The duty of full disclosure in insurance necessitates transparency regarding prior policies, which may impact risk assessment.

1. The fact of the Complaint Case in brief is that on 31.07.2015 and 24.8.2015, the Opposite party issued 3 (three) life insurance policies, in favour the Complainant's father, Sujit Kumar Chatterjee, who was the policy Holder and the Life Insured under the Policies being policy numbers 52287399, 52287392 and 52339067 and sum assured 10,50,000, 3,50,000 and 10,50,000 respectively. That the Complainant was the Nominee under the Policies. That the term of the Policies was 10 (ten) years, i.e., till 31.7.2025 and 24.8.2025. That on 26.7.2015/27.7.2015, i.e., prior to issuance of all the Policies, the Opposite Party subjected the Life Insured to multiple medical examinations / tests at the Opposite Party's own empanelled diagnostic centers and as per the Opposite Party's requirements. The Opposite Party subjected the Life Insured to medical examinations / tests. That on 28.3.2016, i.e., during the term of the policies, the Life Insured passed away. That on 9.6.2016, the Complainant filed a Death Claim under the Policies with the Opposite Party. That in its letters dated 19.8.2016 and 20.8.2016 the two - fold baseless allegations leveled by the Opposite Party were:
(i) Insurance Cover: the Opposite Party claimed that the Life Insured had allegedly not disclosed his insurance cover with other companies to the Opposite Party; and
(ii) Health Issues: The Opposite Party claimed that the Life Assured was allegedly suffering from ailment since 2009.

2. That on 18.9.2016 and 12.10.2016, the Complainant submitted detailed representations, containing cogent reasons and supporting materials, to the Opposite Party's Grievance Redressal Officer. The Complainant rebutted each and every false pretext and contradictory ground put forth by the Opposite Party. That in its letter dated 20.12.2016 the Opposite Party contradicted its own stand as articulated in its earlier letters dated 19.8.2016 and 20.8.2016. That the Complainant has furnished cogent reasons and supporting materials to rebut each and every false pretext put forth by the Opposite Party. That the Opposite Party has leveled false and contradictory allegations against the Life Insured, merely to harass the Complainant and deprive the Complainant of the cumulative Sum Assured under the Policies.

3. Finally Complainant prayed for directions to the Opposite Party to pay the cumulative Sum Assured - INR 24,50,000 along with interest till date of actual payment, and INR 20,000 towards litigation expenses.

4. On 12.7.2017, learned Advocate for the OP undertakes to file vakalatnama by entering appearance. But O.P did not file WV within stipulated time frame. Accordingly, the matter was fixed for ex parte hearing. Over the issue O.P. approached before Hon'ble NCDRC on 22.7.2020, through F.A. No. 1068 of 2018. But the Hon'ble NCDRC dismissed the same.

5. The core issue to be decided in this Complaint is that whether there is any actual suppression of material fact or not at the time of taking the policy by the Complainant.

6. So far suppression of material fact on health ground, O.P had failed to discharge burden of proving that Complainant was suffering from any serious illness Life Insurance Corporation of India v. G.M. Channabasemma , 1990 (SLT SOFT) 208:Civil Appeal No. 1827 of 1974.

7. But regarding the material concealment of insurance coverage of Rs.1.15 crores of the Complainant with other insurance companies prior to O.Ps. proposal, the Complainant remains silent. Apart from that, at the time of taking these three policies, Complainant's age was 62 years so, the conduct of the Complainant breached the principle of "utmost good faith".

8. In view of said