IMPORTANT POINT
Insured has died due to snake bite which is also considered as an accident.

ORDER

This revision petition has been filed by the petitioner Reliance Nippon Life Insurance Co Ltd. against the order dated 29.06.2018 of the State Consumer Disputes Redressal Commission, Maharashtra (in short ‘the State Commission’) passed in FA No.937 of 2017.

2. Brief facts of the case are that the husband of the complainant had taken a Golden years Plan Plus type of policy from the respondent by paying Rs.15,000/- as premium on 08.09.2008. Sum assured under the policy was Rs.2,50,000/-. In case of accident, the complainant is eligible to receive Rs.2,50,000/- as sum assured and another Rs.2,50,000/- towards double benefit of accidental death, totalling Rs.5 lacs. On 08.08.2009, complainant’s husband died due to snake bite. Opposite party was informed about the incident. On 23.10.2009, opposite party repudiated the claim of the complainant wherein the following has been mentioned:-

“On investigation and from medical documents, we understand that late Mr. Patil Gajanan Kashinath, was hospitalised during August 2008 and was diagnosed for Pulmonary Koch. Late Mr. Patil Gajanan Kashinath was advised to continue anit-TB treatment.

Late Patil gajanan Kashinath, submitted proposal for insurance on 08/09/2008 the relevant questions in the proposal form and answers provided by him are reproduced below:

Question 29: ‘Are you currently taking any medication or drugs, other than minor conditions, (eg cold and flue), either prescribed by a doctor, or have you suffered from any illness, disorder, disability or injury during the past 5 years which has required any form of medical or specialized examination (including chest x rays, gynaecological investigations, pap smear or blood tests), consultants, hospitalization or surgery?’

Answer: No

Question 30: ‘Do you suffer from any medical ailments, eg diabetes, high blood pressure, cancer, respiratory disease, kidney or liver disease, stroke, any blood disorder, heart problems, Hepatitis B or C, Tuberculosis, psychiatric disorder, depression, HIV/AIDS or a related infection?’

Answer: No

The non disclosure of Hospitalisation & Pulmoany Disease was material to the issuance of the policy and ought to have been disclosed in the proposal form. By not doing so, the Proponent had misled us to grant his insurance cover on the terms as stated in the policy schedule.

In the light of the above facts and the irrefutable evidence we hold that we were provided with false and inaccurate answers, we are constrained to repudiate the claim under the policy in terms of Section 45 of the Insurance Act, 1938. According to our policy conditions, all claim benefit shall cease and all monies that have been paid will be forfeited to us. But as a good will gesture, we are pleased to inform you that the fund balance of Rs.13456.59 is being paid. Our branch officials will personally hand over the cheque to you.”

3. Aggrieved, the complainant filed a consumer complaint bearing No.91/2010 before the District Consumer Disputes Redressal Forum, Jalgaon (in short ‘the District Forum’). The complaint was resisted by the opposite party on the same ground on which the repudiation was made. However, the District Forum vide its order dated 08.06.2015 allowed the complaint and directed the opposite party Insurance Company to pay Rs.5,00,000/- to the complainant along with 9% interest from the date of repudiation till actual payment along with Rs.5,000/- as compensation for mental agony and Rs.2000/- for cost of litigation.

4. Aggrieved by the order of the District Forum, the Insurance Company preferred an appeal before the State Commission. The State Commission vide its order dated 29.06.2018 dismissed the appeal on the ground of limitation.

5. Hence, the present revision petition by the petitioner Insurance Company.

6. Heard the learned counsel for the petitioner at the admission stage.

7. Learned counsel for the petitioner stated that the State Commission has dismissed the appeal on the ground of limitation. The learned coun