A person approaching a court for redressal of grievances must come with clean hands and disclose all facts, whether favorable or unfavorable. The insurer is entitled to repudiate a claim based on fraudulent means for the approval of the claim.

ORDER

V.K. Jain, Presiding Member. (Oral) - The complainant/petitioner purchased one Renault Car bearing no. PB-03-AB(T)-1151 on 13.03.2013 and got the said vehicle insured with the respondent, Reliance General Insurance Co. Ltd. for the period from 13.03.2013 to 13.03.2014. On 22.03.2013, the aforesaid vehicle met with an accident and got damaged. The vehicle was being driven by the petitioner/complainant, Ravinder Singh Mangat himself at the time it met with an accident. The petitioner/complainant was taken to hospital for his medical examination and a report in the hospital was prepared by one Dr. Jane Mathew of CMC Ludhiana. The claim lodged by the complainant for reimbursement for the damage to the vehicle came to be rejected by the insurer, vide its letter dated 21.05.2013, which, to the extent it is relevant, reads as under:-

"Mr. Ravinder Singh Mangat was driving the car at time of loss and he was under the influence of liquor as per investigation report and also there was tempering of medical report as per investigator and statement of E.M.O. Dr. Jane Mathew of C.M.C.

In view of above this claim the company shall not be liable to make any payment in respect of:-

Any accidental loss or damage suffered whilst the insured or any person driving the vehicle with the knowledge and consent of the insured is under influence of intoxicating liquor or drugs."

Being aggrieved from the rejection of the claim, the complainant/petitioner approached the concerned District Forum by way of a complaint. The said complaint having been dismissed vide order dated 24.07.2014, he approached the concerned State Commission by way of an appeal. The appeal filed by the petitioner/complainant also having been dismissed vide impugned order dated 05.11.2015, he is before us by way of this revision petition.

2. It is not in dispute that the petitioner/complainant himself was driving the vehicle in question when it met with an accident. It is also no in dispute that the petitioner/complainant received injuries in the aforesaid accident and was taken to CMC, Ludhiana, from where he was taken to DMC, Ludhiana for his treatment. The Investigator procured the documents and carried out the necessary verification with CMC, Ludhiana. It was found that the medical record prepared by CMC, Ludhiana had been tampered by prefixing the word 'no' against the word 'smell of alcohol present'. The matter was taken up by the Investigator with the Superintendent of CMC, who called the concerned official of the hospital as well as Dr. Jane Mathew in his room, for the purpose of verifying the above referred addition to the report. Dr. Jane Mathew, after verifying the record of the patient confirmed that she had not written the word 'no' before the word 'smell of alcohol present'. She also gave a statement in writing confirming that the word 'no' had not been inserted by her.

3. We have perused the record which was submitted to the insurer. In the report submitted to the insurer and purporting to be written by Dr. Jane Mathew, the words written are "no smell of alcohol present". We have also perused the letter of Dr. Jane Mathew dated 26.04.2013, addressed to the Investigator, Mr. A. P. Singh. In the aforesaid letter, she has clearly stated that the word 'no' before the words 'smell of alcohol present' was not hers. It is thus quite obvious that the word 'no' had been inserted in the medical record submitted to the insurer before the words 'smell of alcohol present'. Since, it is the petitioner/complainant alone, who could benefit from the aforesaid insertion, we have no doubt in our mind that the word 'no' was inserted by or in connivance by the petitioner/complainant, in the medical record submitted to the insurer. The obvious purpose was to represent to the insurer that no smell of alcohol was found when the petitioner/complainant was examined in CMC, Ludhiana. By submitting tampered medical record to the insurer, the petitioner/complainant used fraudulent means for the p