The main legal point established in the judgment is the principle of mutual trust in insurance contracts, the insured's obligation to disclose all material facts, and the insurer's right to repudiate a claim based on the insured's suppression of material information.

ORDER :

Prem Narain, Member—The present revision petition has been filed under Section 21(b) of the Consumer Protection Act, 1986 (hereinafter referred to as “the Act”), whereby the petitioner herein seeks to assail the order dated 18.2.2009 passed by the Kerala State Consumer Disputes Redressal Commission, Thiruvananthapuram (hereinafter referred to as “the State Commission”) in F.A. No. 627/2003. By the impugned order, the order dated 26.6.2003 passed by the Consumer Disputes Redressal Forum, Kottayam in C.C. No. 801/2000 has been set aside.

2. The brief facts of the case are that late Mr. Pushpangadan (hereinafter referred to as “the insured”), husband of the complainant, had taken four life insurance policies from the opposite party on four different occasions. On 26.5.1998, the insured passed away at the Kottayam Medical College, Kottayam, Kerala after undergoing treatment for six days prior to his demise at the same hospital. The claim due under the policy No. 790088986 was paid to Sri. A.K. Raveendran, brother of the insured. The complainant submitted the claim forms in respect of the remaining three policies. However, the opposite party did not respond to the claims lodged by the complainant for quite some time. Aggrieved by the inaction as far as processing the claims under the remaining three policies was concerned, the complainant was compelled to approach the District Forum. During the pendency of the said complaint before the District Forum, the opposite parties repudiated the claim with respect to the remaining three policies on the basis of some inquiry. Upon inquiry, The Insurance Company discovered that the life insured had suppressed material information regarding his health at the time of submitting his proposal for the remaining three policies.

3. As regards the complaint filed by the complainant, the District Forum vide order dated 26.6.2003 dismissed the complaint.

4. Aggrieved by the aforesaid order of the District Forum, the complainant appealed before the State Commission. The State Commission vide order dated 18.2.2009 concluded as follows:

“In the result, appeal is allowed, the impugned order dated 26.6.2003 passed in O.P. 801/2000 is set aside. Respondent/opposite party is directed to honour the insurance claim put forward by the complainant with respect to the 3 policies referred to in the complaint. The opposite party is also directed to pay compensation of Rs. 10,000 to the complainant with cost of Rs. 1,000.”

5. Hence the Revision Petition.

6. Heard the parties and perused records.

7. The learned Counsel for the petitioner submitted that the remaining three policies bearing Nos. 781330334, 78132219 and 78046851 have resulted into an early death claim and the Insurance Company, therefore, conducted an inquiry. Upon inquiry, they found that the life assured had suppressed the material information regarding his health at the time of submitting the proposal for these three policies. The learned Counsel for the petitioner stated that as per medical records, particularly the medical attendant’s certificate dated 30.6.1999, it can be clearly understood that the insured was a diabetic patient for the past 15 years as is clear from the entry against the column 5 relating to cause of death, where it is clearly written ‘before death-diabetes-mellitus-15 years’. To substantiate this claim the learned Counsel also referred to the discharge summary of the medical college, which clearly states that the patient was a known diabetic for 15 years with irregular treatment. Apart from this , the learned Counsel also drew our attention to the treatment history supplied by the Holy Ghost Mission Hospital on the request of LIC vide their letter dated 16th March, 2001, wherein it is stated that he was a known diabetic on regular treatment. The learned Counsel further drew our attention to the cause of death mentioned at