The court established that the burden of proof lies with the Insurance Company to demonstrate the insured's awareness of the illness at the time of policy issuance, and the interest rate determination was influenced by the provisions of the Consumer Protection Act, 1986, and the Motor Vehicles Act.

Mr. Justice K.C. Bhargava, President—This complaint has been filed by the complainant for recovery of Rs. 1,00,000/- as sum insured against the Life Insurance Corporation of India. It is alleged that the wife of the complainant, Smt. Brij Bala was having an insured policy for a sum of Rs. 1,00,000/- only. The proposal form was filled up on 8.3.1989 and the date of commencement of the policy was 28.3.1989. The date of maturity of policy is 28.3.2014. During the existence of the policy, Smt. Brij Bala died on account of Breast Cancer on 11.9.1990. The Insurance Company was informed and a claim was also put forward. The death certificate, cremation certificate, written statement of nominee/claimant, certificate of hospital treatment, medical attendant’s certificate and the document of policy etc. were supplied to the Insurance Company. The opposite party has repudiated the claim of the complainant by letter dated 30.3.1991. The grounds for repudiation the claim are totally false and baseless. After repudiation of claim certain lettres were sent to the Insurance Company for review but nothing was done.

2. The opposite party in its written version has accepted the insurance of Smt. Brij Bala wife of the complainant who was the nominee in the insurance policy. It is also admitted that Smt. Brij Bala had died and a claim was submitted before it. The Insurance Company sent the claim forms to the complainant for getting them filled from the competent person and submit the same along with death certificate, original policy for consideration by the Life Insurance Corporation of India.

3. The copies of those letters have been filed. The ‘B’ Form which was given by the complainant, was completed by Jeevan Hospital and Nursing Home, New Delhi, Forms B1 and B2 were completed by Batra Hospital and Medical Research Centre, New Delhi and Jeevan Hospital and Nursing Home, New Delhi. Histopathology Report was issued by Jeevan Hospital and Nursing Home (P) Ltd., New Delhi. The death certificate etc. were also submitted. The representative of the Life Insurance Corporation of India could not get the copy of the details of patient history from the Jeevan Hospital and Nursing Home in order to show as to who has treated the patient. It is further alleged that on account of suppression of material facts the policy has been repudiated. According to the Insurance Company, it is alleged that the deceased knew about the breast cancer from the date prior to the filling of the proposal form.

4. The parties led evidence in support of their respective contentions. We have heard the learned Counsels for the parties and perused the evidence on record. The learned Counsel for the opposite party, Insurance Company has argued that in this case Brij Bala was having a lump and breast cancer at the time when she had filled up the proposal form. In the present case it has been said in the earlier part of the judgment that the proposal form was filled up on 8.3.1989 and the date of commencement of the policy was from 28.3.1989. We have to see whether Smt. Brij Bala was suffering from Cancer or was having a lump on these dates and knew about it. Certain papers were filed by the Life Insurance Corporation of India in order to prove these facts. We may go through these papers. The first paper is certificate of hospital treatment dated 9.1.1991. A perusal of it goes to show that the deceased was admitted in the hospital on 27.6.1989. There was pain and lump right breast and fever. The duration of the disease as reported to the medical examiner was not known. The answer to the query in Colomn 5 as to what was the exact history reported by the patient at the time of admission, is written as fever. It was further mentioned as to what was the symptoms narrated, it is written as not known. Whether the history of the patient was reported by patient or by someone else. It is written as yes. The name of the Doctor to whom the history was reported, it is written as Dr. D. Sessem