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GAUTAM CHOURDIYA, PRAMOD KUMAR VARMA
Sanskriti Shukla – Appellant
Versus
General Manager, Reliance Life Insurance Co. Ltd. – Respondent
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 q
Insurance—Repudiation of death claim on the ground of concealment of disease must be supported with reliable and cogent evidence.
(1) Full Knowledge – DLA had the full knowledge of pre-existing ailments at the time of filling the proposal form and there was a nexus with preexisting disease and the cause(s) of death.(2) Proposal....
(1) Policy was obtained by concealment of material fact; hence, insurance contract became void ab initio in terms of the declaration signed by the insured, not a valid contract.(2) Finding of materia....
(1) Proposal form – In filling up the proposal form, the agent normally, ceases to act as agent of the insurer but becomes the agent of the insured and no agent can be assumed to have authority from ....
Date of – The approximate period reported by the life assured or any other source is not mentioned to determine as to for how long the life assured was alcoholic and this ambiguous situation is not s....
Pre-existing disease – life assured has deliberately concealed the true facts about his state of health and suppressed his pre-existing disease.
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....
(1) The “Three-Year Rule” (Section 45) – Under the amended Section 45, a policy cannot be questioned after three years from issuance or risk commencement on any ground.(2) Agent’s Responsibility – Th....
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