1.       The present Revision Petition has been filed by the Petitioners against order dated 08.09.2020 passed by the State Consumer Disputes Redressal Commission, Andhra Pradesh, Vijayawada (for short “State Commission”) in First Appeal No.422 of 2017.

2.       Case of the Complainant/Respondent is that his wife had obtained Dream Plan Policy No.0241797636 for a sum of Rs.1,67,562/- for period from 15.11.2011 to 15.12.2025, by paying an annual premium of Rs.13,249.59. Complainant’s wife died on 21.10.2013. Complainant being the nominee informed the Opposite Party about the death of the life assured and filed a claim with Opposite Party No.1. The claim was repudiated, vide letter dated 16.12.2013 on the ground, that in the investigation it was found that the life assured suppressed her health condition of her taking treatment for "Chronic non-specific cervicitis" prior to obtaining the Policy. Complainant filed Consumer Complaint No.66 of 2017 before the District Forum with the following prayer:-

a) Direct the Opposite Parties to pay the claim amount of Rs.1,67,562/-, (Rupees One lakh sixty-seven thousand five hundred and· sixty-two only);

b) To direct the Opposite Parties to pay a sum of Rs.30,000 /- (Rupees Thirty thousand only} as deficiency of service;

c) Subsequent interest@ 24% p.a. on Rs.1,67,562 /- from 21.01.2012 to till realization;

e) Costs of the Petition;

d) For any other relief or relives as the Forum may deem fit and proper in the above circumstances

3.       The Complaint was contested by the Opposite Parties stating that wife of the Complainant deliberately and with malafide intention suppressed the material fact of pre-existing disease since 2009 which was material information for assessment of risk. It was submitted that the contract of Insurance is a contract of "uberrima fides" and the Opposite Party issued the said Policy in good faith. It was further contested that in view of the regulatory provisions and suppression of material information by the Life Assured, the Opposite Parties rightfully repudiated the claim of the Complainant, vide letter dated 16.12.2013.

4.       District Forum after hearing Learned Counsel for the Parties and perusing the record held that it was duty of the Insurance Company to examine the concerned doctor who treated the Policy Holder for the alleged ailment, but no such steps were taken by the Opposite Party. It was further held that mere filing of some hospital records was not sufficient to show that the Policy holder was suffering from the ailment at the time of filing the proposal form. In absence of specific and cogent evidence, District Forum was unable to hold that the Policy holder/Deceased/Insured suffered from any ailment and suppressed this fact at the time of filing the Proposal form. District Forum allowed the Complaint as follows: -

“In the result, the complaint is allowed in part, directing the Opposite Parties 1 to 3 to pay claim amount of Rs.1,67,562/- (Rupees One lakh, Sixty-seven thousand, five hundred and sixty-two only) with interest @ 9% p.a. from 16.12.2013 till the date of actual realization, a compensation o Rs.10,000 - Rupees ten thousand only) and costs of Rs.2,500/- (Rupees Two thousand and five hundred only) to the Complainant. Time for compliance, one month from the date of receipt of this order.”

5.       Aggrieved by the order of the District Forum, the Opposite Party filed First Appeal No.422 of 2017 before the State Commission. The State Commission after hearing the Learned Counsel for the Parties and perusing the record observed that burden of proof lies on the Opposite Parties to establish, by producing cogent and convincing material that the Life Assured suppressed material information in the proposal form. The Opposite Party did not place on record any material to substantiate its contention that the deceased Policy holder had supressed the material fact of her pre-existing ailment. The Opposite Parties did not produce the original medical record of the Life Assured. In such circumstances, it is not safe to arrive at a conclusion that this medical record pertains to the life assured. The State Commission observed that the Opposite Parties repudiated the claim of the Complainant on flimsy and untenable grounds, which amounted to deficiency in service. The State Commission dismissed the Appeal as follows: -

"Having regard to the facts and circumstances discussed above, we do not find any grounds much less valid grounds to interfere with the impugned order of the District Forum. Hence the appeal fails. In the result, the appeal is dismissed confirming the order of the District Forum. The appellant/opposite party is directed to pay a sum of Rs.5000/- to the respondent/complainant towards costs of the appeal.”

6.       Aggrieved by the order of the State Commission, the Petitioners/Opposite Parties preferred the present Revision Petition before this Commission with the following prayer-

“In the facts and circumstances aforesaid, the Petitioners respectfully pray that this Hon'ble Commission may be pleased to pass the following Orders:

(a) Set aside the final Order dated 08.09.2020 passed by the Learned Andhra Pradesh State Consumer Disputes Redressal Commission at Viskhapatnam in First Appeal No.422/2017; and/or

(b) Pass such further order or orders as this Hon'ble Commission may deem fit, proper and necessary, in the facts and circumstances of the instant case.”

7.       Heard Learned Counsel for the Petitioners and carefully perused the record. Learned Counsel for the Petitioners submitted that the State Commission while passing the impugned order had ignored the basic principle of Insurance Law with respect of suppression of material fact while applying for the Policy of Insurance. State Commission failed to appreciate the evidence placed on record. It was also submitted that on 12.12.2011, the Life Assured submitted the proposal form to the Petitioners for the purpose of obtaining Life Insurance coverage named 'Bajaj Allianz Super Cash Gain’. He further submitted that the Life Assured was hospitalized/under treatment during 01.04.2009 to 11.04.2009 for Dysfunctional Uterine Bleeding with Chronic non-specific cervicitis as per the medical reports and the same was not disclosed in the proposal form dated 12.12.2011 submitted by the Life Assured.

8.       From the record it is seen that Petitioners in support of their contention, placed reliance on the treatment record, which was a mere photocopy and not certified. The Doctor who treated the Life Assured was also not examined nor was his affidavit filed by the Petitioners. Also, Petitioner failed to satisfy this Commission that there was any co-relation between death of the Life Assured and the suppression of ailment "Chronic non-specific cervicitis". At this stage, it would not be just and fair to reassess or re-evaluate the evidence.

9.       Jurisdiction of this Commission under Section 21 (b) is very limited. This Commission is not required to re-appreciate and reassess the evidences and reach to its own conclusion. The Court can intervene only when the Petitioner succeeds in showing that the Fora below have wrongly exercised its jurisdiction or there is a miscarriage of justice. It was so held by the Hon’ble Supreme Court in the case of Mrs. Rubi (Chandra) Dutta Vs. M/s United India Insurance Co. Ltd. (2011) 11 SCC 269 has held as under: -

“13.       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.”

10.     Same principle has been reiterated by Hon’ble Supreme Court in the case of Lourdes Society Snehanjali Girls Hostel and Ors. Vs. H & R Johnson (India) Ltd. and Ors. (2016 8 SCC 286 wherein Hon’ble Supreme Court has held as under:-

“23. The  National Commission has to exercise the jurisdiction vested in it only if the State Commission or the District Forum has failed to exercise their jurisdiction or exercised when the same was not vested in their 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.”

11.     I find no reason to interfere with the concurrent findings of both the Fora below. Petitioners have failed to point any illegality or irregularity in the impugned order passed by the State Commission, warranting interference in exercise of Revision Jurisdiction of this Commission. Revision Petition is accordingly dismissed.