Page 137 - Suri’s - NCDRC ON LIFE INSURANCE 2017 V1.3

Suri’s - NCDRC ON LIFE INSURANCE 2017 137

self as R and enjoyed the benefits under the Central Government
Health Scheme (CGHS) in the name of R - The information ob-

tained under the Right to Information Act reveals that R was a
constable in Delhi Police and was suffering from neck problem

only - The State Commission should have examined the relevant

medical record available at the places, where the treatment was
taken in order to find out whether it was B, who had taken the

treatment or it was R - It is, therefore, necessary that the matter

be thrashed out in detail to bring out, whether there has been an
act of fraud on the part of the insured. It is evident from the facts

recorded above that the order of the State Commission has not
taken into account the crucial issue involved in the matter and de-

cided the case, based on technical aspects only. The order passed
by the State Commission is, therefore, perverse in the eyes of law

and the same is hereby set aside. ...37

Free Look Period - Request for cancellation and refund of the premium
paid was sent after the free look period, as such the policy could

not be cancelled as per the IRDA regulations and also as per the

terms of the policy contract. ...69
Insurance Act, Section 45 - Material fact - Suffering from diabetes, hy-

pertension etc. and getting treatment for ARF was a material fact
which must be within the knowledge of the deceased policy

holder - It was, therefore, the bound duty of the deceased to have
disclosed these facts and for his failure to do so, he cannot take

advantage of section 45 of Insurance Act, on the ground that the

death took place after two years of obtaining the policy in ques-

INDEX