ORDER

Gautam Chourdiya, President.—This appeal is directed against order dated 17.10.2023 passed by District Consumer Disputes Redressal Commission, Raipur (hereinafter called “District Commission” for short) in Complaint Case No.CC/2013/412 whereby the complaint was dismissed. Aggrieved the complainants have preferred this appeal.

2. In nutshell the facts of the case are that deceased father of complainant Nos.1 & 2/ appellant Nos.1 & 2 who was husband of the complainant No.3/ appellant No.3 on 27.12.2011 obtained two Reliance Child Plan life insurance policy Nos.19625556 & 19624672 for sum assured of Rs.1,50,000/- & Rs.2,00,000/- for insurance term till 27th December of 2026 & 2031 respectively, in which himself was the life assured. On 04.07.2012 the life assured died during treatment in Dr. Bheemrao Ambedkar Hospital, Raipur. In the death certificate cause of death was mentioned as head injury suffered earlier in a road accident. It was further averred in the complaint that father of the complainant Nos.1 & 2/ appellant Nos.1 & 2 met with an accident on 26.03.2010 but after taking treatment for 13 days he became alright and thereafter on 27.12.2011 he obtained the policies in question and after few months he fell ill, he was admitted in the Hospital and during treatment he died on 04.07.2012. Intimation was given to the insurance agent and claim was submitted before the insurance company. Investigating officers were sent by the insurance company but insurance claim was not paid. Thereafter, advocate notice through registered post was sent but the claim has not been paid yet. Hence consumer complaint was filed before District Commission.

3. The opposite party Nos.1 & 2/ respondent Nos.1 & 2 in their joint written version except the admitted facts denied all the adverse allegations leveled in the complaint and averred that on investigation it revealed that the policyholder met with an accident in the year 2010 and suffered head injuries for which he took treatment till June 2012 but the life assured concealing the above facts submitted proposal forms dated 26.12.2011 for obtaining the policies in question. On the basis of said investigation vide letter dated 10.04.2013 the complainants/ appellants were intimated that as the policyholder obtained the policies concealing the material facts regarding his ailments and treatments, his nominee is not entitled to get benefits under the policies. It was further averred that the repudiation was done as per provisions of Insurance Act 1938 in which no deficiency in service was committed, hence the complaint be dismissed with cost.

4. The opposite party No.3/ respondent No.3 in her written version denied the allegations leveled against her and averred that she is an unnecessary party in this case as being an agent she only collected premium from the deceased life assured and deposited the same with the insurance company. In case the complainants are held entitled to get any benefit under the policies in question, then the liability for the same would be upon the opposite party Nos.1 & 2/ respondent Nos.1 & 2 insurance company.

5. Learned District Commission in the impugned order observed that deceased life assured obtained the policies in question concealing the fact of his earlier accident and treatment taken by him, hence the opposite party Nos.1 & 2/ respondent Nos.1 & 2 did not committed any deficiency in service in repudiating the claim and accordingly dismissed the complaint.

6. Final arguments heard. Record perused. As well as the written arguments submitted by both parties.

7. The dispute involved in this appeal revolves around a very narrow issue as to whether the policies in question were obtained concealing the facts regarding head injury suffered by the life assured in an accident prior to the date of proposal and about the treatment taken for the same in the proposal form and whether the insurance company was justified in repudiating the claim on the above ground.

8. Learn