Case Law Details
Bharti Axa Life Insurance Ltd Vs Amrik Kaur (NCDRC Delhi)
Conclusion: In present facts of the case, it was held that the power of National Commission to review under section 21 of the Act is limited to cases where some prima facie error appears in the impugned order and where two interpretations of evidence are possible, concurrent findings based on evidence must be accepted and such findings cannot be substituted in revisional jurisdiction.
Facts: In present facts of the case, the revision petition under the Consumer Protection Act, 1986 assails the order dated 01.09.2017 State Commission, Chandigarh arising out of order dated 27.03.2017 in Consumer Complaint No. 320 of 2016 of the District Consumer Disputes Redressal Forum, Amritsar.
In the said case, the late husband of the respondent/complainant had obtained a life insurance policy from the petitioner on 31.10.2012 for an assured sum of Rs 25,00,000/-. On 03.11.2012 the insured expired suddenly. A claim was preferred by the respondent on 23.04.2014 after which the petitioner investigated since the death of the insured had occurred within 2 years of the policy being taken. During investigations it came to notice that the Deceased Life Assured (DLA) had concealed material evidence at the time of filling the proposal form relating to his hospitalization from 06.09.2012 to 07.09.2012 for Diagnostic Laparoscopy Biopsy prior to the issuance of the policy. The claim was therefore repudiated on 16.07.2014. The respondent filed a consumer complaint no. 320 of 2016 which came to be decided on contest on 27.03.2017 with the District Forum upholding the complaint by directing the Insurance Company to pay Rs. 20,00,000/-. The appeal before the State Commission against this order in Appeal No. 341 of 2017 was dismissed on 01.09.2017.
The petitioner submitted that the Deceased Life Assured (DLA) had deliberately not disclosed the fact of his hospitalization prior to the taking of the policy as per the proposal form which constituted suppression of a material fact. The respondent/ complainant submitted that the proposal form relied upon was unsigned and, therefore, not reliable. The fact of hospitalization is not denied although it was for a minor reason and that no evidence of the doctor concerned had been brought on record. It was also contended that the policy was approved after the conduct of a medical examination which did not reveal any pre-existing illness.
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