Learned counsel for the appellant is present.

2.              Learned counsel for the respondent is continuously absent. This is a matter of 2015. Learned counsel for the appellant submits that there is very small matter involved in this case.

3.                Heard the learned counsel for the appellant.

  4.              The appellant was the OP whereas the respondent was the complainant before the learned District Forum. Hereinafter, the parties to this appeal shall be referred to  with reference to their respective status before the learned District Forum.    

5.                Learned counsel for the appellant submitted that the complainant has purchased a insurance policy bearing Policy No.580476822 for  a sum of Rs.1,00,000/-  which was valid from 26.12.1991 to 26.12.2016 on payment of premium to the OP-Insurance Company. It is also stated that the complainant was purchased of the said policy. It is alleged inter-alia that during subsistence of the policy the insured died on 15.08.1996 after which the claim was filed. The complainant alleged that the OP  without any basis repudiated the claim and as such filed the complaint. 

6.               Learned counsel for the appellant submitted that the OP filed written version refuting the allegation of the complainant. It is case of the Op that the insured had suppressed the material facts of his previous illness  while filled-up the proposal form and for that the OP repudiated the claim. The OP has taken plea that the insured was suffering from Rheumatic Heart disease for 7 to 8 years prior to 11.09.1995.

7.              Learned counsel for the appellant further submitted that learned District Forum, without understanding the fact and law in this case allowed  the complaint by directing the insurer to pay Rs.1,00,000/- to the complainant with interest @ 9% per annum from the date of receipt. He further submitted that learned District Forum ought to have considered the medical certificate produced by the OP vide Ext.G & F.

8.        Learned counsel for the appellant further submitted that  since insurance  of contract has been violated by the complainant’s wife by suppressing the material facts of previous disease, the order of the learned District Forum is illegal and improper and as such should be set-aside by allowing the appeal.

9.       Considered the submission of learned counsel for the appellant, perused the DFR including  impugned order.

 10.        It is settled in law that the complainant has proved the deficiency of service on the part of the OP. It is an admitted fact that the complainant has purchase the insurance policy bearing No.580476822 on 26.12.1991 is not in dispute that the insured died on 15.08.1996.Section-45 of the Insurance Act is as follows:-

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   “ Policy not to be called in question on ground of mis-statement after two years- No policy of life insurance effected before the commencement of this Act shall after the expiry of two years from the date of commencement of this Act and no policy of life insurance effected after the coming into force of this Act shall, after the expiry of two years from the date on which it was effected, be called in question by an insurer on the ground that a statement made in the proposal for insurance or in any report of a medical officer, or referee, or friend of the insured, or in any other document leading to the issue of the policy, was inaccurate or false, unless the insurer shows that such statement was on a material matter or suppressed facts which it was material to disclose and that it was fraudulently made by the policy-holder and that the policy-holder knew at the time of making it that the statement was false or that it suppressed facts which it was material to disclose;

     Provided that nothing in this section shall prevent the insurer from calling for proof of age at any time if he is entitled to do so, and no policy shall be deemed to be called in question merely because the terms of the policy are adjusted on subsequent proof that the age of the life insured was incorrectly stated in the proposal.”

11.        The aforesaid provision in the Insurance Act clearly shows that the insurer has got right to repudiate the claim within two years from the date of commencement of the policy. Also the reasons for repudiation will be that mis-statement or suppression of material facts or fraudulent statement made by the insurer while filing filled-up proposal form. Since, in the instant case the death of the insurer occurred long after five years of the commencement of the policy the insurer can not repudiate the claim even if the insured has suppressed his previous disease. Apart from this OP has not taken step to examine the concerned doctor to proof the medical certificate of the insurer, same fact has observed by the learned District Forum.

12.    In view of the aforesaid analysis the Commission of the view that the repudiation of the claim being not illegal and improper, the complainant has proved the deficiency of service on the part of the OP. As such there is nothing to interfere the order of the learned District Forum. The impugned order is confirmed and the appeal stands dismissed. The impugned order of the learned District Forum should be complied within 30 days.                

              Free copy of the order be supplied to the respective  parties.                            

                DFR be sent back forthwith.