IMPORTANT POINT
Entries in the proposal form should be explained by the agent to the proposer, particularly when he or she is illiterate.

S.C. Vyas, President— This appeal has been preferred by Life Insurance Corporation of India Ltd. (hereinafter called “Insurance Corporation” for short), feeling aggrieved by the order dated 04.11.2008 of District Consumer Disputes Redressal Forum, Durg (hereinafter called “District Forum” for short), in Complaint No.194/2008, whereby the Insurance Corporation has been directed to pay sum assured Rs.90,000/, along with cost of litigation Rs.2,000/- within a period of two months otherwise the amount would be payable along with interest @ 7% per annum.

2. It is not in dispute that Sukhdeo, who was husband of respondent/complainant, was working in Bhilai Steel Plant and had purchased three insurance policies from the appellant herein, each valuing Rs.30,000/-. The said person died on 29.08.2005 in

Sector-9 Hospital of Bhilai Steel Plant, then his wife respondent herein, preferred claim for the insurance amount before the appellant but the claim has been repudiated by the Insurance Corporation, on the ground that at the time of making proposal, the deceased had wilfully suppressed material facts regarding his previous illness and therefore, the complainant/respondent is not entitled for any benefit of the insurance policy. Receiving this reply of the Insurance Corporation, complaint was filed before the District Forum.

3. In reply, the Insurance Corporation reiterated the same ground of repudiation and averred that deceased was suffering from Hypertension and Diabetes, prior to making proposal for insurance and had wilfully suppressed these diseases in the proposal form.

4. Learned District Forum, after having considered the material placed before it, came to the conclusion that deceased had not suppressed any material fact regarding his illness wilfully from the Insurance Corporation and on this finding the complaint was allowed.

5. We have heard arguments of both parties and perused record of the District Forum.

6. From the record of the District Forum, it is clear that as per Death Certificate available at Page No.31 in the record, Sukhdeo, the insured died on 29.08.2005 and cause of death was Carcinoma Stomach and Septicaemia. This shows that the deceased was patient of Cancer and died because of that disease. Carcinoma Stomach was diagnosed on 26.07.2005, as per medical certificate available at Page No.33. So this disease was not previously known nor deceased was suffering from this disease prior to date of making proposal for insurance. Learned counsel for the appellant had failed to show any connection of Carcinoma Stomach with Diabetes or Hypertension. This indicates that cause of death was totally different from the disease from which deceased was alleged to have been suffered.

7. Learned counsel for the appellant submitted that as per treatment papers of the deceased available in the Medical Department of Sector-9 Hospital of Bhilai Steel Plant on 20.09.2000, he was prescribed medicine for Diabetes and the record of Blood Sugar which has been mentioned thereafter shows that Blood Sugar was on higher side. He was also advised to get examined his blood sugar. On the basis of this record and mention of the fact in the treatment paper of the deceased on 8.8.2005, to the effect that he was having such symptom, learned counsel submitted that this fact was known to the deceased that he was patient of Diabetes as well as Hypertension.

8. Page No.93 contains the history written by Doctor on 08.08.2005. It reads as under:-

H/O Dm on Px

9. Learned counsel for the appellant submitted that these words are having the meaning that the deceased was suffering from Diabetes. We fail to understand as to how and on what basis this meaning has been assigned to these words. There appears no affidavit of any Medical person or no such Certificate of any Doctor to show that these words were indicating that the deceased was suffering from Diabetes and that too to his knowledge. Below these words, again there is mention that NO H/O HTN, to whic