- (1.) THE complainant s husband who was working as a Spinning Master in a mill at Coimbatore, sent a proposal of insurance and also paid a premium of Rs. 4,139/ -. On the basis of the said insurance policy, relief is claimed in this complaint.
(2.) THE lower Forum held that there is no acceptable evidence on the side of the complainant to show when the proposal was given and when the first premium amount was paid. The complainant would say that her husband paid the amount to a LIC agent. But, though there is nothing to show that the amount was received by the LIC, the proposal form Ex. B1 was received by the opposite party on 12.12.1992, the receipt for payment of first premium has been given on 9.12.1992 and the policy was issued on 27.3.1993. The cover under the policy commenced from 12.12.1992 and the sum assured was Rs. 50,000/ -. The complainant s husband was having symptoms of Malignant Gastric Ulcer . He was later admitted at G.K.N.M. Hospital, Coimbatore, where he died on 25.12.1992 due to cardio pulmonary arrest. The complainant claiming to be a nominee under the policy claims the amount.
(3.) THE opposite party repudiated the claim on the ground that the complainant s husband was suffering from a pre -existing disease and that he has suppressed the same. In Ex. B8, the doctor has stated that the patient would have been suffering from the disease for about 1 years preceding his death. Ex. B9 is the certificate given by G.K.N.M. Hospital in respect of the complainant s husband while Ex. B10 is the certificate given by the employer giving the particulars of leave taken by the complainant s husband. The employer has sent a reply on 19.11.1993 with a photostat copy of the hospital records for sanction of leave from 3.12.1992 to 25.12.1992. He has also stated that no medical certificate or medical records is available for the period from 19.11.1992 to 2.12.1992. The deceased was on leave and was taking treatment in G.K.N.M. Hospital. The G.K.N.M. Hospital, Coimbatore, have also sent records which have been marked as Ex. B16 series. The insured had died within 13 days from the commencement of the policy. The records thus produced would show that the complainant s husband has been suffering from the disease even prior to the date of proposal and suppressing this fact, he has submitted a proposal. The insured was fully aware of the ailment of which he was suffering. In fact, the medical records produced namely Ex. B16 series show that he underwent a surgery as well. He had been taking frequent leave on the ground of illness but suppressing all these he has submitted a proposal claiming to be maintaining good health and answering the other questions under relevant column in the negative. He has persuaded the opposite party to accept his proposal. If all the facts have been stated, the opposite party would not have accepted to underwrite. The contract of insurance mainly rests upon good faith. Here what we find is suppression of material facts relating to the health of individual. The facts relating to the insurability are suppressed. A wilful misrepresentation is also made. Thus, we find that the contract has been vitiated by reason of suppression of material facts relating to the health of the insured. Therefore, the lower Forum was justified in dismissing the complaint. Hence, we do not see any merit in this appeal. In the result, this appeal is dismissed but in the circumstances without cost confirming the order passed by the lower Forum.;