JUDGMENT

1. The present complaint has been filed by the complainant before this commission for  the following reliefs-

1. The Op be directed to reimburse the complainant assured sum Rs. 5000000/ with pendente lite and future interest at the rate 9% per annum.

2. The Complainant has stated that his wife Late Farzana Tabbusum had subscribed an insurance policy No. 0406349763  issued by OP as per letter dated 3.09.2020 of which first premium deposit of Rs. 18776/ was made to the Op vide receipt no. 0839318684 as per premium deposit acknowledgement annexure 2. Complainant being the nominee in the policy applied for the insurance claim on the death of his wife Farzana Tabbusum. The claim was declined by the Op and communicated to the complainant vide letter dated 31.07.2021. Op has wrongly and illegaly repudiated the claim alleging that Late Farzana Tabbusum had been suffering from cancer from the year 2018 and the fact of illness was  concealed in the proposal form dated 14.07.2020. Op has wrongly alleged that the policy was void on account of non discloser and fraud committed by the policy holder. Complainant further stated that the insured had been suffering from  jaundice since 26.01.2021 and she stared her treatment with herbes as advised by hakim and on happening sudden pain in heart and vomiting on 31.01.2021. she died in the way while going to hospital. Op has wrongly and illegally alleged about concealment of disease of cancer in the proposal form of the policy and illegally repudiated the claim alleging the policy to be void on account of non  discloser of material facts. The insured had no knowledge of being suffered from the disease like cancer at the time of filling in the proposal form and she was under obligation to fulfill the proposal form to the best of her knowledge and belief. At the time of filling in the proposal form she had no knowledge that she was suffering from the disease of cancer. The insurance Company could seek details regarding the medical condition of the insured by getting her examined by its empanelled doctors and through medical test. If on consideration of medical report the company was satisfied about medical condition of insured and issued the policy then the company cannot repudiate the claim by citing preexisting disease. Op has failed to discharge his obligation and committed deficiency in service.
3. Op stated in the WS that the complainant is the nominee in the policy no. 0406349763 which was issued to Farzana Tabbusum after receiving premium of Rs. 18776/. Farzana Tabbusum had expired on 31.01.2021. She had paid premium and the sum assured  was Rs. 5000000/. Op has further stated that insured furnished information in the proposal from having under stood entire terms and conditions of the policy. She had concealed the facts regarding her health. She was fully aware regarding cancer disease and it is wrong to say that she had no knowledge having undergone any disease like cancer at the time of submitting the proposal form. It is also wrong to say that she had been suffering from jaundice and took treatment from Hakim and died due to sudden pain in heart and vomiting. The real fact is that disease was cancer.
4.  Complainant has filed his affidavit and papers in support of his pleadings. Op has also filed affidavit in support of his pleadings.
5. We have perused the material available on record and heard the parties counsel.
6. The first question of consideration before us is whether the policy is void on account of concealment of material facts?
7. Admittedly, complainant’s wife Farzana Tabbusum had subscribed insurance policy issued by the op on submitting proposal  dated 14.07.2020 with nomination of her husband who is complainant in the case. She expired on 31.01.2021 and death claim was submitted by the complainant with op which was repudiated on the ground of concealment of preexisting diseases cancer. Complainant has deposed in his affidavit that his wife had been suffering from jaundice since 26.01.2021 and she started her treatment with herbs advised by hakim and died on 31.01.2021 on occurring sudden pain in heart and vomiting. Complainant further deposed in his affidavit that his wife had no knowledge of having undergone any disease like cancer at the time of submitting proposal form of the policy. She had disclosed the information whatever was within her knowledge
   and she cannot be expected to know about the disease of cancer at the time of submitting the proposal from. In our view it is correct to say that the insured who was a lady cannot be expected to know the cause of the ailment of which she was under the impression of jaundice which can be expected by an ordinary person. On the other hand the op was competent to know details regarding health condition of the insured by getting her examined  by its empanelled doctors and  through medical examination and medical test. It can not be denied that the op having satisfied with the medical examination and test of the insured , the policy was issued. Having issued the policy, it cannot be contended that the insured was suffering from  preexisting disease and the op is estopped from the same. The insured was under obligation to disclose whatever were known to her and not to what she ought to have known. The insured was an ordinary woman and she can not be expected to know the cause of her ailment as a disease like cancer. Under the circumstances the insured cannot be held liable for concealment of material facts like disease of cancer at the time of submitting the proposal of the policy and the claim cannot be repudiated on the ground of concealment of material facts. Op has committed illegality in repudiating the claim and is liable for deficiency in rendering the service. Complainant is entitled for the assured sum Rs. 5000000/.
8. The question formulated above is decided in favour of the complainant.
9. Op’s counsel has referred to the following rulings in support of the ground for repudation of the claim-

1. LIC vs M/s Mamta Revision No. 3223/2010 NC.
2. LIC V/s C Venkataramudu II 2014 CPJ 190 NC
3. Sunita V/s HDFC Standred Life Ins. Co. I2021 CPJ 287 NC.

10. We have gone through the rulings submitted by the learned counsel of Op and we find that these rulings have no force in view of law laid dowm by Hon’ble Supreme Court in the case Manmohan Nanda V/s United India assurance Co. Ltd decided on 6.12.2021 which is applicable in the present case.
11. Keeping in view of the facts of the present case and the law applicable to the case , we hereby direct to Op to pay the assured sum Rs.5000000/ (Fifty Lakh) with pendente lite and future interest at the rate 9% per annum.
12. Op shall comply with the direction within a month failing which OPs shall be prosecuted for non-compliance in accordance with section 72 of the Act for awarding punishment against him.
13. A copy of this judgment be provided to all the parties as per rule as mandated by Consumer Protection Act, 2019. The judgment be uploaded forthwith on the website of the commission for the perusal of the parties.
14. File be consigned to record room along with a copy of this judgment.