Page 49 - Suri’s - NCDRC ON LIFE INSURANCE 2017 V1.3

Suri’s - NCDRC ON LIFE INSURANCE 2017 49

BE-
FORE:
HON'BLE MR. DR. B.C. GUPTA,PRESIDING MEMBER
HON'BLE MR. DR. S.M. KANTIKAR,MEMBER

For the Peti- Mr. Gautam Talukdar, Ad-
tioner : vocate

For the Respon- Mr. Gaurav Kumar, Ad-
dent : vocate

Dated : 13 Sep 2017
ORDER
DR. S. M. KANTIKAR, MEMBER
1. Ms. Shail Devi, since deceased, took an insurance policy from Sahara India
Life Insurance Co. Ltd. (OP) for the amount of Rs.1,00,000/-. The policy was issued
on 04-01-2010. During subsistence of the policy, she expired on 16-12-2010 due to
cardio respiratory failure. Her son, Shailender Kumar Pandey, the complainant herein
filed a death claim before the OP, but it was repudiated on the ground that the insured
had given false answers to the questions Nos.7(6)(d) and 8 of the proposal form. Also,
ground was taken that the deceased was suffering from diabetes mellitus for more
than a decade. It was concealed while filing the proposal form. The complainant also
contacted the review committee of OP, but there was no positive response even after
lapse of five months. Hence, the complainant filed a complaint against OP for alleged
deficiency in service before the District Consumer Disputes Redressal Forum,
Vaishali, Hazipur (herein referred as District Forum).
2. The OP resisted the complaint on the ground of territorial jurisdiction, as
the policy was issued from Muzzafarpur branch of OP. Therefore, the District Forum
Vaishali had no jurisdiction. The OP further stated that the insured had concealed
material information in the proposal form about her past illness of Diabetes Melli-
tus(DM), and hence, the claim was correctly repudiated. Past illness of DM was
proved from the discharge summary of Heart Hospital at Patna where she was admit-
ted at the time of death.
3. The District Forum vide order dated 15-06-2015 allowed the complaint and
directed the OP to pay an amount of Rs.1,00,000/- with interest at the rate of 10% per
annum from the date of filing of the complaint within one month. The District Forum
held that doctrine of Good Faith i.e. ―Uberimma Fides‖ is applicable to both the par-
ties. Being aggrieved by the order of the District Forum, the OP approached the State
Commission by way of appeal. It was also dismissed by the State Commission with
cost of Rs.5,000/-. The State Commission held that the OP had failed to establish that
the assured was suffering from Diabetes Mellitus for last 10 years. Aggrieved by the
order of the State Commission, the OP filed this instant revision petition.
4. We have heard the learned counsel for both the parties. The counsel for the
petitioner vehemently argued that the deceased/insured had deliberately suppressed
medical history in the proposal form that she was having good health. The counsel

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