1. This revision petition has been filed under section 21(b) of the Act 1986 in challenge to the Order dated 18.12.2007 of the State Commission in appeal no. 1044 of 2004 arising out of the Order (02 nos.) dated 19.04.2004 of the District Commission in complaint no. 112 of 2003.

2. We have heard the learned counsel for the two sides and have perused the record including inter alia the Orders dated 19.04.2004 (02 nos.) of the District Commission, the impugned Order dated 18.12.2007 of the State Commission and the petition.   

3. The dispute relates to repudiation of the claim on the death of the insured. The insurance co. is the petitioner herein. The nominee / widow of the deceased insured is the respondent herein.

4. The insurance co. had repudiated the claim on ground of concealment of pre-existing fatal diseases at the time of taking the insurance i.e. at the time of filling the proposal form. 

5. The root of the matter was whether or not the insured knew that he was suffering from fatal diseases and he deliberately suppressed his medical condition when he took the policy. In the District Commission a bench comprising of three members considered the matter. The President held that the insured had knowledge of his medical condition when he took the policy and he deliberately suppressed material facts when he took the policy. The other two members held that the insured came to know of his fatal diseases only subsequent to the taking of the policy, when the relevant tests and investigations were conducted in the hospital where he was admitted for treatment just before he died. Accordingly the majority view was that the complaint deserved to be allowed. The insurance co. was ordered to pay the assured sum of Rs. 5 lakh with interest at the rate of 8% per annum from the date of filing of the complaint along with Rs. 3,000/- towards ordeal, documentation charges and cost of litigation.

6. The insurance co. preferred appeal before the State Commission. The State Commission made a holistic and comprehensive appraisal of the facts & circumstances and the evidence and dismissed the appeal (“In our opinion, the present appeal lacks merits, hence, liable to be dismissed.”). It observed that the onus of proving the fact that the insured had prior knowledge that he was suffering from fatal diseases and as such he deliberately suppressed these material facts at the time of filling up the proposal form was on the insurance co. However, the evidence adduced did not to lead to establish this, to the contrary it was apparent that the insured came to know that he was suffering from fatal diseases when later on he was fully examined in a hospital. The State Commission inter alia critiqued the minority view of the President of the District Commission, and pointed out where he had erred. It came to the clear findings that there was no evidence on record to show that the insured had knowledge that he was suffering from fatal diseases prior to taking of the policy and there was inadequate evidence to support that he had deliberately suppressed his medical condition i.e. made deliberate suppression of material facts as may go towards breach of the conditions of insurance.

7. The Orders of the two fora below are a matter of record and no useful purpose will be served by reproducing them all over again. It should suffice that we find that the State Commission has passed a well-appraised reasoned Order. We notice no perversity in its appreciation of the facts & circumstances and the evidence. Nor do we notice a jurisdictional error or some material irregularity or any miscarriage of justice having been occasioned. As such no good ground for interference in the exercise of the revisional jurisdiction of this Commission is forthcoming.

8. Here we may add that we agree with the learned counsel for the insurance co. that suppression of material facts about pre-existing disease / medical condition would undoubtedly be a breach of the insurance contract, which is of utmost good faith.

9. However, in the instant case, the onus of establishing the fact that there was deliberate suppression of material facts was on the insurance co., which onus it failed to discharge by adducing the adequate evidence to substantiate such contention. 

10. The revision petition, being sans merit, is dismissed.

The award made by the District Commission, as upheld by the State Commission, is confirmed.

The insurance co. shall forthwith make good the award by way of  ‘payee’s a/c only’ bank draft in the name of the complainant / nominee / widow of the deceased insured, failing which the District Commission shall undertake execution, for ‘enforcement’ and for ‘penalty’, as per the law.

11. The Registry is requested to send a copy each of this Order to the parties in the petition and to their learned counsel as well as to the District Commission immediately. The stenographer is also requested to upload this Order on the website of this Commission immediately.