IMPORTANT POINT
Contract of insurance is based on doctrine of utmost good faith.

Ajit Bharihoke, Presiding Member—Husband of the petitioner, namely, Vishnu Das Sharma, purchased a life insurance policy from the opposite party insurance company. The insurance was effective with effect from March, 2003. During the currency of the insurance policy husband of the petitioner/complainant died on 27.4.2004. The petitioner, being widow of the late insured submitted, a life insurance claim. The respondent insurance company, however, repudiated the claim of two counts, namely, the deceased Vishnu Das Sharma had obtained the insurance policy by concealment of material facts and he also concealed that prior to taking of the subject insurance policy the deceased already had two policies with life insurance corporation. Being aggrieved of the repudiation of the claim the petitioner raised a consumer dispute by filing a consumer complaint in District Consumer Disputes Redressal Forum, Nanded.

2. The respondent/opposite party, on being served with the notice of the complaint, justified the repudiation of the claim on the plea that in the insurance proposal form the late insured had concealed the information that while applying for the insurance policy the deceased was already having two other insurance policies and he also concealed the material facts regarding his previous medical condition and as such the repudiation of the insurance claim is justified.

3. The District Forum on consideration of pleading and the evidence produced by the parties allowed the complaint and directed the respondent opposite party as under: -

“The application of the applicant is allowed.

The respondent shall pay the amount of Rs.15,00,000/- (Rs.Fifteen lacs only) on the insurance policy no.0000 81371 alongwith an interest @ 6% p.a. from 12.7.2006 till the realization of the amount within 30 days from the date of receipt of the order.

The 1,000/- shall be given to the complainant as costs.”

4. Being aggrieved of the order of the District Forum the respondent insurance company preferred an appeal. The State Commission on consideration of record was of the view that the insured was suffering from chronic renal problem from the year 2001 and he had concealed this fact from the opposite party while obtaining the insurance policy and in view of the aforesaid the State Commission allowed the appeal, set aside the impugned order and dismissed the complaint. Being aggrieved of the order of the State Commission the petitioner has filed the revision petition.

5. Learned counsel for the petitioner has contended that the impugned order holding that the insured obtained the insurance policy by concealing material facts regarding his previous ailment is not sustainable because State Commission has failed to appreciate that by not answering the questions pertaining to his medical condition in the section of the proposal form containing the questionnaire in this regard, the insured has not done any concealment because the section itself provide that the questions may not be answered if the insured was required to be medically examined before the acceptance of the insurance proposal. It is argued that the record would show that before accepting the insurance policy medical examination of the insured was got done through Dr. Govind Bhattad of Radhe Govind Hospital, Shivaji Nagar, Nanded whose affidavit was placed on the record of the District Forum besides his letter dated 15.9.2004 addressed to the Chief Medical Officer of the insurance company. It is argued by learned counsel for the petitioner that if the answers in the medical section were not given then the underwriter should not have accepted the proposal and accepted the insurance premium. Once the insurance proposal has been underwritten now the insurance company cannot take shelter of the fact that the insured did not disclose about his previous renal problem in the proposal form.

6. We do not find merit in the above contention.

7. On perusal of proposal form submitted by the deceased insured for purc