Wife of the complainant/petitioner took three life insurance policies from Life Insurance Corpn. of India – respondent herein, being (i) Policy No.380931532 effective from 28.2.1995 to 28.2.2017, sum assured was Rs.50,000 and quarterly premium payable was Rs.860/- ; (ii) Policy No.377578540 effective from 6.3.1998 to 6.3.2013, sum assured was Rs.25,000 and quarterly premium payable was Rs.860/- ; and (iii) Policy No.377835648 effective from 28.1.2002 to 28.1.2027, sum assured was Rs.5,00,000/- and quarterly premium payable was Rs.7,600/-.  Petitioner was the nominee in all the three policies.  Policy No.377578540 (second policy) lapsed due to non-payment of premium in March 2001.  Respondent had sent intimation to the insured about the lapse of policy on 21.7.2001.  The insured died on 5.8.2002.  Except Policy No.377578540, other two policies were in force.  Petitioner lodged a claim with the respondent in respect of the remaining two policies, i.e., Policy No.380931532 and Policy No.377835648.  Respondent settled the claim in respect of Policy No.380931532 and repudiated the claim in respect of Policy No.377835648 on the ground that the insured had suppressed material facts about her health at the time of filling in the proposal form.

          Being aggrieved, petitioner filed a complaint before the District Forum.

          Stand taken by the respondent in its written statement was that the insured died within 6 months and 7 days of the taking of the third policy.  The policy was taken on 28.1.2002 and the insured died on 5.8.2002.  As per investigation carried, the insured was suffering from chronic renal failure and sever anaemia and was admitted in the hospital for taking treatment for the same.

          District Forum held that the insured was guilty of suppression of facts regarding her ailment; that she knew about the ailment prior to the taking of the third policy, which she failed to disclose while filling in the proposal form.  The complaint was dismissed with costs which were quantified at Rs.1,000/-.  The order of the District Forum is in Hindi.  Petitioner has filed its translation.  Relevant findings recorded by the District Forum from the translation provided by the petitioner reads as under :

10.           As far as the second objection of the OP is concerned, in relation to this it has been stated in para no.13 of the proposal for insurance.  Exhibit D/1, that she has not been suffering from any disease in past 5 years, whereas at 4 pm on 29.7.2002 Smt. Kamlesh Singh Kaul was admitted in Holy Cross Hospital, at that time the history of disease which was given, according to it and according to the medical attendant certificate of Exhibit D/6, the deceased was suffering from the said disease 1½ (one and half) years prior to getting admitted and Smt. Kamlesh Singh Kaul died in the Holy Cross Hospital on 05.08.2002 due to chronic renal failure.  On behalf of the OP, the witness no.1, Dr. Smt. R. Pushpa, who is a doctor in Holy Cross Hospital, Ambikapur, she has clarified that Smt. Kamlesh Singh Kaul was suffering from renal disease from past two years and this witness has also clarified that her qualification is M. D. Medicines, she has admitted Smt. Kamlesh Singh Kaul in Holy Cross Hospital and the patient has shown her papers of earlier treatment.  The patient has told also about her treatment done in MMI Hospital, Raipur.  At the time when the patient was admitted in the Holy Cross Hospital on 29.07.2002, at that time the patient was very critical.  Being asked for a copy of bed head ticket by the insurance company, on 13.06.2003 the bed head ticket of the deceased was provided.  This witness has also clarified that seeing the condition of the disease of the deceased, it can be said that she was suffering from the disease from past 6 (six) months to 5 (five) years.

11.           This witness has clarified in last para of the written statements that she is telling on the basis of her medical examination that the deceased was suffering from the said disease at least from past 6 (six) months.  In this way the deceased was suffering from the said disease at the time of obtaining the insurance policy.  Because the deceased, Smt. Kamlesh Singh Kaul, was a nurse and was aware of her disease, in this way by concealing the fact of her disease necessarily she stated in the insurance proposal about not having any disease and Smt. Kamlesh Singh Kaul died within 7 (seven) months from obtaining the insurance.  In this way, necessarily the claim of the complainant comes under the category of early death claims and according to the conditions of the insurance, conducting investigation OP is obvious and upon conducting investigation by the OP it is clear that Smt. Kamlesh Singh Kaul was suffering from chronic disease from the very beginning and concealing the facts about her disease she obtained the insurance policy.  In this way, according to conditions of the policy, during the period when insurance policy of Exhibit-B was lapsed and when it was not renewed, new insurance cannot be obtained.  In this way, by concealing the fact about disease and about the lapse of insurance policy, Smt. Kamlesh Singh Kaul obtained the new insurance policy of Exhibit-C and at the time of obtaining insurance policy of Exhibit-C despite knowing the fact of having prior disease because she herself was a nurse, she obtained the insurance policy concealing the fact about disease, in such situation, the OP has not committed any deficiency in services by not paying the insurance amount to the complainant.  The OP has rightly repudiated the claim of the complainant, therefore, the complainant is not entitled to any insurance amount. 

          Not satisfied with the order passed by the District Forum, petitioner filed an appeal before the State Commission, which has been dismissed by the impugned order.  State Commission has reiterated the findings recorded by the District Forum.

Admittedly the insured had taken three policies.  The first two policies were in the sum of Rs.50,000/- and Rs.25,000/-.  Second policy had lapsed.  The first policy was taken in the year 1995.  Respondent insurance company has settled the claim in respect of the said policy as the same had been taken before the detection of the disease by the insured.  The third policy was taken by the insured for a sum of Rs.5 lakh on 28.1.2002 by which time it had been detected that she was suffering from renal failure, which she failed to disclose while filling up the proposal form.  The District Forum has recorded a detailed finding, which has been reproduced above, which shows that the insured was guilty of suppression of facts of her disease. 

          From the evidence on record, it is evident that the insured was guilty of suppression of facts regarding her illness from which she was suffering.  In the proposal form, she failed to disclose that she was suffering from renal failure.  In the history recorded at the time of admission on 29.7.2002 in the Holy Cross Hospital, it is clearly mentioned that she was suffering form the said disease for 1½ year prior to her admission in the hospital.  Dr. R. Pushpa, who is the Doctor in the Holy Cross Hospital, has clarified that the insured was suffering from renal disease for the last two years and according to her, the insured was admitted in the hospital on 29.7.2002 in a critical condition and by looking at her, it could be said that she was suffering from the disease for the past 6 months to 5 years.  The contract of insurance is based on utmost good faith.  A person taking the policy is required to disclose all relevant and material facts.  In case of failure to disclose the relevant facts, insurance company is entitled to repudiate the claim.  Supreme Court of India in P.C. Chacko & Anr. vs. Chairman, Life Insurance Corpn. of India & Ors. – (2008)1 SCC 321 has held that “a deliberate wrong answer which has a great bearing on the contract of insurance, if discovered, may lead to the policy being vitiated in law”.

          In the present case, the insured had given a deliberate wrong answer to a question having a great bearing on the contract of insurance.  Thus, the contract was clearly vitiated. 

          For the reasons stated above, we do not find any merit in this Revision Petition and dismiss the same with no order as to costs.