STATE CONSUMER DISPUTE REDRESSAL COMMISSION

BIHAR, PATNA

Appeal No. 357 of 2017

Reliance Nippon Life Insurance Company Ltd, H, Block, 1^st Floor, Dhirubhai Ambani Knowledge City, Navi Mumbai- 400710

                                                                                                                                                      … Complainant/Appellant

Versus

Keshiya Devi, W/o- Late Nagendra Manhi, Village- Deshrajpur, PO & PS- Mahnar, District- Vaishali

                                                                                                                                                 …. Opposite Parties/Respondents

Counsel for the appellant:

Counsel for the Respondent: Adv. Pritam Kumar

Before,

Hon’ble Mr. Justice Sanjay Kumar, President

Mr. Ram Prawesh Das, Member

Dated 27.02.2023

As per Sanjay Kumar, President.

O r d e r

1. Present appeal has been filed on behalf of behalf of appellant/opposite party Reliance Nippon Life Insurance Company Ltd. for setting aside the order dated 08.11.2017 passed by District Consumer Disputes Redressal Forum, Vaishali at Hajipur in Complaint Case no. 50 of 2015 whereby and whereunder appellant has been directed to pay sum assured amount of Rs. 1,00,000/- along with 20,000/- as compensation with interest @9% p.a from 22.03.2012 within forty five days from the date of order.
2. Briefly stated the facts of the case as disclosed in Complaint petition is that husband of complainant had purchased life insurance policy on 14.02.2011 from appellants for sum assured amount of Rs. 1,00,000/- in which complainant being the wife was made nominee in the insurance policy.
3. Insured Nagendra Manjhi died on 22.03.2012 during his treatment due to cardio respiratory failure. Complainant presented her claim before the appellant/insurance company but same was repudiated by the appellant/insurance company on the ground that the insured while filling up the proposal form had suppressed material fact that he was suffering from throat cancer and as such the claim was repudiated for non disclosure of preexisting disease at the time of filling proposal form in which against column no. 29 in which it was asked whether insured is suffering from Cancer, he stated “NO”.
4. Against repudiation of her claim complainant filed Consumer Complaint case before the District Consumer Forum, Vaishali for payment of sum assured amount of Rs. 1,00,000/-.
5. On notice appellant/ insurance company appeared and filed its written statement stating therein that insured was suffering from throat cancer and he was under treatment in Mahavir Cancer Sansthan and this material fact was suppressed by him as such complainant is not entitled for any compensation. In support of their contention appellant/insurance company filed documentary evidence that insured was being treated in Mahavir Cancer Sansthan.
6. Appellant/insurance company placed on record a consent form in the name of Nagendra Manjhi (Exhibit-B), a DL scopy report of Mahavir Cancer Santhan (Exhibit-C), Pathological report of Mahavir Cancer Sansthan (Exhibit-D)  one prescription in the name of Nagendra Manjhi (Exhibit-D-1) & Certificate of Ward commissioner (Exhibit-E). However, the District Consumer Forum disbelieved those documents as there were anomalies in documents and said documents did not bear the signature of insured. The District Consumer Forum held that documents submitted by appellant/insurance company were not trustworthy and convincing or related to the insured and as such found ground of repudiation to be nonest and baseless and allowed the complaint case. Aggrieved by which the appellant/insurance company has preferred this appeal.
7. Heard the parties.
8. In this case the claim of claimant has been repudiated on the ground that insured had concealed his prior illness. It is a settled preposition of law that the burden to prove undeclared preexisting disease is upon the opposite party and they are required to discharge this burden by producing reliable and cogent evidence. However, they have failed to place on record any piece of evidence which could prove that insured was suffering with any disease at the time of submitting proposal form.
9. The appeal is further fit to be dismissed on the ground that preexisting disease should be the cause of death. In present case appellant/insurance company has repudiated the claim for concealing the material fact that insured was suffering from throat cancer but cause of death is not cancer but cardio respiratory failure and cause of death is nowhere connected to preexisting disease, even it is assumed to be true.
10. The suppression of information regarding any pre-existing disease, if it has not resulted in death or has no connection to cause of death would not disentitled the claimant for the claim.
11. For the reasons as stated above there is no merit in this appeal and is accordingly dismissed.

(Ram Prawesh Das)                                                                            (Sanjay Kumar,J)

       Member                                                                                             President

Md. Fariduzzama