Heard learned Counsel on behalf of appellant.
2. This appeal has been filed U/S-41 of Consumer protection Act 2019 (Hearin after called the Act) 2019 against impugned order passed by Learned District C.D.R, Commission, Balasore. The parties are referred in complaint case may be read as same in this appeal for convenience.
3. The case of the complainant in nut-shell is that the complainant has purchased postal Life Insurance Policy No. OR-331222-CS for sum assured of Rs. 2,00,000/- with monthly premium of Rs. 1750/- on 13-05-2010. He had paid pemium for the period from May 2010 to August -2012 and expired on 13-09-2012 i,e after 2 years from the date of taking policy. The complainant alleged inter-alia that the
policy covers death claim benefits . The orginal policy holder due to Tropical Cronic Pancreatities, Diabedties Mellitus and Jundice died on dtd. 13-09-2012 in the hospital .Therefore, the claim was made but it was repudiated by a written letter dtd. 04-06-2014 illigally in spite of submission of all document.Thus complainant got mental agony and financial sufferings. Therefore, the complaint filed by the complainant.
4. The O.P took plea that the complaint is not maintainable. The Complainant has paid premium from May-2010 to August 2012 and expired on 13-09-2012 i.e. within 3 years from taking the policy. The policy holder has filed false information with regard to previous existing diseases in the porposal form. After receiving claim they have investigated the matter and found that policy holder has taken medical leave from office from 13-05-2007 to 12-05-2010. They also found that the copy of the discharg certificate from treating doctor.
It is stated that late policy holder was suffering from Chronic Pancreatitis at the time of taking the policy on 13-05-2010 and he has suppressed the material information about pre-existing diseases and given wrong declaration in the proposal form . As such there is no deficiency in service on the part of O.Ps.
5. After hearing of both parties the Learend District Commission passed the following orders.
“The consumer case is allowed on contest against O.Ps with cost. The O.Ps are jointly or severally directed to pay the death claim benefit of Rs. 2.00 lacs ( Rupees Two lacs ) only along with other benefits and compensation of Rs. 10,000/- ( Rupees Ten thousand ) only and litigation cost of Rs. 2,000/- ( Rupees two thousand ) only to the Complainant within 60 days of receipt of this order , failing which it will carry interest @ 9% per annum on the total amount including the death claim amount along with compesation and itigation cost from the date of order till realization. The complainant is also at liberty to realize the same from the O.Ps as per law, in case of failure by the O.ps to comply the order.”
6. Learend cousnel on beahlf of appellant submitted that the Learned District Forum without analysing the case with proper perspective has passed illegal order. According to him from 28-02-2010 the policy holder was suffering from different diseases but in proposal form he has suppressed same fact. Since, insurance contract is bassed on ubrime-fides and the policy holder has suppressed the material fact by suppressing material facts
in proposal form, they have repudiated claim . But Learend District Forum has failed to apply judicial mind to the facts and law. Thereore, he submitted the matter to be set aside by allowing the appeal.
7. Considered the submission of appellant, perused the DFR and impugned order.
8. It is an admitted fact that the complainant has purchased postal life Insurance policy from the O.Ps for sum assured of Rs. 2,00,000/- It is not in dispute that the policy holder died on 13-09-2022. Section 45 of the Insurnce Act states as follows.
“ No policy of life insurance affected before the commencement of this Act shall after the expiry of two years from the date of commencement of this Act and no policy of life insurance effected after the coming into force of this Act shall after the expiry of two years from the date on which it was effected, be called in question by an insurer on the ground that a statement made in the proposal for insurance or in any report of a medical officer, or referee, or friend of the insured,or in any other document leading to the issue of the policy, was inaccurate or false, unless the insurer shows that such statement was on a material matter op suppressed facts which it was material to disclose and that it was fraudulently made by the policy holder and that the policy- holder knew at the time of making it that the statement was false or it suppressed facts which it was material to disclose
Provided that nothing in this section shall prevent the insurer from calling for proof of age at any time if he is entitled to do so, and no policy are adjusted on subsequent
proof that the age of the life insured was incorrectly stated in the proposal”.
9. The aforesaid provision is clear that no policy can be called in question on ground of mis- statement or suppression of metrial fact or fraudlent statement after two years from the date of commencing the policy.In the instant case the policy commenced admittedly on 13-05-2010 but policy discard on 13-09-2012 . Therefore, we have no hesitation to say the claim of the O.P is barred by section-45 of the Insurance Act. In view of aforesaid provision of law, we hereby confirmed the impugned order and found no merit in this appeal. Hence, appeal is dismissed. No costs.
Free copy of the order be supplied to the respective parties or they may download same from the confonet or website of this Commission to treat same as if copy of order received from this commission.
DFR be sent back forthwith.