The main legal point established in the judgment is that the suppression of material information regarding health condition can only lead to the repudiation of an insurance claim if the cause of death is directly or indirectly linked to the suppressed health information. If the cause of death is unrelated to health conditions, the suppressed information is inconsequential and the claim cannot be repudiated.

JUDGMENT

Vinod S. Bhardwaj. J. - The point which arises for consideration in the present petition is as to whether an Insurance Company would be entitled to repudiate an insurance claim on the grounds of suppression of material information regarding health condition when death in question is wholly unrelated to health conditions and is an outcome of motor vehicular accident.

2. The present writ petition has been filed under Articles 226/227 of the Constitution of India, 1950 raising a challenge to the Award passed by the Permanent Lok Adalat (Public Utility Services), Gurgaon, in case titled as 'Sarita Tripathi Vs. Aviva Life Insurance Company Limited' dated 17.03.2015, in application No.51 of 2014.

3. Briefly summarized, the facts involved in the present writ petition are that respondent No.1- applicant had preferred an application under Section 22 - C of the Legal Services Authority Act, 1987, claiming that her deceased husband Rajesh Kumar Mani had insured himself with the Petitioner - Life Insurance Company in the month of November 2011 for a sum of Rs.20 lacs vide Policy No.ALA3087829. At the stage of availing the said life insurance policy, the deceased husband of the respondent No.1- applicant was assured by the agents of the petitioner -Life Insurance Company about the expeditious disbursement of the claims on occurrence of an unforeseen eventuality. The proposal form was submitted on 15.11.2011 wherein the following declaration is claimed by the petitioner Life Insurance Company to have also been signed by the declarant/deceased husband of respondent No.1-applicant:-

'I/we also understand that in case of any misstatement or suppression of material information, subject to provision of Section 45 of the Insurance Act, 1938, the Company has right to repudiate any claim against the Policy."

4. The premium amount was Rs.10,114/- to be paid annually and the total premium paid before the husband of the respondent No.1/applicant unfortunately passed away, was Rs.20,228/- i.e. two premiums. Unfortunately, the said Rajesh Kumar Mani met with a motor vehicular accident on 12.05.2013 in which he sustained serious injuries and succumbed on the date of accident itself. The FIR No.698 of 2013 was also registered under Sections 279 and 304-A IPC at Police Station, Rampur Kar Khana, Sadar Devriya (U.P.). The post mortem examination of Rajesh Kumar Mani was also conducted on the same day. The respondent No.1-applicant thereafter filed a claim with the petitioner -Insurance Company, however, the said claim was declined vide communication dated 30.08.2013 (wrongly mentioned as 30.08.2011) for the reason that the material information had been concealed at the time of submission of the proposal form regarding his health. It was pointed out by the respondent No.1/applicant that the alleged concealment regarding health is immaterial since occurrence of the eventuality is neither directly nor remotely connected to the information. The prayer of the respondent No.1/applicant having not been accepted by the petitioner - Insurance Company, an application was filed invoking the jurisdiction under Section 22 - C of the Legal Services Authority Act. 1987.

5. Upon notice, a response was filed and it was pleaded that the respondent No.1/applicant was not entitled to the claim due to concealment of material information in the Health and Activity Section of the proposal form. The specific question giving rise to the present dispute is as under:-

'B. Have you ever had any medical or surgical treatment, including investigations, tests, scans or X-rays for any of the following illness or medical conditions:

(i) High Blood Pressure, angina, heart attack, stroke or any disorder of heart or circulation: 'NO'."

6. It was urged that the deceased had undergone a coronary angiography for accelerated hypertension on 23.07.2011 when he was admitted in Paras Hospital, Gurugram. While placing reliance on the discharge summary of the Paras Hospital, Gurugram, it was submitted