ORDER

This Revision Petition No.19 of 2023 challenges the order of the Rajasthan State Consumer Disputes Redressal Commission, Circuit Bench at Udaipur (‘the State Commission’) dated 29.09.2022. Vide this order, the State Commission dismissed Appeal No.140/2017 and affirmed the order of the District Consumer Disputes Redressal Forum, Chittorgarh (‘the District Forum’) dated 20.06.2017.

2. For convenience, the parties are referred to as placed in the original Complaint filed before the District Forum.

3. Brief facts of the case, as per the Petitioners/Complainants, are that the petitioners, residents of Begun, purchased two insurance policies, “Jeevan Aarogya-903”, for their son Tushar Jangid from the OPs. The first policy No.10583072 was issued on 06.08.2011 and the second policy No.108116681 was issued on 28.11.2011. They fully disclosed their son’s health condition to OP agents, including a Medical Imaging Report (MIR) dated 01.05.2007, which indicated that their son had a condition related to his left testis. The agents informed them that the policy would cover any medical expenses related to this condition, including an operation called “unilateral-orchiectomy,” listed in the policy benefits at S.No. 113. In 2014, the petitioners had their son’s testis operation performed at Pacific Medical College & Hospitals, Udaipur. Thereafter, they filed a claim for Rs.2,00,000 under both insurance policies on 24.01.2015. Despite submitting necessary documents multiple times, the respondent/OP failed to either approve the claim or formally communicate a rejection. After several unsuccessful attempts to receive a response from the respondent, including registered letters sent in August and September 2015, the petitioners filed a complaint before the District Forum.

4. The OPs, in their Written Version filed before the District Forum contended that the petitioners concealed important information at the time of filling out the proposal form, particularly regarding their son’s congenital disorder. The respondents pointed out that the petitioners had incorrectly answered “NO” to Question No.10(7)(xii) concerning congenital disorders. Based on this alleged misrepresentation, the respondents contended that the claim should be rejected, as the terms of the insurance contract bind both parties.

5. The District Forum, vide Order dated 20.06.2017, dismissed the complaint with the following reasons:

“05. We have heard the arguments of the learned counsel for the parties and have very seriously thought over & considered their arguments, and have also respectfully studied & thoroughly perceived to the pleadings, affidavits, documents etc., available on the record of the file as also the rulings so cited hereinabove. From perusal of the complaint-case of the applicants/complainants such a conclusion is arrived at that the proposal form for insurance was filled in for obtaining the insurance policy for their son Tushar Jangid and at that time he was already seized with the illness for which treatment was carried out. In the paragraph No.6 of the complaint, the applicants have mentioned that at the time of filling of the proposal form, MRI report dated 1st of May, 2007 of their son Tushar was shown to them, but both the proposal forms through which both of the abovementioned insurance policies have been obtained by the complainants, therein it has been got indicated that Tushar Jangid, son of the complainants/ applicants is ‘not’ seized of any kind of ailment. The applicants had handed over the M. I. R. report dated 1st of May, 2007 of their son Tushar Jangid to the agent of the non-applicants and it was in his knowledge that Tushar Jangid is seized of such-a-such illness, thence its entry ought to have been made by them at the time of filling in the proposal for the insurance, but the applicants had filled in such a proposal form only for taking the insurance policy and therein had not shown the fact about any kind of congenial disorder or illness o