Decided on February 26,2010

MOHAN LAL Respondents


- (1.) APPELLANTS are aggrieved from the order passed by District Forum, Kullu, in Complaint Case No. 48/2008, on 7.11.2008. By means of impugned order, while allowing the said complaint both of them have been directed to pay Rs. 1,00,000 arising out of the Insurance policy of the deceased -wife of respondent No. 1, Mohan Lal, along with interest @ 9% per annum from the date of institution of the complaint (13.6.2008) till realization. A sum of Rs. 2,000 has been allowed as compensation for harassment along with Rs. 1,000 being cost of litigation. Hence, this appeal.
(2.) SMT . Man Dassi having obtained Insurance policy from the appellants in the sum of Rs. 1,00,000 on 22.7.2006 under Plan and Term 149 -25 is not in dispute. She died on 10.1.2008 due to heart attack. Respondent No. 1 was her nominee is again admitted between the parties. This insurance was got done by the deceased from respondent No. 2, who according to respondent No. 1 was the agent of the appellants. Since policy had lapsed, it was revived on 20.11.2007. Copy of document to this effect is at page 41 of the complaint file. Proposal form, when Insurance policy was obtained is Annexure R.1 and the form signed by the deceased while getting the policy revived on 20.11.2007 is Annexure R. 2. Copy of the policy bond is Annexure R. 3. Instalment payable was quarterly in the sum of Rs. 1,359. After her death, claim was lodged. With a view to meet the requirement of the appellants, respondent No. 1 submitted Form No. 3816, Annexure R. 4, duly signed by the Medical Superintendent, Lady Willingdon Hospital, Manali. Its perusal clearly shows that the deceased was admitted with the complainant of not passing stool and duration of the complaint as reported by the patient was one month. In this form exact history given is, complaint of not passing stool + flatus, i.e., showing gas in the digestive tract. When the deceased patient was admitted in the Hospital, it is reported that she was having subacute (somewhat acute or between acute and chronic, said of a disease), intestinal obstruction, Carcinoma Ovary (Stage -IV) and was operated in the Hospital. She was admitted on 8.5.2006 and was discharged on 22.5.2006.
(3.) UNDER the Insurance Act, 1938, contract of insurance is based on utmost good faith and bona fide, embracing the doctrine of uberrima fides. In these circumstances, deceased was supposed to have disclosed her suffering from Carcinoma of Ovary, Stage -IV and her having been operated upon at Lady Willingdon Hospital, Manali. If after having disclosed these facts appellants through respondent No. 2 had undertaken the insurance, then they were precluded from making a grievance that she was guilty of suppression of material facts. A person seeking insurance is supposed to disclose all materials as well as relevant and true/correct facts while obtaining insurance, regarding his/her state of health. When a reference is made to Proposal Form, Annexure R.1 as well as to Annexure R.2, the form filled -in while getting the policy revived, there is not a murmur in any of these regarding the deceased having said anything regarding her state of health. That being the position, we are of the view that the deceased was guilty of suppression of true state of facts regarding her health, as such appellants are not liable to indemnify respondent No. 1 as directed in the impugned order by the District Forum below. For taking this view, reliance is being placed on a recent decision of the Hon ble Supreme Court in the case of Satwant Kaur Sandhu v. New India Assurance Co. Ltd., 2009 4 CPJ 8. Nothing to the contrary has been brought to our notice on behalf of the respondents. Though with a view to support the impugned order, Mr. Bhardwaj, learned Counsel for the respondent No. 1 submitted that the deceased had not filled -in the form. She had only signed the proposal form, Annexure R. 1 as well as the form while getting the policy revived, Annexure R. 2, therefore, it cannot be said to be a case of suppression of any material facts muchless lack of bona fides on the part of deceased Man Dassi whose nominee his client is. Therefore, according to him the impugned order suffers from no infirmity which may call for interference in this appeal. He thus prayed for its dismissal.;

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