The Present Revision has been filed by the Petitioners against the impugned order dated 12.11.2019 passed by the State Consumer Disputes Redressal Commission, Andhra Pradesh, Vijayawada (hereinafter referred to as the “State Commission” ) in Appeal No. 502 of 2016.

Along with the Revision Petition, IA/4357/2021, an application for condonation of delay of 14 days has also been filed by the Petitioners. As per computation done by the Registry, there is a delay of 114 days. For the reasons stated in the application and in the interest of justice, IA/4357/2021 is allowed and delay condoned.

The case of the Complainant/Respondent was that his brother purchased Health Policy No.0244560624 valid from 28.12.2011 to 28.12.2016, for a assured of Rs.3,33,968/-. The Complainant/Respondent was nominee in the Policy. On 05.01.2013, the Life Assured died due to indigestion leading to motions and vomiting. The Complainant informed the Opposite Parties about the death of his brother, along with the death certificate and submitted the Insurance claim. The Opposite Parties appointed a Surveyor who recorded the statement of the Complainant and also collected the original Policy Bond and Death Certificate. On 29.04.2013 the Opposite Parties sent a letter to the Complainant intimating that the claim had been repudiated on the ground of suppression of material fact of pre-existing ailment. Aggrieved by Repudiation of the claim, Complainant filed Consumer Complaint No.228 of 2013 with the District Forum with the following prayer: -

“The Applicant therefore pray that the Honorable Forum may be pleased to pass orders in favour of the Applicant and against the opposite parties as:

a. To direct the opposite parties to pay policy amounts of Rs.3,33,968.00   (Three lakhs thirty three thousand nine hundred sixty eight only) along with benefits thereon.

b. Interest at 24% PA from the date of death of the deceased 5.1.2013.

c. To direct the opposite parties to pay Rs.30,000/- for the deficiency of service and also for causing mental agony, pain and suffering and

d) such other relief or reliefs as the Honorable Forum deems fit and proper in the circumstances of the case.

d. For the cost of the petition Rs.5, 000/-.”

The Opposite Parties/Petitioners resisted the Complaint by filling Written Statement submitting that the Repudiation of the claim was justified, as the Life Assured had not disclosed the material fact regarding pre-existing ailment. The Life Assured was under an obligation to mention the same in the proposal form at the time of applying for the Insurance Policy.

The District Forum after hearing the Learned Counsel for the Parties and perusing the record, partly allowed the Complaint with the observation that the Opposite Parties failed justify the repudiation of claim by filing affidavit of the doctor who treated the Insured as well as the Investigator’s affidavit. The Investigator’s Report was also not duly stamped by the relevant authority. The District Forum further held that it was the duty of the Opposite Party to check the health condition of the Insured before issuing the Health Policy. The District Forum passed the following order: -

“In the result, the complaint is allowed in part, directing the OPs 1 and 2 to pay policy amount of Rs.3,33,968/- (Rupees three lakhs thirty-three thousand nine hundred and sixty-eight only) with 6% p.a., interest from the date of registration of complainant i.e., 20-09-2013 till the date of actual realization and costs of Rs.2,500/- (Rupees two thousand five hundred only) to the complainant. Time for compliance, one month from the date of this order.”

Aggrieved by the order of the District Forum, the Opposite Parties preferred Appeal No.502 of 2016 before the State Commission. The State Commission concurred with the finding of the District Forum that weightage cannot be given to the Investigator’s Report and other evidence which showed concealment of material facts, as they were not certified by the competent authority and were also not on affidavit. The State Commission, vide its order dated 12.11.2019 dismissed the Appeal.

Aggrieved by the order of the State Commission, the Petitioners have filed the present Revision Petition 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 12/11/2019 passed by the Learned Andhra Pradesh State Consumer Disputes Redressal Commission, Vijayawada in First Appeal No. 502 of 2016;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.”

Heard the Learned Counsel for the Petitioners/Opposite Parties on admission and perused the record. The Learned Counsel for the Petitioners submitted that the impugned order was not sustainable as it was contrary to the facts of the case. In reply to question Nos.19 & 20 pertaining to the previous illness and treatment, the Life Assured answered in the negative, whereas he was hospitalized and treated for Acute Respiratory Failure with non-specific mediastinal lymphadenopathy. It was submitted that the Petitioners/Opposite Parties had produced the discharge summary alongwith prescriptions and reports before the District Forum showing that Life Assured had previous ailment, but the District Forum and the State Commission held that weightage could not be given to the evidence submitted by the Petitioners/Opposite Parties as they were not certified by the competent authority. It was also submitted that the contract of Insurance is based on the doctrine of ubberima fides. Life Assured was supposed to answer every question put to him with honesty and truthfulness. As the Life Assured had suppressed the material fact regarding his previous ailment, he had violated the Contract of Insurance. The Contract of Insurance was, therefore, void ab-initio and could not be acted upon.

Brief facts of the case are that the Deceased Life Assured had obtained a Health Policy bearing No. 0244560624, for a sum assured of Rs.3,33,968/-, valid from 28.12.2011 to 28.12.2026. The Complainant/Respondent was the nominee in the Policy. On 05.01.2013, the Deceased Life Assured died. The Complainant submitted the claim application to the Opposite Parties/Petitioners for settlement. The Opposite Parties/Petitioners, vide letter dated 29.04.2013, repudiated the claim on the ground of non-disclosure of material facts.

The Insurance Claim filed by the Respondent/Complainant was repudiated on the ground of non-discloser of pre-existing and pre-treatment of non-specific mediastinal lymphadenopathy. CT SCAN REPORT dated 06.03.2009 showed that the Life Assured underwent treatment for Non-Specific mediastinal lymphadenopathy but the report of the doctor who treated him was not filed on affidavit. The Investigator’s Report, based on which the Insurance Claim was repudiated, was also not filed on affidavit. The District Forum allowed the Complaint on the ground that the documents filed by the Opposite Parties relating to pre-existing ailment of the Life Assured were not filed on affidavit. Opposite Parties failed to prove those documents either before the District Forum or the State Commission. In the Revision Petition also the Petitioners/Opposite Parties have not pleaded filing of the documents before the District Forum on affidavit.

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 269has 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.”

I find no reason to interfere with the concurrent findings of both the Fora below. The Petitioners failed to point any illegality or irregularity in the order passed by the State Commission, warranting interference in exercise of revisional jurisdiction of this Commission under the Consumer Protection Act, 1986. Revision Petition is accordingly dismissed in limine.