ORDER

Date of order:     29 -05-2017

Upendra Jha,Member       

                   This appeal is directed against the order dated 30-12-2015 passed by the District Consumer Forum, Purnea in Complaint Case No. 37 of 2014 by which the appellant is directed to pay the respondent –complainant the sum assured with 8% interest within two months.

 2.               The details of this case is mentioned in Appeal No. 172 of 2016. We do not repeat it in this case.

3.                           Respective written arguments have been filed by the parties. Heard and perused the District Forum order.

 4.                          The counsel for the appellant submits that the life assured had suppressed the material facts regarding her health at the time of proposal. She was under treatment of Lump in left breast and left Auxiliary from the  Mahavir Cancer  Institute, Patna prior to taking policy. Due to suppression of facts the O.P.-appellant has rightly repudiated the claim of the claimant and it was communicated to the complainant vide letter dated 21-11-2013. District Forum order is not sustainable. It is fit to be set aside and the appeal be allowed.

5.                           The counsel for the respondent-complainant submits that the appeal is suffering from non-joinder of the party. Despite notices, the Insurance Company did not file response written statement and was absented on several dates. District Forum had to pass ex-parte order. The appellant has not investigated the claim. The life assured was not suffering from Lump in left breast and left Axillary and she was not under treatment in Mahavir Cancer Institute, Patna. The medical treatment report produced by the appellant of the Mahavir Cancer Institute, Patna is not supported by evidence on affidavit. It cannot be considered. It needs no interference. The appeal having no merits be dismissed.

6.                           Having considered the submission of parties, grounds taken in appeal and on perusal of the order passed by the District Forum, it appears that the life assured had obtained an Insurance Policy of Rs. 2, 99,329 on 25-02-2013 from the appellant in which the complainant is the nominee. Life assured Sushila Soren died on 25-03-2013 due to Heart Attack. On several dates, the O.P.-appellant did not appear before the District Forum, then the District Forum heard the complaint ex-parte and order was passed. Life assured has signed in Hindi where it was required in proposal form where as the entire form is in English and the form has been filled up in English on 25-02-2013 by the Agent. So, the policy holder has not suppressed the material facts regarding her health as he was not knowing the English. Mahavir Cancer Institute papers produced by the appellant is of11-02-2013. So, the repudiation of claim by the O.P.-appellant is not justified. District Forum order in allowing the claim is well justified. We do not find any reason to take a different view in this matter. Hence, the District Forum order is affirmed and the appeal is dismissed.

       S.K.Sinha                         Renu Sinha                  Upendra Jha                                                                       

      President                           Member (F)                   Member (M)                                                                                              

           Anita