Page 97 - Suri’s - NCDRC ON LIFE INSURANCE 2017 V1.3

Suri’s - NCDRC ON LIFE INSURANCE 2017 97

posal Form, as, he being an employee of the Company has been trained by the Insur-
ance Company for filling such Proposal Forms. Accordingly, he took the information
from the Complainant‘s husband and filled the Proposal Form. It was pleaded that
usually, the persons interested in taking medi-claim related insurance policies are
asked queries pertaining to other policy details. In the present case, he did not deem it
fit to ask any such question on the issue of other policies from the life assured as the
policy in question was not a medi-claim policy. It was averred that, all the informa-
tion necessary to the subject policy, was provided in the Proposal Form and there-
fore he cannot be made liable for any deficiency of service.
6. The District forum, based on the evidence and the material on record, dis-
missed the Complaint.
7. Aggrieved by the said order, the Complainant preferred an Appeal before
the State Commission, which was allowed directing the first and second Opposite
Parties to pay an amount of Rs. 15,00,000/- with interest @ 6% p.a. from the date of
filing of the Complaint along with other benefits payable under the policy. While al-
lowing the Appeal, the State Commission has observed as follows:
“(10) In short, we are in agreement with the fact that if the insured is hold-
ing any other life insurance policy the same needs to be disclosed in the proposal
form so that the life insurance company gets an opportunity to deliberate on the
terms and conditions on which the policy is to be issued, but in the present appeal
opposite party insurance company has not been able to prove by way of concrete
evidence that the deceased insured was holding other policies of value of more
than Rs.20 lakhs from any other life insurance company.
(11) Ld. Counsel for the complainant Sh Daxesh Trivedi has placed on re-
cord a judgment in 3 (2002) CPJ 336 (NC) wherein the Hon‟ble National Com-
mission has referred to decision of Hon‟ble Apex Court and Hon‟ble National
Commission relied upon the judgments, which are mentioned below:
i. 3(1998) CPJ page 30(NC)
ii. 1997 AIR-SC 2485
iii. 3(1997) JT 31(SC)
iv. 2(1996) CPJ 77 (NC)
Wherein it is held that „ when there is no legal evidence on record to sustain
the view taken by the investigator. Investigation report is to be proved by an affi-
davit of the investigator.‟ In short, the orders passed by the Gujarat State Com-
mission in Complaint No. 111/2002, C.C. No. 8/2007 and C.C. No. 42/2007 have
been placed before us, wherein in C.C. No. 42/2007 reliance has been placed on
the order of Gujarat State Commission in „New India Insurance Company Ltd. vs.
Jagrat Nagrik‟ reported in 2011 CTJ page No. 464 (Gujarat) wherein it has been
held that „for repudiating an insurance claim it is not sufficient for the insurer to
say that the statement made by the insured was false but it was required to be es-
tablished that the statement made on the material matter and that it was made
fraudulently‟. In the above circumstances, the entire facts are clear that the facts
mentioned by the deceased/insured in the proposal form that he does not have any
other life insurance policy, is true. The grounds on which the insurance company
repudiated the claim under the insurance policy of the complainant is not reason-
able and justified, non payment of the claim to the complainant by the opposite

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