ORDER

THIRU.S.KARUPPIAH, PRESIDING JUDICIAL MEMBER (Open Court).

The Facts:

The complainant submitted that her husband one Mr.S.Veeraiah on

23.03.2004 took a Life Insurance Policy with the opposite party. The policy amount is Rs.50,000/- and the complainant’s husband died on 08.11.2004 at Meenakshi Mission Hospital due to Brain Stroke. When a claim was made the opposite party repudiated the claim on 18.03.2005 as if the complainant’s husband failed to disclose his pre-existing disease of Diabetic Mellitus. The above repudiation is not valid hence she filed the consumer complaint for alleging deficiency in service claiming the insured amount of Rs.50,000/- along with compensation for mental agony of Rs.50,000/- and also cost of the proceedings.

2. The opposite party filed their written version stating that the complainant’s husband failed to disclose his pre-existing disease, and they validly repudiated.

Hence they prayed to dismiss the complaint.

3. The District Commission after perusal of both sides pleadings, documents, marked as Exhibits-A1 to A9, and Exhibits-B1 to B6, finally, dismissed the complaint. 4. Aggrieved with the above dismissal order, the appeal has been preferred by the complainant on the following:

Grounds: disclose the pre-existing disease. The District Commission failed to note her husband was died not because of diabetics when the diabetic is not the cause of death. The repudiation of claim is invalid and hence she prayed to allow the appeal.

5. In this case both sides filed their written arguments and perused by this

Commission.

6. The learned counsel appeared in the opposite party/insurance company would submit that the agreement of insurance is also like any other contract and both parties should be bonafide to each other. But the complainant’s husband in the proposal form for a question about the pre-existing disease answered as ‘No’. Hence

'abinitio void

7. On the other hand, the learned counsel for the complainant would argued that the diabetic is not a root cause of death and the repudiation of claim is not valid.

8. Now the point for consideration is:

Whether the opposite party's/insurance company's repudiation of the claim is valid or not?

Discussion on the Point: husband took a Life Insurance Policy on 23.03.2004. During the subsistence of Insurance Coverage her husband died on 08.11.2004. The opposite party submitted Exhibit-B1 Proposal Form in which for a question related to pre-existing disease the complainant’s husband answered as ‘No’ which is reproduced here under:

14. (g) Any diseases and disorders of the metabolic and endocrine system such as but not limited to

No diabetes, hypothyroidism, hyperthyroidism, goiter or other endocrine diseases?

10. After the claim was made, the surveyor submitted his report along with Medical Attendant’s Certificate which were marked as Exhibit-B4 & B5. They are issued by Meenakshi Mission Hospital. In Ex.B4 the Primary Cause of Death is

“Brain Stem Stroke, Tuberculous meningitis”.

The Secondary Cause of Death as shown “Acute Renal Failure, Diabetes

Mellitus Type-2”.

The surveyor in his report clearly stated that he enquired one

Dr.Sundaravadivel, who treated the deceased as Family Doctor and from the doctor he came to know that the insured was suffering from Diabetes since past eight years and he was under regular treatment.

11. The surveyor further enquired one Mr.Subbaiah who is a Colleague of the life assured, and he informed him that the deceased was good in health prior to his death and used to take leave only twice in a month. The insured was an Ex- Serviceman in Indian Air Force and later joined Indian Oil Corporation Limited on 1st October 1988 as an OP Officer”. So from the surveyor report itself it is proved that the deceased lived a normal healthy life still he suffered with the fever and admitted in the Meenakshi Mission Hospital.

12. At this juncture, it is to be decided whether even the non disclosure of pre- Shri pradeep kumar garg .Vs. National insurance compa