IMPORTANT POINT
Insured had an obligation to disclose all the policies obtained by him irrespective of the sum insured or the time at which the said policies was taken.

ORDER

IA No. 20470 of 2018

This is an application filed by the respondent for condonation of delay.

For the reasons stated in the application the delay is condoned.

FA No. 1963 of 2018

Late Ramkaran Sharma father of the complainant/ appellant had obtained an insurance policy from the respondent on 09.06.2014. He having died on 19.08.2015, a claim was lodged by the complainant for payment of the benefits available under the policy taken by his father. The claim was repudiated vide letter dated 03.03.2016 which, to the extent it is relevant, reads as under:

In section IV – Details of Existing/ Simultaneously Applied insurance Cover on the life to be assured of the proposal form the life assured has answered to various questions which are reproduced below:

52. Have you concurrently/simultaneously applied for any life, health insurance cover with us or any other life, health insurance company which is still under consideration? – Answer is NO.

54. Please provide details of existing insurance cover on your life in the below table. If you do not have any existing insurance on your life, please mention ‘NIL” in sum assured column below. Please include any keyman/ keyperson, partnership cover as well? Answer is Yes 4 Lakh with Aviva Life Insurance.

69. Are your currently taking any medication or drugs either prescribed or not prescribed by doctor? Answer is NO.

71. Have your been absent from work for more than 10 days in the last two year due to health reasons? Answer is NO.

We hold indisputable proof to show that Life Assured had not disclosed the correct information about the previous insurance covers with other insurance companies. Had the life assured disclose correct details of previous insurance coverage, and long medical leave record the same would have influenced our decision in issuance of the policy. In this case, since the life assured had died on 19.08.2015 and the policy commencement date is 09.06.2014 the claim is being repudiated within a period of 3 years from the policy commencement date, the section 45 of the Insurance Act is not attracted.

Important – We would like to inform you that the name of our company has changed from ‘ING Vysya Life Insurance Company Limited’ to ‘Exide Life Insurance Company Limited’. This change of name has no impact on the operations of the company. The company will continue to honour its commitments and obligations under the insurance policy (s) issued in the name of ING Vysya Life Insurance Company Limited”.

Being aggrieved from the repudiation of the claim the complainant approached the concerned State Commission by way of Consumer Complaint.

2. No reply to the Consumer Complaint was filed by the respondent.

3. The State Commission vide its order dated 27.09.2018 dismissed the Consumer Complaint on the grounds that while submitting the proposal the deceased insured had disclosed only one policy taken by him from Aviva Life Insurance, whereas he had concealed three insurance policies which he had taken from the LIC of India and were in force at that time. Being aggrieved from the order passed by the State Commission the appellant is before this Commission by way of this appeal.

4. A perusal of the proposal form would show that while responding to the clause 4 in Section IV, the complainant was required to disclose all the insurance covers taken by him on his life. While replying to clause 52, he was required to disclose the applications submitted by him for grant of insurance covers on his life or his own health. The insured while responding in negative to clause 52 disclosed only one insurance policy while responding to clause 54 of the proposal. He thus concealed three insurance policies which had admittedly taken from the LIC of India and which were in force at the time the proposal was submitted.

5. The declaration given by the insured while applying for the insurance policy to the extent it is relevant reads as under:

1. I/we declare that the answers and statements made by m