Babli Goyal And Another vs Icic Prudential Life Insurance Company ... on 6 March, 2019
5. The counsel for the complainant contended that DLA was
examined by the panelist doctor of OPs before issuing the insurance
policy to him, but no such disorder was detected in his health. This
fact goes a long way in proving that he was hale and hearty and did
not suffer from any cardiac disorder and hence there is no question
of concealment of material fact by suppressing it fraudulently on his
part in this case. As held by the State Consumer Disputes Redressal
Consumer Complaint No.601 of 2018 7
Commission U.T. Chandigarh in F.A.349 of 2013 titled as Ashok
Kumar Vs. Apollo Munich Health Insurance, decided on
23.08.2013, no doubt the insured was subjected to medical
examination by authorized doctor of OPs and only after due
satisfaction, the policy was issued. The mere fact that he was
subjected to medical examination before issuance of policy in
question at the instance of the OPs did not absolve him of his duty of
disclosure of material fact that he was suffering from the concerned
disease, since he concealed this very fact and on the other hand
gave answer in proposal form in the negative and he, thus, breached
the principle of utmost good faith on which the contract of insurance
is based. This submission of counsel for the complainants is not
accepted on the above premise, as the insured was expected to
disclose the correct answers in the proposal form to OPs, despite his
examination by penalist doctor. Similarly, the next submission of
counsel for the complainants is that the proposal form was in
English, whereas the proposer signed the declaration in Punjabi and
as such it is inconsequential. This document does not prove this fact
that DLA was not aware of his pre-existing disease, but he
deliberately concealed it by giving wrong answers in the proposal
form regarding his state of health.