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9.                As per version of the opposite party, the life assured-Partap Singh, was a patient of Asthma for the last about five years when he died. At that time he was also a paralysis patient. The opposite party could not produce any convincing documentary evidence to prove that the life assured during his life time got treatment regarding ailment of Asthma or that he was suffering from Paralysis. It makes no difference if the Death Certificate was issued from Public Health Centre, Tigaon or not because the insurance company itself has admitted in paragraph No.5 of the written version regarding facts of the case. In this way, the situation is clear that the date of commencement of the insurance policy was November 11th, 2008 and the life assured Partap Singh breathed his last on January 23rd, 2009.

10.              The opposite party-Insurance Company has repudiated the claim of the complainant mainly on the basis of the report of the surveyor Sai Associate & Innogative Private Limited (Annexure R-4) and Inquiry Report of Shri Sanjay Bhatt, The Claim Consultant.

11.              From the surveyor report, Annexure R-4, as well as Inquiry Report of Shri Sanjay Bhatt, it is clear that they could not collect any evidence to prove that the life assured Partap Singh ever remained admitted in any hospital and he got treatment of Asthma as well as Paralysis. Sanjay Bhatt as well as Sai Associate & Innogative Private Limited surveyor agency have only stated that they made inquiries from the Public Health Centre, Tigaon regarding issuance of Death Certificate and from other villagers and stated that other villagers told that Partap Singh was suffering from Asthma and Paralysis. The surveyor did not record statement of any other person/resident of the same village. Moreover, even if public persons would have recorded their statements, those statements would have been of no help to the opposite party in this case because on the basis of oral statements alone, findings cannot be given that it is a case of pre-existing disease.

13.              The surveyor as well as Sanjay Bhatt, Consultant, did not record statement of any person mentioned in their repots. Moreover, none of these persons appeared in the witness box to support the version of the opposite party. In these circumstances, on the basis of the inquiry report of Shri Sanjay Bhatt dated August 12th, 2009 as well as report of the surveyor-Sai Associate & Innogative Private Limited, findings cannot be given that Partap Singh died on any day other than January 23rd, 2009 and that Partap Singh during his life time ever got treatment or remained admitted in hospital for his treatment in connection with Asthma as well as Paralysis. Moreover, Doctor on the panel of the insurance company-opposite party, who examined the insured before providing the insurance policy, was also in a position to make observation after check up without any treatment/diagnostic test that the insured was suffering from paralysis. It makes no difference if Partap Singh died in his farmhouse or in his village or at any other place because regarding death of Partap Singh, there is no controversy in between the complainant and the opposite party.

14.              As per discussions above in detail, we feel no hesitation in holding that the opposite party-Insurance Company miserably has failed to prove that the life assured-Partap Singh was suffering from Asthma or paralysis diseases before he was provided insurance policy. So, it is not a case of pre-existing disease of the insured. In these circumstances, findings can be safely given that the act of the opposite party to repudiate the insurance claim of the complainant was illegal and unjustified. It appears that the insurance company through its surveyor and investigator made all possible efforts not to provide payment of the sum assured to the complainant perhaps because Partap Singh died just after three months from the date of commencement of the insurance policy. Such type of negative attitude/role played by the insurance company cannot be appreciated. Moreover, the disease of paralysis allegedly suffered by the life assured-Partap Singh, could have been easily detected by the doctor on the panel of the insurance  company also by whom the insured was examined before providing him life insurance policy. The opposite party tried to create more and more confusion un-necessarily. The District Forum has committed an error while dismissing the complaint and as such the impugned order passed by the learned District Forum cannot be allowed to sustain.