ORDER

For the Appellant                Mr Praveen Mahajan and Ms Vrinda,

                                       Advocates  

For Respondent nos.1 to 3   Mr R C Sharma, Mr Alok Sharma and

                                       Mr Mukesh Kumar, Advocates

For Respondent no.4           Mr Rajat Manchand, Mr Rajesh Manchanda

                                       Mr Mayank Nautiyal, Ms Somya Narula, Mr

                                       Deepanshu Bharti and Ms Megha Gaur,

                                       Advocates   

ORDER

PER SUBHASH CHANDRA

1.     This First Appeal under Section 19 of the Consumer Protection Act,1986 is directed against the order dated 24.12.2021 of the Uttar Pradesh State Consumer Disputes Redressal Commission, Lucknow in Complaint no. 71 of 2018 allowing the complaint and directing the opposite parties 1 and 2 (including appellant herein) to repay the loan under the terms of the insurance policy within 2 months along with interest and directing opposite party 3 to provide a No Dues Certificate with regard to the loan and EMIs thereon.

2.     We have heard the learned counsel for the parties and perused the records. The delay of 96 days in the filing of the appeal was considered in light of the application seeking condonation of the delay. For the reasons stated therein, the delay was condoned in the interest of justice.

3.     The relevant facts of the case, in brief, are that the deceased husband of the respondent had obtained a mortgage home loan for Rs 35,58,263/- from respondent no. 4, Punjab National Bank (PNB) Housing Finance. In order to secure the same, a Bharti AXA Life Loan Secure and a Bharti Axa Life Group Accidental Death Benefit Rider, a Group Insurance Policy, was issued by the appellant in the name of Hemant Kumar Mishra, the late husband of respondent no.1. At the time of obtaining the Life Group Accidental Death Benefit insurance, a questionnaire requiring declaration of previous medical treatment or surgical operations and treatment for complaints of blood pressure, blood sugar, heart disease, kidney/urinary tract disease, cancer or any tumour, respiratory or neurological or liver disease etc., was filled up by the respondent’s husband on 29.06.2016 and a declaration given in the negative. Premium of Rs 1,29,288.75 was paid and the Policy was issued on 31.08.2016 for a term of 84 months. The Life Assured expired on 15.12.2016. The claim under the Policy was repudiated on 10.03.2017 on the basis of an enquiry conducted by the appellant through an investigative agency, ‘Probe India’ which revealed that the deceased life assured (DLA) had been admitted in May 2015 in Metro Hospital and Heart Institute (hospital) for hypertension, coronary heart disease, acute coronary syndrome, inferior wall myocardial infarction and cerebra-vascular accident and that in view of the incorrect disclosure of these diseases in the proposal form, the claim of insurance could not be considered. Respondents approached the State Commission through CC 71 of 2018 which was upheld, on contest.

4.      This order is impugned before us inter alia on the grounds that (i) the pre-issuance medical documents put on record by the appellant does not prove that the treatment at Metro Hospital from 16.05.2015 to 18.05.2015 was related to the ailments mentioned in the repudiation letter although prescriptions dated 15.05.2015, 16.05.2015, 17.05.2015 and 18.05.2015 and ECG report, clinical and other reports indicated that the DLA was diagnosed with coronary artery disease, ACS and IWMI; (ii) the State Commission failed to appreciate merely on the ground of absence of medical certificate certifying the medical ailments ignoring those documents which indicate the medical treatment history of the DLA;

(iii) the State Commission erred in relying upon the judgment of this Commission in Bajaj Allianz Life Insurance Co. Ltd. & 2 Ors. Vs. Kandaru Gangadhara Rao, 1V (2021) CPJ 244 (NC) as it had been held in L