The main legal point established in the judgment is that the repudiation of an insurance claim must be based on sound grounds supported by credible evidence, and any allegations of concealment or non-disclosure must be substantiated.

JUDGMENT/ORDER :

Prem Narain, Presiding Member - This revision petition has been filed by the petitioners Smt. Sunita and Others. against the order dated 27.9.2012 of the State Consumer Disputes Redressal Commission, Haryana (in short 'the State Commission') passed in First Appeal No.95 of 2007.

2. Brief facts of the case are that life insurance policy was taken by the husband of the complainant No.1/petitioner No.1 for Rs. 3,00,000/- as insured amount. The policy commenced from 28.08.2003. The insured died on 05.03.2004. As this was an early claim, Insurance Company appointed an investigator. The investigator reported that Deceased Life Assured (DLA) was consuming alcohol in high doses regularly, therefore, his liver was damaged and he expired. The claim was repudiated on the basis of the report of the investigator vide repudiation letter dated 05.03.2004. The Insurance Company repudiated the claim mainly on two grounds. First that the DLA had taken medical leave on many occasions though in the proposal form he had given a clear "No" answer to the question whether the proposer was absent from his duty on account of medical reason during the five years. The second ground was that the investigator had found that the DLA was consuming alcohol heavily though in the concerned column of the proposal form he had given "No" answer. Thus, on the account of concealment of material information the claim was repudiated.

3. The complainants filed a consumer complaint bearing No.371 of 2005 before the District Consumer Disputes Redressal Forum, Sonepat (in short 'the District Forum") and the complaint was resisted by the Insurance Company on the same grounds as mentioned in the repudiation letter. The District Forum vide its order 27.11.2006 allowed the complaint as under:-

"The respondent is, thus, directed to make the payment of Rs. three lacs to the complainants in respect of policy no.173129891 pertaining to the deceased I.A.Mukesh Kumar alongwith all benefits etc. and the said amount is directed to be paid to the complainants along with interest @9% per annum from the date of death of the deceased Mukesh Kumar till its realization. Since the complainants have been able to prove the deficiency in service on the part of the respondent, the respondent are further directed to compensate the complainants to the tune of Rs. five thousands only for rendering deficient services for causing mental agony and harassment and further to pay compensation to the tune of Rs. five thousands only under the head of litigation expenses.

With these observations, findings and directions, the present complaint stands accepted. The respondent is directed to make the compliance of this order within 30 days from the date of this order."

4. Aggrieved with the order of the District Forum, the opposite party/respondent herein preferred an appeal bearing No.95 of 2007 before the State Commission, which was allowed vide its order dated 27.09.2012 and the complaint was dismissed.

5. Hence the present revision petition.

6. Heard the learned counsel for both the parties and perused the record. Learned counsel for the petitioners/complainants stated that DLA was employed with Delhi Police and the proposal form was filed by the agent of the LIC. Each and every column of the proposal form was not explained to the DLA by the agent. Hence, if there is any mistake in the proposal form, DLA cannot be held responsible nor his claim can be dismissed on this ground. The learned counsel further stated that the Insurance Company has filed details of the leave taken by the DLA, wherein there are initials of somebody and the date on the signature is 21.12.2004. The State Commission has relied upon this document whereas this document does not bear any seal of any authority of Delhi Police and whose signatures are on this document is not clear. It is also not clear as to who has issued this documents and whether this is a true copy of the original record maintained by the Delhi Police. Thus,