O R D E R

( 11.06.2026 )

The following order of the Bench was delivered by Dr. Monika Malik, Member.

This appeal by the complainant/appellant (hereinafter referred to as ‘complainant’), is directed against the order dated 24.9.2024, passed by the District Consumer Disputes Redressal Commission No.2, Bhopal (for short ‘District Commission’), in complaint case No. CC/547/2022, whereby the District Commission has dismissed the complaint filed by her.

2. Briefly put facts of the case are that the complainant’s late husband-Vaibhav Keskar (hereinafter referred to ‘deceased/insured’), had obtained home loan of Rs.50 lakhs from Axis Bank and the said loan was insured by the opposite party/respondent-Max Life Insurance Company Ltd. (hereinafter referred to as ‘Insurance Company’). The deceased/insured passed away on 7.11.2021due to brain stroke and immediately the Insurance Company was informed regarding the same. However, the claim preferred by the complainant was repudiated by the Insurance Company on 31.3.2022 on the ground of suppression of material facts, as the deceased/insured was suffering from heart disease with hypertension, which was not disclosed in the proposal form filled by him. Therefore, alleging deficiency in service against the Insurance Company, the complainant approached the District Commission, seeking relief.

3. The opposite party/Insurance Company resisted the complaint and in its reply before the District Commisson submitted that the contract of insurance is based on the principle of ‘utmost good faith’ and the decease/insured had suppressed the material facts regarding his health and thus violated the said principle. The claim was repudiated on the ground that the deceased was suffering from heart disease and hypertension before obtaining the insurance policy and this fact was suppressed by him in the proposal form. It is therefore submitted that there is no deficiency in service on part of the Insurance Company in rejecting the claim and prayer for dismissal of the complaint was thus made.

4. Heard. Perused the record.

5. Learned counsel for the complainant argued that the District Commisson has erroneously dismissed the complaint on the ground of the deceased/insured suffering from hypertension, whereas the same was not proved by the Insurance Company. Just one note of the deceased/insured having hypertension, with no accompanying documents is there on record. Therefore, the submissions of the Insurance Company have wrongly been relied upon the by the District Commisson. The policy was obtained in 2021 and the deceased/insured died in 2021, which is eleven years after the single instance of hypertension diagnosed in the deceased/insured. It is not possible for a person to mention every single instance of High Blood Pressure, Sugar, Fever etc. that has happened in his lifetime. The deceased/insured had transient hypertension, which was recorded couple of times and cannot be considered as ongoing in nature. The treating doctor, Dr. Pradeep Sankle also gave certificate stating that the deceased/insured was never a known case of hypertension and the same has also been ignored by the District Commisson while passing the impugned order. He prayed that that none of the documents prove that there has been material suppression on part of the deceased/insured and therefore the appeal be allowed and the impugned order be set aside.

6. It is not in dispute that the policy in question was obtained by the deceased/insured to cover a term of 29 years starting from 12.10.2021. The Insurance Company has stated to have conducted investigation in the matter and it was brought to notice that the deceased/insured was having hypertension since the year 2010 but fact regarding the same was suppressed by him in order to obtain the policy in question. Undisputedly in all the treatment papers of the deceased/ insured, it is mentioned that he was a ‘known case of hypertension’. The Insurance Company has also annexed certain OPD repor