Goa

StateCommission

FA/28/2013

S B I Life Insurance Co. Ltd. - Complainant(s)

Versus

Shnyni Valsan Pombally & other - Opp.Party(s)

G.N.Mishra

30 Apr 2013

ORDER

 
First Appeal No. FA/28/2013
(Arisen out of Order Dated null in Case No. of District State Commission)
 
1. S B I Life Insurance Co. Ltd.
Kapas Bhavan,Plot No. 3A CBD Belapur Navi Mumbai
 
BEFORE: 
 HONABLE MR. JUSTICE N.A.Britto PRESIDENT
 
PRESENT:
 
ORDER

As regards the submission that the deceased died due to hepatic encephalopathy and not due to diabetes, it may be firstly stated that ultimate cause of death of the deceased has no relevance whatsoever to the suppression of information regarding health and secondly because hepatic encephalopathy due to which the deceased died was attributable to alcoholic liver disese which the deceased had suppressed in giving answer. The medical records show that the deceased was a regular smoker,drinker, a diabetic and suffering from cirrhosis o liver and as such was almost  a physical wreck and yet obtained the said policy by suppressing vital information sought for by OP No. 2 and by committing fraud on OP No. 2. As already stated, the Apex Court in Satwant Kaur Sandhu(Supra) has also held that any inaccurate answers will entitle the Insurer to repudiate his liability because there is clear presumption that any information sought for in the proposal form is material for the purpose of entering into a contract of Insurance.

To sum up, the deceased obtained the Insurance policy by suppressing the information sought for by OP NO.2  and or giving false answers and thus playing fraud on OP No. 2. Had he disclosed the said ailments or given positive answers to the said questions OP No. 2 would not have accepted the proposal as stated by them. The deceased having suppressed material facts in the said questionnaire,OP No.2 could not be faulted in repudiating the claim of the Complainant and such there was no question of deficiency in service.

For reasons aforesaid, the Lr. District Forum ought to have dismissed the Complaint. Consequently, we allow this appeal and set aside the impugned order and dimiss the complaint and considering the facts, with no order as to costs.

 

 

 
 
[HONABLE MR. JUSTICE N.A.Britto]
PRESIDENT

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