1.       This revision petition has been filed under Section 21(b) of the Consumer Protection Act, 1986 against the order dated 20.11.2009 passed in FA No. 1364 of 2008 by Andhra Pradesh State Consumer Disputes Redressal Commission, Hyderabad whereby the State Commission allowed the appeal and set aside the order of District Forum, Kurnool.

2.       The brief facts relevant for the disposal of this revision petition are that Mr. D. Ayyapu Reddy, since deceased, (hereinafter referred as ‘the insured’) had obtained life insurance policy from Bajaj Allianz Life Insurance Company Ltd. for the period commencing from 17.1.2006 to 18.10.2007.  The insured died on 18.10.2007 during the subsistence of the insurance policy.  The complainant, Mr. D. Ayyapu Reddy, the nominee, who was the nephew of deceased filed a claim to the OP alongwith relevant documents.  The OP repudiated the claim on 14.12.2007 on the ground that the insured was suffering and under treatment of Asthma since 2005.  The insured suppressed the fact in the proposal form, which was filled on 4.1.2006.

3.       Aggrieved by the repudiation, the complainant filed a complaint before District Consumer Disputes Redressal Forum, Kurnool (in short, ‘the District Forum’) for recovery of insured amount alongwith compensation.  The OPs filed written version contending that the insured had suppressed the material fact that he was suffering from Asthma since 2005 and he had also undergone the treatment for the said disease.  Therefore, the complaint is liable to be dismissed.

4.       On the basis of pleadings and evidence, the District Forum dismissed the complaint and agreed with the view of OP that the insured had taken treatment from Gowri Gopal Hospital, Kurnool.

5.       Being aggrieved by the order of District Forum, the complainant filed first appeal before A.P. State Consumer Disputes Redressal Commission, Hyderabad ( in short, ‘the State Commission’).  The State Commission vide its order dated 20.11.2009 allowed the appeal and directed the OPs to pay Rs. 5 lakhs within a period of four weeks.

6.       Aggrieved by the impugned order dated 20.11.2009, the OP filed this instant revision petition. 

7.       Heard learned counsel for the parties.  Learned counsel for the petitioner vehemently argued that the insured had concealed about his suffering from Asthma.  The legal position is that the life assured at the time of making insurance, is duty bound to make correct and true disclosure as to his health condition.  The contract of insurance is based on the principle of uberrima fides.  He further submitted that the State Commission erred in holding as Asthma is not a dreadful disease or debilitating disease without any evidence to such effect.   Therefore, this revision petition deserves to be allowed. 

8.       Learned counsel for the complainant submitted that the insured was not educated person.  The proposal form was in English, it was filled by the agent of OP without disclosing the relevant question and obtained the signatures of the insured in the proposal form.  Thus, the burden lies on the OP to prove that the questions of proposal form were informed to the insured and the same were explained to him in Telugu.  He also denied that the insured was suffering from any pre-existing disease and the doctors who treated him were not examined by the OP.  There is no evidence that the insured was suffering from pre-existing disease and moreover, the insured was examined by a panel of doctors of OP before issuing the policy and the doctor certified that the insured was free from any disease.  Therefore, it cannot be said that the insured was suffering from Asthma.  Moreover, the insured died in the night during sleep, his death was not due to Asthma as such, alleged to be pre-existing disease.  Hence, the OPs are liable to pay insurance claim.  The arguments on behalf of petitioner/OP are that there was no deficiency in service and the repudiation was proper as legally.  The repudiation was done after thorough scrutiny of all the factors and it was noticed that the insured was having serious respiratory disease ‘Asthma’ and had taken prolongs treatment as out-patient as well as in-patient in Gowri Gopal Hospital, Kurnool.  The insured deliberately suppressed the fact to obtain the insurance policy.  He relied upon the case-sheet and the discharge summary from the hospital which clearly establishes that the insured was in the hospital and discharged on 23.12.2005.  It is submitted that he signed the false declaration.  Thus, it is evident that the insured committed ‘suppressio veri’ and ‘non-divulgences’ by vital information deliberately and obtained the policy.  The contract of insurance is uberrima fides.

9.       I have perused the proposal form, the policy document and the relevant medical record.    It is transpired that the proposal form was filled in English by the agent of insurance company and the signature of proposed insured was in vernacular language i.e. Telugu.  On its face, it appears that the insured is illiterate and he was unable to put his signature properly.  There is no medical record to prove that the OP was suffering from Asthma.  The cause of death was not known.  He died during the sleep.  There is no evidence that the death was due to Asthma, which was mentioned in the repudiation letter.

10.     On the basis of foregoing discussion, I do not find any merit in the instant revision petition.  Accordingly, it is dismissed.