Per – Hon’ble Mr. S. R. Khanzode, Presiding Judicial Member
Admitted and with the consent of the parties, heard forthwith.
[2] This appeal takes an exception to an order dated 8/4/2011, passed by the District Consumer Disputes Redressal Forum, Nashik (‘the Forum’ in short) in Consumer Complaint No.344 of 2010, Mr. Pradeep Devram Jadhav Vs. Oriental Insurance Company Ltd.
[3] It is a case of alleged deficiency in service on the part of the Appellant/original Opponent (hereinafter referred to as ‘the insurance company’ for the sake of brevity) for repudiating the mediclaim on the ground of ‘breach of utmost good faith’. The Forum upheld the contention of the Respondent/original Complainant and awarded the claim and directed the insurance company to pay to the Respondent/original Complainant, an amount of `2,00,000/- towards policy amount together with interest thereon @ 9% p.a., from 7/9/2010 alongwith an amount of `15,000/- towards compensation for mental agony and `1,000/- as costs of the complaint. Feeling aggrieved thereby this appeal is preferred by the insurance company.
[4] Referring to the repudiation letter dated 10/6/2010, it is submitted that the current illness of the Respondent/original Complainant is a complication of hypertension, which is since four years prior to the event in question as per indoor case-papers and hence, relates to pre-existing disease, and therefore, since the said fact was materially suppressed while taking the insurance policy and filling the proposal forum, the claim stood repudiated.
[5] The insurance company obviously tried to refer to the discharge report card of Magnum Heart Institute, a photocopy of which is produced on the record. When we made an enquiry from the Learned Counsel for the Appellant as to what sort of evidence is led as per provisions of Section-13(4) of the Consumer Protection Act, 1986 to establish the disputed fact of concealment of material fact, the answer was in the negative. He only made reference to mere filing of certain photocopies, which is not synonymous to tendering of evidence. Thus, the disputed fact is not at all established. In case of repudiation, it is for the insurance company to justify the same, onus of which is not discharged by the insurance company in the instant case. Therefore, ultimately we find no reason to take a different view in the matter than what is already taken by the Forum. Thus, we find present appeal devoid of any merits. We hold accordingly and pass the following order:-
ORDER
The appeal stands dismissed.
No order as to costs.
Pronounced & dictated on 11th October, 2011
