BEFORE THE CIRCUIT BENCH A.P STATE CONSUMER DISPUTES REDRESSAL COMMISSION AT VIJAYAWADA
F.A.No.867
Between
1. M/s Birla Sun Life Insurance Co.Ltd.,
By its Managing Director,
G Corp Tech Park 5 and 5th Thane-601, Mumbai
2. M/s Birla Sun Life Insurance Co.Ltd.,
By its Manager, Near Benz Circle, Jewellery, M.G.Road, Vijayawada
Shaik Sirajunnissa W/o Shaik Ataullal,
Housewife R/o 11-36B, Islampet, Vijayawada-001, Krishna Dist.
Counsel for the Appellant
Counsel for the Respondents
QUORUM: SRI R.LAKSHMINARSIMHA RAO, HON’BLE MEMBER
1.
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4.
However, without admitting any liability under the Policy, we have decided to refund the Cash Surrender Value under the Policy as exgratia.
5.
A) | Life Style Information | |
6) | Do you smoke cigarettes/bidis or use of any other form of tobacco like pan gutkha etc | No |
(D) | Have you ever had or sought advice for the following | |
(e) | Ulcer, Chronic, Diarrhea, hepatitis or jaundice or other liver or diagnosed disorders | No |
f) | Cancer, tumor, thyroid disorder enlarged glands, enlarged lymph nodes | No |
5) | Do you have any health symptoms or complalint for which the Physicians has not been consulted or treatment received. | No |
6. The appellant contends that the claim investigation revealed that the insured was a smoker. The appellant had taken shelter under Section 45 of the Insurance Act which reads as under:
45.
7.
“(a) the statement must be on a material matter or must suppress facts which it was material to disclose,
(b)
(c ) the policy holder must have known at the time of making the statement that it was false or that it suppressed facts which it was material to disclose.”
8.
8 | Within the past 12 months have you used any products alcohol or nicotine | No |
10 | Are you on a diet or taking any vitamin herbal, medicine reducing pills or other mediine of any kind? | |
11 | Have you ever been examined for or treated for high blood, pressure, stroke heart trouble, diabetes, cancer, tumour, chest pain, digestive tract disorder or had such treatment been recommended by Physicians or Other Practitioner | No |
13 | Since the Applicatoin for this Policy, have you | |
a. | Consulted any doctor or other health Practitioner | No |
b. | Been told you or sought advice for any illness disease or injury | No |
c. | Submitted to ECG, X-ray blood test or other tests? | No |
d. | Been submitted or been admitted/advised to be advised as inpatient in hospital or clinic except for pregnance birth or routine check up | No |
9.
i) Life Insurance Corporation of India vs Asha Goel & another-AIR 2001 SC 549.
ii) Satwant Kaur vs New India Insurance Company Ltd- SC2776(2002)
10.
11.
“The purpose for taking a policy of insurance is not, in our opinion, very material. It may serve the purpose of social security but then the same should not be obtained with a fraudulent act by the insured. Proposal can be repudiated if a fraudulent act is discovered. The proposer must show that his intention was. It must appear from the face of the record. In a case of this nature it was not necessary for the insurer to establish that the suppression was fraudulently made by the policy holder or that he must have been aware at the time of making the statement that the same was false or that the fact was suppressed which was material to disclose. 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.”
12.
“Thus it needs little emphasis that when an information on a specific aspect is asked for in the proposal form, an assured is under a solemn obligation to make a true and full disclosure of the information on the subject which is within his knowledge. It is not for proposer to determine whether the information is sought for is material for the purpose of the policy or not”.
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