Page 62 - Suri’s - NCDRC ON LIFE INSURANCE 2017 V1.3

Suri’s - NCDRC ON LIFE INSURANCE 2017 62

the insured on 04.05.2009. The learned counsel for the appellant would contend
that the doctor was won over by the respondent and her husband. Ex A1 is subse-
quently issued to the date of issue of Ex B1. Though the doctor‟s evidence is not
considered in view his admitting issuance of Exs A1 and B1, the laboratory report
which is not rebutted by the respondent clinchingly prove the fact that the insured
was diabetic as the urine sugar and albumin had shown abnormal value. The in-
sured concealed from mentioning in the proposal that it was confirmed by that
time he was a diabetic.
15. In view of foregoing discussion, this Commission is of the view that find-
ing recorded by the District Forum that the appellants had not established con-
cealment material fact as regards to his health by the insured is not sustainable
and the order of the District Forum, as such is liable to be set aside.
16. In the result, the appeal is allowed setting aside the order of the District
Forum. Consequently, the complaint is dismissed. There shall be no separate or-
der as to costs”.
6. Hence, the present revision petition.
7. The present revision petition has been filed with a delay of eight days. For
the reasons given in the application for condonation of delay, the delay is condoned.
8. I have heard the learned counsel for the parties. Learned counsel for the peti-
tioner has contended that the insurance company had wrongly concluded that the in-
sured Ramaiah had suppressed the information that he was suffering from diabetes,
urine infection and kidney failure and he died a natural death by heart attack. He fur-
ther contended that Dr Kadiyala Venkateswara Rao on 18.06.2010 had certified that R
Ramaiah had been treated by him on 04.05.2009 but later by a certificate dated
07.06.2011 he denied the same. The petitioner had no other evidence of any previous
ailments. The investigation got conducted by the respondents was motivated and not
supported by any affidavits. He further admitted that he had not filed the death certifi-
cate or a medical certificate as after the death of R Ramaiah no Doctor was called and
hence, there is no certificate by any Doctor certifying the cause of death nor was there
any post mortem report. The family had said the cause of death was heart attack.
9. Learned counsel for the respondent on the other hand, drew our attention to
the copy of the lab report dated 04.05.2009 which the petitioner had omitted to file.
The report of the urine test of the deceased clearly shows that he had tested positive
for sugar and albumin which would indicate that he was suffering from diabetes, and
kidney failure. His Serum level was also high. The State Commission had correctly
concluded that if the Doctor‘s evidence is not considered, the petitioner/ complainant
had failed to rebut the laboratory report which clinches the fact that the insured was
diabetic as the urine sugar and albumin had been shown abnormal values.
10. I have carefully gone through the record as also the record filed before the
District Forum. The petitioner with the revision petition had filed the survey report of
G Ramamurthy but omitted to file the investigation report by Amma Claims Bureau.
The significant findings of the survey report are as under:
51 years as per the proposal. No. ID of either
the LA or the claimant were provided to us. As
Age Particulars
per the medical certificate issued by a doctor, the
LA is aged about 53 years.

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