Page 54 - Suri’s - NCDRC ON LIFE INSURANCE 2017 V1.3

Suri’s - NCDRC ON LIFE INSURANCE 2017 54

was a nominee in the policy taken by her husband. The insured deposited the instal-
ment of premium regularly till his death which took place on 30.03.2010. The com-
plainant filed the insurance claim with the opposite party alongwith all requisite
documents for release of the sum assured and payment of other due benefits by the
OPs. After the exchange of some correspondence between the complainant and the
insurance company, a repudiation letter dated 21.09.2010 was received by the com-
plainant from the OP, in which it was stated that the deceased had history of diabetes
mellitus (DM) since 15 years and was under hospitalisation/treatment for acute renal
failure (ARF) since 2006. The OP insurance company stated that these facts, known
to the deceased, had not been disclosed in the proposal form for taking the policy and
hence, there was suppression of material information on the part of the deceased in-
sured. The State Commission, after taking into account the averments made by both
the parties, concluded that the OP Insurance Company were justified in repudiating
the claim of the complainant on the ground that there was suppression of material
information and concealment of serious diseases by the insured at the time of taking
the policy. The consumer complaint was ordered to be dismissed. Being aggrieved
against the order of the State Commission, the complainant is before this Commission
by way of the present first appeal.

3. There is a delay of 224 days in filing the present appeal. An application for
condonation of delay has been filed by the appellant, in which it is stated that the
complainant is a resident of Jalandhar town in Punjab and that she could not visit
Delhi because of her knee problem and hence, could not contact any counsel for filing
the said appeal. She had to visit Chandigarh also to collect the necessary papers. The
delay in filing the appeal was neither intentional nor deliberate, but it was due to the
reasons beyond her control.

4. During arguments before us, the learned counsel for the appellant stated that
the appellant had filed medical reports in support of her contention that she could not
file the appeal in time, because of her health problems. The learned counsel has
drawn attention to an order passed by the Hon‘ble Supreme Court in ―N. Balakrish-
nan vs. M. Krishnamurthy‖ [VII (1998) SLT 334], saying that the primary function
of a court is to adjudicate the dispute between the parties and to advance substantial
justice. The delay in filing the appeal should, therefore, be condoned. The learned
counsel further stated that the husband of the appellant alongwith his two brothers had
obtained the insurance policies in question, for which they were subjected to requisite
medical tests by the insurance company, in which nothing adverse was found against
them. The husband of the complainant had also paid premium for about four years.
His brothers had been paying the premium regularly. The learned counsel argued at
length, saying that the deceased was suffering from ―acute renal failure‖ (ARF) and
not ―chronic renal failure‖ (CRF). The learned counsel has given references to medi-
cal literature and tried to draw a distinction between ARF & CRF. The learned coun-
sel argued that the ARF occurs suddenly, but it is reversible. However, the CRF hap-
pens gradually and its incidence may not be known till there is about 75% damage to
the kidneys. The learned counsel stated that even if the deceased had undergone
treatment for the ARF, he would have been fully cured by the time, the Insurance Pol-

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