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2005 (3) CPR 535
KERALA STATE CONSUMER DISPUTES REDRESSAL COMMISSION, THIRUVANANTHAPURAM
T.M. Hassan Pillai, President and Smt. A. Radha, Member
The Divisional Manager and Anr.—Appellants
versus
Mareena Mathew—Respondent
Appeal No. 1011/1999
Decided on 28-2-2005

Advocates:
Counsel for the parties :
For the Appellants :Sri. S.S. Kalkura, Advocate.
For the Respondent: None.

Headnote:Consumer Protection Act, 1986 – Section 2(1) – Insurance claim – Repudiation of – Suppression of material facts – Death of insured on account of alcoholic liver cirrhosis – Factum of consumption of alcohol and previous accident caused in drunken stage, not disclosed at the time of making proposal – A clear-cut case of suppression of material facts – Repudiation of claim justified.

       Facts of the case :

       (A)Present appeal is filed by the Insurance Company against the order of District Forum. The Forum held that the repudiation of claim made by the complainants to nominees of insured under the Life Insurance Policy was unjustified and the same, amounts to deficiency in service. The appellants claimed that the insured at the time of making the policy suppressed the facts relating to his habit of drinking alcohol and causing accident in drunken stage.

       (B)One of the questions in column no. 11 in the proposal form is DO you use or have you ever used alcoholic drinks, narcotics or any other drugs ? and the answer given by the deceased was ‘No’. It is clear from the medical records produced by the appellants that deceased was consuming alcohol daily and he started consuming alcohol much before taking of the policy and was consuming daily 400 ml of brandy. Thus it is clear that at the time of making proposal, he was consuming daily 400 ml of brandy and also started for treatment of alcoholic liver disease before making proposal. So it can be safely concluded that there was suppression of material facts by the insured at the time of entering into the contract of insurance. So the appellant is justified in repudiating the claim. The appeal is allowed.

       Result : Appeal allowed.

JUDGMENT

T.M. Hassan Pillai, President — The order passed by the Consumer Disputes Redressal Forum, Kasaragod in OP No. 135/98 has been under challenge in this appeal preferred by the opposite parties. The lower forum directed the opposite parties “to pay a sum of Rs. 2,00.000/- with interest at the rate of 18% per annum from 10-12-1997 till payment, along with another sum of Rs. 3,000/- towards compensation and Rs. 500/- as cost of proceedings”. Two months time from the date of receipt of the order has been given by the forum below to comply with the order.

2. The wife of the deceased Mathew Paul filed the complaint against the opposite parties alleging that the opposite parties repudiated the claim made by her as nominee under policy No. 791115064 dated 27-3-1995 without any justifiable reason and there was deficiency in service on the part of opposite parties.

3. Claim of the respondent was repudiated by the appellants on the ground that the insured had fraudulently failed to disclose the information in reply to question in the proposal form and there was deliberate suppression of material facts. It is contended that full disclosure of material facts which were relevant for the insurer to take into account while deciding whether proposal should be accepted or not was not made. Opposite parties also contended that the fact of consuming alcohol in large quantity daily by the insured at the time of making the proposal was not disclosed and he also failed to disclose the fact that he met with an accident in the year 1992 while he was driving his own vehicle (jeep) in a drunken state. It is contended that suppression was made knowingly and fraudulently.

4. The lower forum accepted the case of the complainant that there was no fraudulent failure to disclose the material facts or suppression of material facts as asserted by the appellants and passed the impugned order.

5. Challenging the order passed by the Forum below the learned counsel appearing for the appellants took us through the evidence both oral and documentary and contended before us that there is sufficient evidence to show that insured was daily consuming 400 ml. of brandy and he started to consume so much quantity daily three years prior to his death. He started to consume alcohol eleven years before his death. He met with an accident in the year 1992 while driving vehicle consuming alcohol. Counsel submitted that the above stated material facts were suppressed by insured at the time of making proposal. Counsel also submitted before us that evidence produced by the appellants proved clearly that secondary cause of death of the insured was alcoholic liver cirrhosis and there is nexus between that alcoholic liver cirrhosis and death of the insured. He submitted that a contract of insurance is contract uberrimaefide and there must complete good faith on the part of the insured. He submitted that it was the duty of insured to make full disclosures of material facts and as the insured failed to disclose the relevant and material facts to take into account while deciding whether proposal should be accepted or not by the insurer the lower forum is not justified in granting the reliefs granted by it.

6. The learned counsel appearing for the complainant supported the finding recorded by the forum below and submitted that no error has been committed by the forum below in arriving at its conclusion warranting interference by us.

7. In this appeal the question that is to be considered is whether there was fraudulent failure to disclose information in reply to questions in the proposal form and whether deliberate suppression of facts said to be material justify interference with the impugned order awarding amount to the respondent who is the nominee under the policy.

8. There is no dispute between the parties regarding the fact of taking of policy by the deceased. Mathew Paul, that policy was issued in the year 1995

and that the policy taken was for Rs. 2,00,000/-. It is also an undisput
























































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