Hemant Gupta, J. - (1.) THE Challenge in the present petition is to the order passed by the Insurance Ombudsman, Chandigarh, on 5th August, 2008, Annexure P -l, whereby the complaint filed by Respondent No. 2 was allowed and finding was given that insurance claim is payable by the Petitioner.
(2.) SMT . Harjinder Kaur, wife of Respondent No. 2, was insured by the Appellant with the date of commencement of the policy as 22nd November, 2007. Smt. Harjinder Kaur died on 7th January, 2008 but the claim lodged by Respondent No. 2 was repudiated on the ground that the insured was suffering from hypertension for the last 10 years but such information was not disclosed. It was the claim of Respondent No. 2 that his wife was not having any medical problem and her death was sudden. The stand of the Petitioner is that in the proposal form, the insured has categorically stated that she was not suffering from any hypertension or high blood pressure, whereas, as per attending physician statement, Annexure P -8, the insured was suffering from hypertension for the last 10 years and, thus, the insured having withheld the material information in respect of hypertension, the Petitioner has rightly repudiated the claim.
(3.) THE learned Insurance Ombudsman has found that though the doctor has stated that the insured was suffering from hypertension for the last 10 years, but there is no documentary proof or any other documentary record to support this statement. A clarification was sought from Dayanand Medical College, Ludhiana, the place of death of the insured. The summary of the record was produced wherein it is mentioned that the patient is suffering from hypertension for the last ten years but no supporting document could be furnished to substantiate the statement regarding the patient suffering from hypertension for ten years. On the basis of the hospital treatment certificate, learned Insurance Ombudsman recorded a finding that the insured had difficulty in swallowing and breathlessness but there is no record to the effect that the insured disclosed that she was suffering from hypertension for the last 10 years. Thus, it could not be substantiated on record that the insured was suffering from hypertension for 10 years.;