and cogent reasons.”

14.   The Hon’ble Supreme Court in its judgment dated 05.04.2019 in the case of T Ramalingeswara Rao (Dead) Through LRs & Ors Vs. N Madhava Rao and Ors, Civil Appeal No. 3408 of 2019 dated 05.04.2019 held as under:

“12. When the two Courts below have recorded concurrent findings of fact against the Plaintiffs, which are based on appreciation of facts and evidence, in our view, such findings being concurrent in nature are binding on the High court. It is only when such findings are found to be against any provision of law or against the pleading or evidence or are found to be perverse, a case for interference may call for by the High Court in its second appellate jurisdiction.”

15.    The foras below have pronounced orders which are detailed and have dealt with all the contentions of the petitioner which have been raised before me in this revision petition. It is also seen that the orders of these fora are based on evidence on record.  In view of the settled proposition of law that where two interpretations of evidence are possible, concurrent findings based on evidence must be accepted and such findings cannot be substituted in revisional jurisdiction, this petition is liable to fail.

16.   In the light of the foregoing and in view of the facts and circumstances of this case, I find no illegality or infirmity or perversity in the impugned order warranting any interference of this Commission. The present revision petition is, therefore, found to be without merits and is accordingly dismissed. The order of the State Commission is set aside and that of the District Forum is affirmed.  There shall be no order as to costs. Revision Petition No. 3295 of 2017 is also disposed of in the above terms. Accordingly, all pending IAs are also stand disposed of.