Heard Learned Counsel for the appellant. None appears for the respondent.
2.The case of the Complainant innutshell is that the husband of the Complainant had purchased two life insurance policies bearing nos.592067283 & 592068617 for sum assured of Rs. 150,000/- and Rs. 1,00,000/- respectively from the O.P on 28-07-2010 . The policy holder died on 29-02-2012. Thereafter, the Complainant nominee applied for the sum assured but the O.P on the other ground repudiated claim aspolicy holder has suppressed thepre-existingdisease while filing up of the proposal form.Alleging about deficiency in service of O.P complaint was filed.
3.The O.P filed written version stating that two policies have been purchased by the deceased police holder butsuppressed the pre-existingdisease while filling up of the proposal form .It is averred that questions alleged in clause 11 was rendered in negative by the policyholder in proposal form although he has suffered from pre-existingdisease. For that they have repudiated claim.
4. After hearing the both parties, Learned District forum allowed on complaint.
5. Learned Counsel for the appellant submitted that the LearnedDistrict forum has not gone through the written version filed by the O.P.According to him the police holder has suffered from previous disease but he has not disclosed such fact in his proposal form. He further submitted that Insurance contract is based on the principles of “Uberrima fide” i.e Utmost Good Faith”Sincethe policy holder has violated the insurance contract by suppressing material fact ,O.P has called thepolicy in question U/s 45 ofInsurance Act. So complainant is not liable to get the sum assured. He submitted to set aside the impugned order by allowing the appeal.
6. Considered the submission of learned counsel for appellant and perused the DFR and impugned order. It is admitted fact that the policy holder has purchased two policiesfor sum assured of Rs.1,50,000/- & 1,00,000/-.No doubt onus lies on the complainant to prove the case but as per settled principle of law the O.P has to provepre-existingdisease, suppression of material fact of his pre- existing disease the policy holder while filled up of proposal form.In the instant case, written version filed by the O.P clearly it is averred that the policy holder had under -taken kidneytransplant in the year2004 as perrecord but not a singledocument is filed to substantiate his claim .In absence of any document, we are in view that the O.P has not discharged onus of proving the suppression of material fact. When policy holder has answered clause 11 of proposal form correctly, the repudiation of claim by O.P is deficiency in service .Complainant has been proved deficiency in service on the part of O.P. We, therefore confirmed the impugned order. Thus, appeal being devoid of merit stands dismissed. No. Cost.