IMPORTANT POINT
Onus of proving ground for repudiation of insurance claim lies heavily on insurance Company.

Ajit Bharihoke, Presiding Member—This revision is directed against the order of the State Consumer Disputes Redressal Commission Punjab, Chandigarh (in short, ‘the State Commission) dated 14.12.2012 in First Appeal No. 55/09 whereby the State Commission dismissed the appeal preferred by the petitioner insurance company against the order of the District Forum Sangrur.

2. Briefly put, the facts relevant for the disposal of this revision petition are that the respondent Harvinder Kaur filed a consumer complaint in District Forum Sangrur alleging that her husband Sukhwinder Singh had obtained a life insurance policy from the petitioner OP for a sum of Rs.1,00,000/- appointing the respondent as the nominee. The date of maturity of insurance policy was 24.08.20122. The insured suffered an attack of breathlessness on 17.11.2007 which persisted for 2/3 days. The insured, was, therefore admitted in Tagore Hospital, Jalandhar City on 20.11.2007. He was discharged on 07.12.2007. The insured, however, died on 08.12.2007. The intimation of the death of the insured was given to the petitioner. The petitioner, however, repudiated the claim on the ground that insured while obtaining the insurance policy concealed that he was already suffering from pulmonary hypertension. This led to the filing of the consumer complaint.

3. The petitioner OP in its response to the complaint admitted that Sukhwinder Singh had obtained life insurance policy for Rs.1.00 lacs and that he died on 08.12.2007. The petitioner, however, justified repudiation of the claim on the ground that insurance policy was obtained by concealing the material fact that the insured was suffering from primary pulmonary hypertension.

4. In the rejoinder respondent complainant took the stand that nothing was concealed at the time of obtaining of the insurance policy. The insured Sukhwinder Singh was neither suffering from any disease prior to the filling up of the proposal form nor he knew about it.

5. The District Forum on consideration of the pleadings and evidence on record allowed the insurance claim and directed the petitioner to pay to the complainant a sum of Rs.1.00 lac with benefits alongwith interest of 9% p.a. from the date of repudiation i.e. 14.07.2008 till realization and also to pay additional sum of Rs.3000/- as compensation.

6. Being aggrieved of the order of the District Forum, the petitioner preferred an appeal on the plea that the District Forum has committed a grave error in ignoring the fact that insured Sukhwinder Singh was suffering from pulmonary hypertension at the time of filling of proposal form and that he concealed the aforesaid fact. The above plea of the petitioner, however, did not find favour with the State Commission and State Commission dismissed the appeal vide the impugned order.

7. Learned Shri Rakesh Malhotra, Advocate, counsel for the petitioner insurance company has contended that the impugned order of the foras below are perverse as both the foras below have failed to appreciate that the insurance policy was obtained by the insured by concealing the material fact that he was suffering from pulmonary hypertension. In support of this contention, learned counsel for the petitioner has referred to the discharge card of the insured Sukhwinder Singh issued by Tagore Hospital on 21.06.2007 wherein against the history and findings it is recorded K/C/O Primary Pulmonary hypertension × 2 yrs on Rx and the diagnosis K/C/O Primary Pulmonary Hypertension Mod.PAH C. It is contended that though the State Commission has taken note of the fact that the insured Sukhwinder Singh was admitted and treated in Tagore Hospital from 20.11.2007 to 07.12.2012 yet it has ignored the earlier discharge certificate issued by Tagore Hospital which clearly prove that the insured has concealed information regarding his medical condition while filling the proposal form Thus, it is contended that the impugned order is liable to be set aside. In support of this contention, the pe