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Iffco Tokio Gen Ins Co Ltd vs Kiran Ashok Shankhla on 31 July, 2023 cites

Reliance Life Insurance Co. Ltd. vs Rekhaben Nareshbhai Rathod on 24 April, 2019

25. That, we have gone through all the three decisions of the Hon'ble National Commission cited by the learned advocate Mr. A.N. Patel for the respondent - original complainant. In all the three decisions, the Hon'ble National Commission observed that if the insurance company failed to prove the nexus of the suppression of pre- existing disease with the cause of death, then, the insurance company is not entitled to repudiate the claim. But, we are relying upon the latest decision of the Hon'ble Apex Court in the case of Reliance Life Insurance Company Vs. Rekhaben Nareshbhai Rathod, reported in AIR 2019 SC 2039 and another decision of the Hon'ble Apex Court in the case of Branch Manager Bajaj Allianz Life Insurance Co. Lts. Vs. Dalbir Kaur, reported in 2020 (4) CPJ 60. In Kushal A/540/2017 Page 17 of 20 both the decisions, the Hon'ble Apex Court has held and observed that the contracts of insurance including the contract of life assurance are contracts uberrima fides and every fact of material (sic material fact) must be disclosed, otherwise, there is good ground for rescission of the contract. The duty to disclose material facts continues right up to the conclusion of the contract and also implies any material alteration in the character of the risk which may take place between the proposal and its acceptance. If there are any misstatements or suppression of material facts, the policy can be called into question and in the said decision, the Hon'ble Apex Court has also observed what is the meaning of "Proposal Form" and what is the meaning of "Material" in context of insurance policy and has categorically observed that there is a clear presumption that any information sought for in the proposal form is material for the purpose of entering into a contract of insurance and finding of material misrepresentation or concealment in insurance has a significant effect upon both the insured and the insurer in the event of a dispute, the fact it would influence the decision of a prudent insurer in deciding as to whether or not to accept a risk is a material fact. So, as per the said decision of the Hon'ble Apex Court, it was the duty of the insured to state correct facts in the proposal form and if the insured failed to disclose the correct facts or suppressed the information put forth to the insured in the proposal form, then, the insurance company is entitled to repudiate the claim on the ground of non-suppression of material fact. So, in our considered opinion, the above latest two decisions of the Hon'ble Apex Court will prevail over the judgment cited by the learned advocate Mr. A.N. Patel for the respondent - original complainant.
Supreme Court of India Cites 20 - Cited by 115 - D Y Chandrachud - Full Document

Bharti Axa General Insurance Company ... vs Bhag Chand on 10 May, 2016

7 of the impugned order that the insurance company has also not provided the general conditions clause-4 of the insurance policy to the insured and therefore, the insurance company cannot rely on the said condition. But, we do not agree with the said finding of the learned District Forum and for that, we rely upon the decisions of the Hon'ble National Commission cited by the learned advocate of the appellant - insurance company in the case of Bharti AXA General Insurance Company Ltd. Vs. Bhag Chand, reported in IV Kushal A/540/2017 Page 16 of 20 (2016) CPJ 219 and in the case of Kamlesh Gupta Vs. ICICI Lombard General Insurance Co. Ltd. & Ors., reported in I (2017) CPJ 123.
National Consumer Disputes Redressal Cites 6 - Cited by 1 - Full Document

Kamlesh Gupta vs Icici Lombard General Insurance ... on 18 February, 2016

7 of the impugned order that the insurance company has also not provided the general conditions clause-4 of the insurance policy to the insured and therefore, the insurance company cannot rely on the said condition. But, we do not agree with the said finding of the learned District Forum and for that, we rely upon the decisions of the Hon'ble National Commission cited by the learned advocate of the appellant - insurance company in the case of Bharti AXA General Insurance Company Ltd. Vs. Bhag Chand, reported in IV Kushal A/540/2017 Page 16 of 20 (2016) CPJ 219 and in the case of Kamlesh Gupta Vs. ICICI Lombard General Insurance Co. Ltd. & Ors., reported in I (2017) CPJ 123.
National Consumer Disputes Redressal Cites 1 - Cited by 6 - Full Document

Neelam Chopra vs Life Insurance Corporation Of India on 8 October, 2018

13. That, the learned advocate for the respondent - original complainant has submitted that in document R-2, there is no Kushal A/540/2017 Page 8 of 20 signed of the person, who had given history of the illness of the deceased and on page-43, document R-3, there is no name of the insured in the column of name. Furthermore, the learned advocate for the respondent - original complainant has also submitted that even presuming for the sake of argument that the DLA had suppressed the illness of Diabetes and Hypertension in his proposal form, even though, the insurance company failed to prove the nexus of the suppression of the illness and cause of death of the DLA and in support of the said contention, the learned advocate for the respondent - original complainant has placed reliance upon three decisions of the Hon'ble National Commission in the case of (i) Neelam Chopra Vs. Life Insurance Corporation of India, reported in 2018 (4) CPJ 321, (ii) New India Assurance Co. Ltd. & Anr. Vs. Rajinder Singh S/o Tarlochan Singh, rendered in Revision Petition No.2495 of 2018 and (iii) Life Insurance Corporation of India Vs. Naseem Bano, reported in 2012 (3) CPJ 208, and accordingly, the learned advocate for the respondent - original complainant submitted that the impugned order passed by the learned District Commission is just and proper and therefore, the same deserves to be upheld in this appeal and accordingly, the appeal filed by the insurance company may dismiss with heavy cost.
National Consumer Disputes Redressal Cites 2 - Cited by 18 - Full Document

Divisional Manager, Lic Of India & Ors. vs Smt.Anupama & Ors. on 17 April, 2012

So, only because the column of name is left blank, cannot be said that the said document does not pertains to the deceased Ashok S. Shankhla. Furthermore, learned District Forum has also recorded the finding in para-7 of the impugned order that in order to prove the pre-existing disease of insured, the insurance company has not produced any affidavit of the doctor. But, when the said medical treatment papers provided by the wife of the insured alongwith the claim form, there is no reason to raise any doubt or suspicion regarding the facts stated in the said medical treatment papers. Furthermore, as per the decisions of the Hon'ble National Commission in the case of LIC of India & Ors. Vs. Anupama & Ors., reported in II (2012) CPJ 672 and in the case of Smt. A. Sujata Vs. Life Insurance Corporation of India, reported in II (2014) CPJ 53 rendered in Revision Petition No.776 of 2011 dated 04.03.2014 that mere absence of an affidavit of the concerned treating doctor is not an adequate reason to reject the proof and even as per the decision of the Hon'ble National Commission in the Kushal A/540/2017 Page 15 of 20 case of Pushpa Patel Vs. HDFC Standard Life Insurance Co., rendered in First Appeal No.630 of 2018 dated 03.05.2018, when the wrong information was recorded in the certificate or in the discharge summary by the doctor, then, it was the duty of the complainant to approach the concerned hospital to correct the discharge summary or certificate and to clarify that no such information had actually been given by the attendant at the time of admission of the patient in the hospital. So, in this case, the complainant has not approached the hospital for clarification before filing of the consumer complaint or during the pendency of the said complaint. Therefore, as per our considered opinion, the finding recorded by the learned District Forum in para-7 that since the affidavit of the doctor is not submitted, it cannot be believed that the deceased Ashok S. Shankhla was suffering from Diabetes and Hypertension before the proposal form in question are also not correct. So, whatever findings recorded by the learned District Forum in para-7 for not acceptance of the evidence of the insurance company, are not correct and the said findings are erroneous and perverse.
National Consumer Disputes Redressal Cites 3 - Cited by 16 - Full Document

Tata Aig Gen Ins Co Ltd vs Arjanbhai R Barvadiya on 31 March, 2023

11. The learned advocate of the appellant - insurance company has also placed reliance upon the judgment passed in Appeal No.500 of 2016 in the case of TATA AIG General Insurance Company Limited Vs. Arjanbhai Ravajibhai Barvadiya dated 31.03.2023 of this Commission and drawn the attention towards para-9 of the said judgment and submitted that when the insured has suppressed the material fact regarding his illness in proposal form, then, repudiation of the claim by the insurance company is quite legal and valid.
State Consumer Disputes Redressal Commission Cites 6 - Cited by 0 - Full Document

New India Assurance Co. Ltd. & Anr. vs Rajinder Singh on 31 October, 2022

13. That, the learned advocate for the respondent - original complainant has submitted that in document R-2, there is no Kushal A/540/2017 Page 8 of 20 signed of the person, who had given history of the illness of the deceased and on page-43, document R-3, there is no name of the insured in the column of name. Furthermore, the learned advocate for the respondent - original complainant has also submitted that even presuming for the sake of argument that the DLA had suppressed the illness of Diabetes and Hypertension in his proposal form, even though, the insurance company failed to prove the nexus of the suppression of the illness and cause of death of the DLA and in support of the said contention, the learned advocate for the respondent - original complainant has placed reliance upon three decisions of the Hon'ble National Commission in the case of (i) Neelam Chopra Vs. Life Insurance Corporation of India, reported in 2018 (4) CPJ 321, (ii) New India Assurance Co. Ltd. & Anr. Vs. Rajinder Singh S/o Tarlochan Singh, rendered in Revision Petition No.2495 of 2018 and (iii) Life Insurance Corporation of India Vs. Naseem Bano, reported in 2012 (3) CPJ 208, and accordingly, the learned advocate for the respondent - original complainant submitted that the impugned order passed by the learned District Commission is just and proper and therefore, the same deserves to be upheld in this appeal and accordingly, the appeal filed by the insurance company may dismiss with heavy cost.
National Consumer Disputes Redressal Cites 2 - Cited by 0 - Full Document

Smt. A. Sujata, vs Life Insurance Corporation Of India, on 4 March, 2014

So, only because the column of name is left blank, cannot be said that the said document does not pertains to the deceased Ashok S. Shankhla. Furthermore, learned District Forum has also recorded the finding in para-7 of the impugned order that in order to prove the pre-existing disease of insured, the insurance company has not produced any affidavit of the doctor. But, when the said medical treatment papers provided by the wife of the insured alongwith the claim form, there is no reason to raise any doubt or suspicion regarding the facts stated in the said medical treatment papers. Furthermore, as per the decisions of the Hon'ble National Commission in the case of LIC of India & Ors. Vs. Anupama & Ors., reported in II (2012) CPJ 672 and in the case of Smt. A. Sujata Vs. Life Insurance Corporation of India, reported in II (2014) CPJ 53 rendered in Revision Petition No.776 of 2011 dated 04.03.2014 that mere absence of an affidavit of the concerned treating doctor is not an adequate reason to reject the proof and even as per the decision of the Hon'ble National Commission in the Kushal A/540/2017 Page 15 of 20 case of Pushpa Patel Vs. HDFC Standard Life Insurance Co., rendered in First Appeal No.630 of 2018 dated 03.05.2018, when the wrong information was recorded in the certificate or in the discharge summary by the doctor, then, it was the duty of the complainant to approach the concerned hospital to correct the discharge summary or certificate and to clarify that no such information had actually been given by the attendant at the time of admission of the patient in the hospital. So, in this case, the complainant has not approached the hospital for clarification before filing of the consumer complaint or during the pendency of the said complaint. Therefore, as per our considered opinion, the finding recorded by the learned District Forum in para-7 that since the affidavit of the doctor is not submitted, it cannot be believed that the deceased Ashok S. Shankhla was suffering from Diabetes and Hypertension before the proposal form in question are also not correct. So, whatever findings recorded by the learned District Forum in para-7 for not acceptance of the evidence of the insurance company, are not correct and the said findings are erroneous and perverse.
National Consumer Disputes Redressal Cites 5 - Cited by 1 - Full Document

Pushpa Patel vs Hdfc Standard Life Insurance Co. Ltd. & ... on 3 May, 2018

So, only because the column of name is left blank, cannot be said that the said document does not pertains to the deceased Ashok S. Shankhla. Furthermore, learned District Forum has also recorded the finding in para-7 of the impugned order that in order to prove the pre-existing disease of insured, the insurance company has not produced any affidavit of the doctor. But, when the said medical treatment papers provided by the wife of the insured alongwith the claim form, there is no reason to raise any doubt or suspicion regarding the facts stated in the said medical treatment papers. Furthermore, as per the decisions of the Hon'ble National Commission in the case of LIC of India & Ors. Vs. Anupama & Ors., reported in II (2012) CPJ 672 and in the case of Smt. A. Sujata Vs. Life Insurance Corporation of India, reported in II (2014) CPJ 53 rendered in Revision Petition No.776 of 2011 dated 04.03.2014 that mere absence of an affidavit of the concerned treating doctor is not an adequate reason to reject the proof and even as per the decision of the Hon'ble National Commission in the Kushal A/540/2017 Page 15 of 20 case of Pushpa Patel Vs. HDFC Standard Life Insurance Co., rendered in First Appeal No.630 of 2018 dated 03.05.2018, when the wrong information was recorded in the certificate or in the discharge summary by the doctor, then, it was the duty of the complainant to approach the concerned hospital to correct the discharge summary or certificate and to clarify that no such information had actually been given by the attendant at the time of admission of the patient in the hospital. So, in this case, the complainant has not approached the hospital for clarification before filing of the consumer complaint or during the pendency of the said complaint. Therefore, as per our considered opinion, the finding recorded by the learned District Forum in para-7 that since the affidavit of the doctor is not submitted, it cannot be believed that the deceased Ashok S. Shankhla was suffering from Diabetes and Hypertension before the proposal form in question are also not correct. So, whatever findings recorded by the learned District Forum in para-7 for not acceptance of the evidence of the insurance company, are not correct and the said findings are erroneous and perverse.
National Consumer Disputes Redressal Cites 0 - Cited by 3 - Full Document
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