Dtd.19.08.2023                                            A/421/2018

O R D E R

        BY Mr.K.B.SANGANNANAVAR : Pri.Dist & Session Judge (R) - JUDICIAL MEMBER.

1.    This is an appeal filed U/s.15 of CPA 1986 by Complainant/Appellant aggrieved by the order dtd.20.12.2017 passed in CC/102/2017 on the file of Davanagere District Forum. (Parties to this appeal would be referred to as their rank assigned by the Forum below.)
2. The Commission examined grounds of appeal, impugned order, appeal papers and heard.  
3. The Complainant/Gangadharappa Kaikada was aged about 58 years on the date of complaint. His son by name Mr.K.G.Kumar, had obtained an insurance policy from OP on 30.09.2016 for the period of 20 years and the sum assured was Rs.12 lakhs. While the policy was in force insured died on 06.03.2017. In other words, he died 5 months 6 days after obtaining the policy from OP. According to the Complainant he died due to chest pain at his residence. His claim submitted to OP came to be repudiated as per letter dtd.23.06.2017 marked as Ex-A3/Ex-B16, wherein could see, “OP regretted to inform the Complainant that, they have decided to repudiate all liability under the said policy as Mr.K.G.Kumar was suffering from Chronic Kidney Disease prior to policy issuance and the same was not disclosed on the proposal form dtd.27.09.2016. If this information was disclosed at proposal stage, they would have declined the policy issuance. They hold indisputable proof to show that life assured had suffered from Chronic Kidney Disease prior to proposal.”
4. According to the Complainant/Appellant herein the policy was issued after obtaining medical test report from company Doctor  Mr.Shivanand of Sri Basaveswara Diagnostic Center, Davanagere. But facts remain herein that, insured died within two years from the date of issuance of the policy and after due investigation, OP secured medical records from Kasturba Hospital Manipal-Udupi marked as Ex-B18 to 20. The Forum below found KMC hospital issued medical reports/Ex-B18 to 20 related to K.G.Kumar bearing IP No.2784774 and in all the  three sheets mentioned name of Mr.K.G.Kumar, is mentioned was aged about 26 years and was visited on 03.10.2015 at about 11 am,  got the lab test reports from the department of Bio-Chemistry-Urine Microscopic Examination – CBC and peripheral smear. Further in Ex-19/Bio Chemistry Report, range of urea/serum has gone beyond the average range, which clearly establishes that the insured was a chronic disease, since 2015, yet, while answering in the proposal to questionnaire no.77 recorded as ‘No’, but records speaks otherwise as the insurer found from the medical records he had chronic kidney disease from 2015 itself and this material fact had been suppressed in his proposal. In such circumstances OP/insurer has to be held justified in repudiating the claim of the Complainant who is none other father of the deceased insured.
5. In view of the above such conclusion, Commission did not find any error or irregularity either of law or facts committed by the Forum below in dismissing the complaint. Hence proceed to dismiss the appeal with no order as to cost.

6. Notify copy of this Order to the District Commission and parties.

                                       Judicial Member               

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