O RDE R

PER: - JUSTICE GAUTAM CHOURDIYA, PRESIDENT This appeal, filed under Section 41 of the Consumer Protection Act

2019 (hereinafter called “the Act” for short) is directed against order dated 09.01.2024 passed by District Consumer Disputes Redressal Commission, Raigarh (hereinafter called “District Commission” for short) in complaint case No.CC/2022/202 whereby the complaint filed by the respondent No.1 herein was partly allowed and the opposite party No.1 / appellant was directed to pay within 45 days the outstanding amount of housing loan after death of the insured Shyam Singh Sarthi to the opposite party No.2/ respondent No.2. The opposite party No.1/ appellant was also directed to pay the complainant/ respondent No.1 Rs.4,14,410 (Four Lakhs Fourteen Thousand Four Hundred and Ten) paid by her against the housing loan account after death of her husband deducting Rs.1,35,050/- (One Lakh Thirty Five Thousand Fifty) i.e. the amount deposited by the opposite party No.1/ appellant in the account of complainant/ respondent No.1. Compensation towards mental agony Rs.5,000/- (Five Thousand) and cost of litigation Rs.2,000/- (Two Thousand) were also directed to be paid within 45 days. The above entire amount was directed to be paid within 45 days failing which the above entire amount was directed to be paid with interest @ 6% p.a. from the date of order. Feeling aggrieved the insurance company opposite party No.1 has preferred this appeal.

2. In nutshell the facts of the case are that the deceased husband of the complainant/ respondent No.1 during his lifetime obtained a housing loan of Rs.37,00,000/- from the opposite party No.2/ respondent No.2 and for security of which obtained a Rin Raksha Insurance Policy from the opposite party No.1/ appellant. The complainant / respondent No.1 was made nominee in that policy. On 17.05.2021 the insured husband of the complainant/ respondent No.1 died due to cardiac arrest caused by Covid-19. As per terms and conditions of the insurance policy the opposite party No.1/ appellant was duty bound to pay the entire outstanding balance of the housing loan in the event of death of the borrower during loan period. Hence claim was preferred but the opposite party No.1/ appellant vide letter dated 18.11.2021 informed that the deceased insured Shyam Sarthi suppressed material fact of his chronic kidney disease at the time of making proposal and the amount of deposited premium Rs.1,35,119.38 was deposited in the account of the nominee complainant/ respondent No.1. As per averments made by the complainant/ respondent No.1 her husband never suffered kidney disease nor concealed any such facts and alleging the action of the opposite party No.1/ appellant as deficiency in service filed complaint seeking reliefs as mentioned in the complaint.

3. The opposite party No.1 / appellant except the admitted facts denied all the adverse allegations leveled in the complaint and resisted the complaint mainly on the ground that the deceased life assured suppressed material information about his health condition at the time of making proposal and breached the doctrine of utmost good faith and uberrima fides applicable in the contract of insurance. He was suffering from kidney disease and was on dialysis for the same for last four years, but he replied the specific question regarding kidney disease in the proposal in negative. Therefore, the insurance claim was repudiated in which no deficiency in service was committed by the insurance company. It was further averred that insurance contracts must be interpreted in the words of contract expressed by the parties and it is not for the courts to make a new contract, however reasonable. Thus, no deficiency in service in repudiating the claim was committed by the opposite party No.1/

appellant and the complaint be dismissed with cost.

4. The opposite party No.2 / respondent No.2 also except the admitted facts denied all the adverse allegations leveled in the complaint and resisted