ORDER (ORAL) The present Revision Petition, under Section 58 (1) (b) of the Consumer Protection Act, 2019 (for short “the Act”) has been filed by the Petitioner Insurance Company against the order dated 21.07.2020 of the State Consumer Disputes Redressal Commission, Gujarat (for short “the State Commission”) in Appeal No.191/2014. This Appeal had been filed by the Petitioner -2- challenging the order dated 28.02.2014 of the Surat District Consumer Disputes Redressal Forum (Additional), (for short “the District Forum”) in Complaint No.615 of 2011 filed by the Respondent/Complainant which was allowed. 2. The brief facts of the case are that the Complainant had wanted to travel to Manchester (U.K.) and he purchased a medical insurance policy. This policy was known as Travel Elite Silver Policy. This policy had become operative on the day the Complainant left India and till the day when he returned to India and that the trip was valid upto 11.06.2009. While in U.K., on 24.04.2009 at about 8:30 am when the Complainant returned home after a morning walk, he felt weakness on the left side of the whole body. Then he went to Central Manchester University Hospital run by NSS Foundation Trust. There he was admitted as indoor patient. He underwent CT scan and ECG etc. It was diagnosed that the Complainant had acute stroke secondary to right interior circulation infection. He was given treatment. He remained admitted in the Hospital from 24.04.2009 to 19.05.2009, the date on which he was discharged. As per the Travel Elite Silver Policy, the treatment done was cashless upto the limit of 50,000 US $. The Complainant at the time when he was admitted -3- in the Hospital duly informed the Hospital about the said insurance policy and had given the copy of the policy and other necessary information with reference to the policy, and the approval of the Insurance Company was sought by the Hospital for giving treatment to the Complainant on cashless basis. As per the Complainant, the Insurance Company had given its approval for the cashless treatment in the Hospital. The Complainant was not given a bill by the Hospital and the Complainant returned to India as per his schedule around 11.06.2009. Around 16.07.2009, he was informed by the Hospital that his bill had not been paid by the Insurance Company and it was he who had to make the payment. He was asked to pay a sum of 4283 pounds. He also received a letter from the Insurance Company on 17.07.2009 whereby the Insurance Company rejected the treatment claim of the Complainant on the ground that he had suppressed the material fact while taking the insurance policy that he had been suffering with diabetes for the last 15 years. The Complainant, thereafter, had paid to the Hospital a sum of 3,50,000/-. In his Complaint, the Complainant has claimed this amount along with interest and compensation for mental torture etc. -4- 3. Notice was issued to the Insurance Company by the District Forum. Written Statement had been filed. The only defence taken was that at the time of buying the policy, the Complainant had concealed the information relating to his diabetic condition with which he was suffering for the last 15 years. Since he had concealed this material fact, the Insurance Company had rightly rejected his claim and there is no deficiency in service on their part. 4. Parties led their evidences before the District Forum. After hearing the arguments of the parties and after assessing and appreciating the evidences on record, the District Forum has held that although, the Insurance Company had taken the plea that the Complainant/insured was suffering with diabetes for the last 15 years, but they had not produced any evidence to prove this fact and thus had not been able to prove it. The District Forum also observed that the disease for which the Complainant was admitted in the Hospital is not related to diabetes. The District Forum has held as under: “2. xxxxxxxxxxxxx. In this case, the Insurance Company has taken the defence that Complainant has the illness of diabetes since 15 years and the complainant has suppressed the said fact in the proposal form. But the burden to prove the said fact lies upon the Insurance Company. In this -5- regard, the judgment reported in-III (2009) CPJ Page-6 delivered by the Hon’ble National Commission in the case of the New India Assurance Co. Ltd. Vs. Arun Krishnan Puri is very clear. Although diabetes is not a disease which fact should be mentioned in the proposal form. Thus, L.A. Shri B. C. Shah for the opponents has not been able to prove that diabetes is directly connected with the treatment taken by the complainant. In this regard he has produced the judgment of the Hon’ble National Commission delivered in the case of Life Insurance Corporation of India vs. Naseembanu reported in III (2012) CPJ 208 in which the Hon’ble National Commission relied upon the judgment of the Hon’ble Supreme Court delivered in the case of P.C. Chako vs. Life Insurance Corporation of India reported in III (2008) CPJ 78 which has been also referred. Thus, at the end of aforesaid all discussion it is decided to allow the complaint filed by the complainant and the following order is passed. ORDER The complaint filed by the complainant is hereby partly allowed. Each opponent should pay to the complainant ₹3,50,000/- (Three Lacs Fifty Thousand only with 9% interest from the date of filing the complaint till its realization. The opponents are directed to pay ₹2000/- (Rupees Two Thousand only) to the complainant for physical and mental torture and also the cost of the complaint at ₹10,000/- (Rupees Ten Thousand only) to him. This order be implemented within 30 days. Parties be informed regarding this order free of cost.” 5. This order was impugned by the Petitioner Insurance Company before the State Commission and similar contention that the Complainant/insured had concealed that he had been suffering with diabetes while filling the proposal form had been raised. The State Commission had re-appreciated and re-assessed all the -6- evidences on record and after hearing the arguments of learned Counsel for the parties has held as under: “13. But with regard to the illness of the complainant, it was not related to and due to diabetes. Moreover opponent insurance company had given approval to Manchester Hospital for doing the treatment of the complainant on cashless basis and thereafter Manchester Hospital had done the treatment of the complainant on cashless basis and without charging any amount. Thus once the insurance company accepted the liability to pay all the expenses regarding the illness of the complainant and after giving assurance to Manchester Hospital upto 50,000 US $ expenditure regarding the illness of the complainant, the insurance company becomes liable to the said amount. Further diabetes is not a disease, it is a lifetime disease and this fact has to be mentioned in the proposal form. The opponents have not been able to prove that there is a direct relation of diabetes with the treatment taken by the complainant and the opponents have not been able to prove that the said disease was done to the complainant because of diabetes and the judgment submitted by the complainant applies to the present case. 14. The judgment produced by the Learned Advocate of the opponents is regarding other policy and it does not apply to the facts of the present case. Hence, we are of the opinion that as the judgment delivered by the Hon’ble Forum is legal, no interference requires to be done therein. Hence following order is passed. ORDER Appeal is dismissed. The judgment delivered by the Hon’ble Forum is hereby confirmed. The office is directed that Vivadis have deposited ₹2,44,117/0 (Rupees Two Lacs Forty Four Thousands One Hundred Seventeen only) on 21/03/2014 vide Draft No.873322 before this Commission in CMA No.667/2014 and after verifying the said amount with any interest accrued thereon, the account Payee cheque of the said amount be given in the name of Vivadi to the Advocate of Vivadi for giving it to Vivadi and Pucca receipt for receiving the said cheque be obtained from Vivadi.” -7- 6. This order is impugned before us and the similar contentions have been raised. We have given thoughtful consideration to the arguments of learned Counsel for the Petitioner and have gone through the record. 7. It is a settled proposition of law that this Commission has a limited revisional jurisdiction. It is not required to re-assess and re-appreciate the evidences on record and then to reach to its own conclusion on facts, especially when the findings on facts are concurrent. It has been so held by the Hon’ble Supreme Court in “Rubi (Chandra) Dutta Vs. United India Insurance Co. Ltd. – (2011) 11 SCC 269” has held as under:
“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”. 8. Again in “Lourdes Society Snehanjali Girls Hostel and Ors. Vs. H&R Johnson (India) Ltd. and others, (2016) 8 -8- Supreme Court Cases 286,” the Hon’ble Supreme Court has reiterated the same principle and has held as under: “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.” 9. In T. Ramalingeswara Rao (Dead) Through L.Rs. and Ors. Vs. N. Madhava Rao and Ors. decided on 05.04.2019 passed in Civil Appeal No. 3408 of 2019, the Hon’ble Supreme Court has 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.” 10. It, therefore, is clear that the concurrent findings of the Fora below can be disturbed only when it is pointed out that there is a jurisdictional error or where the findings are perverse. A finding can be said to be perverse where the finding is based on no evidences or material evidence on record has been ignored or where it is contradictory to any settled proposition of law. The -9- burden to prove material concealment by the insured at the time of taking the policy is upon the Insurance Company. Although, it has been so held in the case “P. Venkat Naidu V/s. LIC of India IV (2011) CPJ 6 (SC), wherein the Hon’ble Supreme Court has clearly held that the burden is upon the LIC to produce cogent evidences to prove the allegations that the insured had withheld material information. In the present case, although the stand of the Insurance Company is that the insured had been suffering with diabetes for the last 15 years as disclosed by him to the Doctor of the Hospital where he took the treatment, no evidences had been produced to this effect by the Insurance Company. Also from perusal of the said documents wherein the Doctor, giving treatment to the patient has given the history, has not mentioned that the medical history was disclosed by the Complainant. The Doctor is not examined to prove that the medical history was given by the patient himself. Even otherwise, if the insured was suffering with diabetes for the last 15 years and was aware of the fact on 31.03.2009 when the policy was issued to him or prior to that when he filled the proposal form, he must have been taking treatment in some Hospital and the Insurance Company could have produced that record to prove that the Complainant was suffering with -10- diabetes and was also aware of this fact. There is not even an iota of evidence produced by the Petitioner to prove that the Complainant was aware on the date he filled the proposal form that he was suffering with diabetes or that he was taking treatment for diabetes or he was suffering with this disease on the date of filling the proposal form. 11. It is also an admitted fact that the insured was not admitted in the Hospital for any diabetic complication. He was diagnosed with acute stroke secondary to right interior circulation infection and there is nothing on record to show that this condition is related to diabetic condition of the patient. It is neither contended nor claimed nor proved that there is any direct relation between the disease allegedly suppressed and the disease for which the treatment was taken. Also in several matters including “Veena Sharma vs. LIC, 1999 (I) RCR (Civil) 646” and “Mamta Kumari vs. Bharti Axa Life Insurance Company Limited, 2016 (1) CPJ 613 (NC)” it has been observed that mere not mentioning by insured being a patient of hypertension does not amount to suppression of material facts as it being a lifestyle disease. In many other case law, it has been clearly mentioned that -11- hypertension and diabetes are lifestyle diseases and its suppression does not amount to suppression of material illness. 12. From the above discussion, it is clear that the Foras below have acted within their jurisdiction and there is no illegality or perversity in the impugned order. The present Revision Petition has no merit and the same is dismissed in limine with no order as to costs. 13. Copy of this order be sent free of cost to the Complainant as well as the District Forum. | 
