Page 78 - Suri’s - NCDRC ON LIFE INSURANCE 2017 V1.3

Suri’s - NCDRC ON LIFE INSURANCE 2017 78

1. This revision petition has been filed under Section 21(b) of the Consumer
Protection Act, 1986 against the order dated 20.11.2009 passed in FA No. 1364 of
2008 by Andhra Pradesh State Consumer Disputes Redressal Commission, Hyderabad
whereby the State Commission allowed the appeal and set aside the order of District
Forum, Kurnool.
2. The brief facts relevant for the disposal of this revision petition are that Mr.
D. Ayyapu Reddy, since deceased, (hereinafter referred as ‗the insured‘) had obtained
life insurance policy from Bajaj Allianz Life Insurance Company Ltd. for the period
commencing from 17.1.2006 to 18.10.2007. The insured died on 18.10.2007 during
the subsistence of the insurance policy. The complainant, Mr. D. Ayyapu Reddy, the
nominee, who was the nephew of deceased filed a claim to the OP alongwith relevant
documents. The OP repudiated the claim on 14.12.2007 on the ground that the in-
sured was suffering and under treatment of Asthma since 2005. The insured sup-
pressed the fact in the proposal form, which was filled on 4.1.2006.
3. Aggrieved by the repudiation, the complainant filed a complaint before Dis-
trict Consumer Disputes Redressal Forum, Kurnool (in short, ‗the District Forum‘) for
recovery of insured amount alongwith compensation. The OPs filed written version
contending that the insured had suppressed the material fact that he was suffering
from Asthma since 2005 and he had also undergone the treatment for the said dis-
ease. Therefore, the complaint is liable to be dismissed.
4. On the basis of pleadings and evidence, the District Forum dismissed the
complaint and agreed with the view of OP that the insured had taken treatment from
Gowri Gopal Hospital, Kurnool.
5. Being aggrieved by the order of District Forum, the complainant filed first
appeal before A.P. State Consumer Disputes Redressal Commission, Hyderabad ( in
short, ‗the State Commission‘). The State Commission vide its order dated
20.11.2009 allowed the appeal and directed the OPs to pay Rs. 5 lakhs within a period
of four weeks.
6. Aggrieved by the impugned order dated 20.11.2009, the OP filed this in-
stant revision petition.
7. Heard learned counsel for the parties. Learned counsel for the petitioner
vehemently argued that the insured had concealed about his suffering from Asthma.
The legal position is that the life assured at the time of making insurance, is duty
bound to make correct and true disclosure as to his health condition. The contract of
insurance is based on the principle of uberrima fides. He further submitted that the
State Commission erred in holding as Asthma is not a dreadful disease or debilitating
disease without any evidence to such effect. Therefore, this revision petition de-
serves to be allowed.
8. Learned counsel for the complainant submitted that the insured was not
educated person. The proposal form was in English, it was filled by the agent of OP
without disclosing the relevant question and obtained the signatures of the insured in
the proposal form. Thus, the burden lies on the OP to prove that the questions of pro-
posal form were informed to the insured and the same were explained to him in Te-
lugu. He also denied that the insured was suffering from any pre-existing disease and
the doctors who treated him were not examined by the OP. There is no evidence that

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