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2. The facts of the complaint of the respondent/ complainant before the District Forum are : that Late Kushdhwaj Nayak, who was husband of the respondent/complainant, had obtained an insurance policy from the appellant/O.P./Insurance Corporation on 02.09.2008. The insurance policy No. is 385600101 and sum assured is Rs.2,50,000/-. The insured was regularly paying the premium amount and he paid a sum of Rs.31,346/- towards premium on quarterly basis. At the time of making proposal for the insurance policy, the insured mentioned in the proposal form that he was fully healthy and the appellant/O.P./Insurance Corporation accepted the proposal of the deceased after obtaining report from their authorized doctor in respect of health of the policy holder. During the subsistence of the insurance, on 02.04.2010 the insured Kushdhwaj Nayak died. The respondent/complainant submitted claim form for obtaining the benefits under the insurance policy before the appellant/O.P./Insurance Corporation after completing all formalities and necessities, but the appellant/O.P./Insurance Corporation has not paid any amount to her till today. The respondent/complainant contacted several time to the appellant/O.P./Insurance Corporation // 3 // and request to pay the amount but appellant/O.P./Insurance Company did not pay the amount. On 05.03.2012 she sent legal notice to the appellant/O.P./Insurance Corporation, but even the appellant/O.P./Insurance Corporation did not pay amount. The respondent / complainant filed consumer complaint before the District Forum.

3. The appellant/O.P./Insurance Corporation filed its written version and denied the allegations leveled by the respondent/complainant in the complaint and averred that at the time of making proposal for the insurance on 25.08.2008 the policy holder Kushdhwaj Nayak (deceased) had given false and incorrect information regarding his health. Prior to making proposal for the insurance, the policy holder suffered from DM/H.T.N./S.L.D./CR.F./UTI c diabetes, hypertension, liver, syrosis, chronic renal failure and uti and was on leave for 155 days for the period from 19.07.2008 to 24.12.2008. The policy holder replied in negative form to the questions asked at serial no.11 of the proposal form which is in respect of his personal history and he intentionally suppressed the facts regarding the previous diseases. The appellant/O.P./Insurance Corporation further averred that in the proposal form, the person whose life is herein being proposed to be assured, do hereby declare that the foregoing statements and answers have been given by him/her after fully understanding the questions // 4 // and the same are true and complete in every particular and that he/she has not suppressed any information and do hereby agree and declare that these statements and this declaration shall be the basis of the contract of assurance between him/her and the Life Insurance Corporation of India and that if any untrue averment be contained therein, the said contract shall be absolutely null and void and all monies which shall have been paid in respect thereof shall stand forfeited to the Corporation. The death of the husband of the respondent/complainant, namely Kushdhwaj Nayak occurred on 02.04.2010 i.e. within 3 years from the date of obtaining the insurance policy, which comes in the category of "early claim". As per provisions, the claim of the respondent/complainant was investigated and it was clear the policy holder had given false and incorrect information in the proposal from in respect of the diseases which are serious diseases and to which the policy holder suffered and he intentionally suppressed material facts. Therefore, the appellant/O.P./Insurance Corporation, is not liable to pay the insurance amount and other benefits and her claim was not allowed. Thus, the appellant/O.P./Insurance Company did not commit any deficiency in service and the complaint of the respondent/complainant is baseless, hence the complaint of the respondent/complainant, be dismissed.

14. Deceased Kushdhwaj Nayak obtained insurance policy No.385600101 for the value of Rs.2,50,000/- from the // 8 // appellant/O.P./Insurance Corporation and at that time, he submitted proposal form for insurance on her life on 25.08.2008. In the proposal form, which is annexed in the record of the District Forum at Page No.22 to 28,) in sub clause (d) and (e) of clause 11 it is mentioned thus :

11 Personal History Answer If Yes, please Yes/No give full details

20. Looking the above documents, it appears that deceased Kushdhwaj Nayak was already suffering from CRF, UTI & DM prior to submitting proposal form for the insurance and proposal form was filled up by the deceased himself. In the proposal form, the deceased did not disclose the above diseases.

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21. From above discussions, it becomes clear that the respondent/complainant has not come with the clean hands and the deceased insured Late Kushdhawaj Nayak, has suppressed material facts regarding his sufferance from aforesaid diseases since very long time, when he obtained policy and at that time he was a patient of above diseases and above fact was not mentioned in the proposal form for the insurance. The impugned order passed by learned District Forum, is erroneous and is labile to be set aside.