Page 79 - Suri’s - NCDRC ON LIFE INSURANCE 2017 V1.3

Suri’s - NCDRC ON LIFE INSURANCE 2017 79

the insured was suffering from pre-existing disease and moreover, the insured was
examined by a panel of doctors of OP before issuing the policy and the doctor certi-
fied that the insured was free from any disease. Therefore, it cannot be said that the
insured was suffering from Asthma. Moreover, the insured died in the night during
sleep, his death was not due to Asthma as such, alleged to be pre-existing disease.
Hence, the OPs are liable to pay insurance claim. The arguments on behalf of peti-
tioner/OP are that there was no deficiency in service and the repudiation was proper
as legally. The repudiation was done after thorough scrutiny of all the factors and it
was noticed that the insured was having serious respiratory disease ‗Asthma‘ and had
taken prolongs treatment as out-patient as well as in-patient in Gowri Gopal Hospital,
Kurnool. The insured deliberately suppressed the fact to obtain the insurance policy.
He relied upon the case-sheet and the discharge summary from the hospital which
clearly establishes that the insured was in the hospital and discharged on 23.12.2005.
It is submitted that he signed the false declaration. Thus, it is evident that the insured
committed ‗suppressio veri‘ and ‗non-divulgences‘ by vital information deliberately
and obtained the policy. The contract of insurance is uberrima fides.
9. I have perused the proposal form, the policy document and the relevant
medical record. It is transpired that the proposal form was filled in English by the
agent of insurance company and the signature of proposed insured was in vernacular
language i.e. Telugu. On its face, it appears that the insured is illiterate and he was
unable to put his signature properly. There is no medical record to prove that the OP
was suffering from Asthma. The cause of death was not known. He died during the
sleep. There is no evidence that the death was due to Asthma, which was mentioned
in the repudiation letter.
10. On the basis of foregoing discussion, I do not find any merit in the instant
revision petition. Accordingly, it is dismissed.

......................
DR. S.M. KANTIKAR
PRESIDING MEMBER

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