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RAVISHANKAR, SUNITA CHANNABASAPPA BAGEWADI
Birla Sun Life Insurance Co. Ltd. – Appellant
Versus
Basavarajappa – Respondent
ORDER
Ravishankar, Judicial Member.—The Appellant/Opposite Party preferred this appeal being aggrieved by the order dated 23.02.2017 passed in CC.No.54/2016 on the file of District Consumer Disputes Redressal Commission, Kopal.
2. Heard from appellant, respondent not present. The crux of the case is that the son of the complainant one Mr. Lokesh had obtained Life Insurance Policy wide No.005939029 for an assured amount of Rs.3,83,438/- on 30.01.2013. After obtaining the policy his son died on 01.03.2013 due to heart attack. Being the legal representative, the complainant had claimed for assured amount as per the policy. After receipt of the claim, this appellant repudiated the claim for the reason of separation of pre-existing disease. Aggrieved by the repudiation complainant approached the District Commission alleging deficiency in service and sought for payment of assured amount by virtue of the policy.
3. The District Commission hearing from both sides had allowed the complaint and directed this appellant to pay an assured amount of Rs.3,83,438/- along with Rs.5,000/- as a compensation and Rs.1,500/- towards litigation charges.
4. The learned advocate for appellant submits that
Life Insurance Policy – Repudiation of claim by Insurance Company justified – Suppression of pre-existing disease of TB by Life Assured.
Petitioners failed to point any illegality or irregularity in the order passed by the State Commission, warranting interference in exercise of revisional jurisdiction of this Commission.
Death – The death of the life assured within one month of obtaining the policy raises suspicious on its own.
The court affirmed that an insurer's repudiation based on non-disclosure of facts requires solid evidence, and concurrent findings of both forums must be respected unless a jurisdictional error is sh....
Life Insurance Policy – Repudiation of death claim on the ground of suppression of material facts – Mere existence of past medical records is insufficient unless knowledge on part of insured is prove....
Repudiation of death claim on the ground of concealment of pre-existing ailment – Onus lies upon Insurance company to prove factum that at the time of taking insurance policy in question, deceased li....
Pre-existing disease – life assured has deliberately concealed the true facts about his state of health and suppressed his pre-existing disease.
Insurance – Repudiation of death claim on the ground of suppression of pre-existing ailment cannot be sustained when medical reports are categorically denied.
Mere filing of some hospital records was not sufficient to show that the policy holder was suffering from the ailment at the time of filing of proposal form.
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