1.       This revision petition has been filed under section 21(b) of the Act 1986 in challenge to the Order dated 18.07.2017 of the State Commission in appeal no. 905 of 2013 arising out of the Order dated 27.02.2013 of the District Commission in complaint no. 111 of 2011.    

2.       Heard arguments from the learned counsel for the complainant (the petitioner herein) and for the insurance co. (the respondent herein), and also perused the record including inter alia the Order dated 27.02.2013 of the District Commission, the impugned Order dated 18.07.2017 of the State Commission and the petition.

3.       The matter relates to the repudiation of the insurance claim on the death of the insured (husband of the complainant).

Briefly, the husband of the complainant took an insurance policy from the insurance co. for sum insured of Rs. 2 lakh. He died on 10.06.2010 when the policy was in subsistence. The insurance co. repudiated the claim vide letter dated 12.02.2011 on ground that at the time of taking the policy the insured had concealed material facts regarding his health condition.

The complainant filed a complaint with the District Commission in 2011.

The District Commission vide its Order dated 27.02.2013 partly allowed the complaint. It directed the insurance co. to pay Rs. 2,00,000/- and bonuses to the complainant with simple interest at the rate of 6% per annum along with cost of litigation of Rs. 2,000/-.

The insurance co. appealed before the State Commission.

The State Commission vide its Order dated 18.07.2017 allowed the appeal and set aside the Order dated 27.02.2013 of the District Commission. Resultantly the complaint stood dismissed.

The complainant preferred the instant revision before this Commission.

4.       The relevant extract of the proposal form is reproduced below for reference:

It is thus seen that to the question “Have you remained absent from place of work on grounds of health during the last 5 years ?” the insured had answered “No” and to the question “Are you suffering from or have you ever suffered from ailments pertaining to Liver, Stomach, Heart, Lung, Kidney, Brain or Nervous System ?”, the insured has answered “No”.

However, in the period of five years prior to the taking of the policy, on three occasions, from 07.06.2009 to 30.06.2009, from 02.11.2009 to 22.11.2009 and from 12.05.2008 to 06.06.2008, he had taken medical leave, meaning thereby that he had been absent from his place of work on grounds of heath. The insurance co. has produced copies of the related medical certificates on the basis of which leave was taken as also the relevant fitness certificates on the basis of which duty was rejoined after leave. To have answered that he was not absent from the place of work on grounds of health during the last five years was a false statement of material significance. In two of the medical certificates it is written that he suffered from “acute abdomen with acute hepatitis, Acute Gastritis and Hepatitis and Anxiety neurosis and peripheral Neuropathy”. As such to have answered that he was not suffering from ailment pertaining to liver was also a false statement again of material significance.

Pertinently, learned counsel for the complainant in his arguments does not deny or challenge the authenticity of the medical and fitness certificates produced by the insurance co.

It is quite apparent that crucially relevant material facts had been concealed while taking the policy.

The State Commission appears to have appraised the evidence correctly in arriving at its finding that this was a clear case of concealment of material facts at the time of taking the policy. On the other hand, the District Commission appears to have been overly liberal and has obviously erred by incorrectly appreciating the evidence on this count.

As such there appears no jurisdictional error or material irregularity in the State Commission’s impugned Order as may go to vitiate its findings. No good ground or persuasive reason for interference in the exercise of the revisional jurisdiction of this Commission is forthcoming.

5.       The revision petition is dismissed.

6.       The Registry is requested to send a copy each of this Order to the parties in the petition and to their learned counsel immediately. The stenographer is also requested to upload this Order on the website of this Commission immediately.