KERALA STATE CONSUMER DISPUTES REDRESSAL COMMISSION VAZHUTHACAD THIRUVANANTHAPURAM
APPEAL 569/2009
JUDGMENT DATED: 6/12/2010
PRESENT
JUSTICE SRI.K.R.UDAYABHANU : PRESIDENT
SRI.S.CHANDRAMOHAN NAIR : MEMBER
The Manager, : APPELLANT
M/s National Insurance Company Ltd.,
East Fort Complex, Fort Maidan,
3rd Floor, Kunnathumedu.P.O.,
Palakkad.
(By Adv.Prasanna Kumar Nair)
Vs.
Parvathy Amma, : RESPONDENT
7/916, Vadukapalayam,
Kalpathy, Palakkad – 678003.
(By Adv.C.S.Rajmohan)
JUDGMENT
JUSTICE SRI.K.R.UDAYABHANU : PRESIDENT
The appellant is the opposite party in CC.123/08 in the file of CDRF, Palakkad. The appellant is under orders to pay a sum of
Rs. 50,000/- as the claim amount and Rs.10000/- as compensation and Rs.1000/- as costs.
2. The matter relates to repudiation of the medi claim policy on the ground that the complainant suppressed material facts relating to her state of health. It is the contention that the complainant was having diabetics and hypertension and other illnesses for a period of 7 years past. She underwent cardiac surgery on 10.7.2008.
3. The evidence adduced consisted of the testimony of PW1; Exts.A1 to A4 and Exts.B1 to B5.
4. The Forum has allowed the complaint on the ground that the opposite party has not adduced any evidence to show that the insured was suffering from the cardiac illnesses prior to the issuance of the policy, or having the knowledge of the disease. We find that discharge summary produced by the opposite parties from Lekshmi hospital, Palakkad and Kovai Medical Centre & Hospital, Koimbatore specifically mentions that she was a known diabetic/hypertensive since 7 years and on regular medication.
5. The counsel for the appellant has also relied on the decision of the Supreme Court in Satwant Kaur Sandhu vs New India Assurance Co. Ltd. (2009) 8 SCC 316 to substantiate the contention that in the contracts of insurance that fall in the category of uberrimae fidei there should be utmost good faith on the part of the assured. It is seen Ext.B1 proposal form that the complainant has answered in the negative all the questions as to the state of health. The complainant was duty bound to reveal the actual state of affairs as to her health. In the circumstances we find that the complainant has committed serious suppression of material facts. Hence the order of the Forum is set aside and the appeal is allowed.
Office will forward the LCR to the Forum along with the copy of this order urgently.
JUSTICE SRI.K.R.UDAYABHANU : PRESIDENT
SRI.S.CHANDRAMOHAN NAIR : MEMBER
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