Per Shri S.R. Khanzode – Presiding Judicial Member:

(1)          This appeal takes an exception to an order dated 30.12.2009 passed in Consumer Complaint No.572/2008, Smt.Kusum Ashok Sharma V/s. Divisional Manager, Life Insurance Corporation, by District Consumer Disputes Redressal Forum, Thane (in short ‘Forum below’).  The insurance claim consequent to the accidental death of Shri Ashok Sharma was made by his wife as per the Insurance policy taken with Appellant/Original Opposite Party.  The said claim stood repudiated and therefore, the consumer complaint was filed.  Upholding the contention of the Complainant, Forum below directed Opposite Party to pay `.2,00,000/- along with interest @9% per annum, `.10,000/- as compensation for mental harassment and Rs.5,000/- as cost.  Feeling aggrieved thereby this appeal is preferred by the Opposite Party Insurance Company.

(2)          Heard Mr.A.S. Vidyarthi, Advocate for the Appellant and Mr.S.D. Tigde, Advocate for the Respondent.

(3)          In the instant case, Appellant Insurance Company heavily relied upon personal statement regarding health given by late – Ashok Sharma while applying for revival for lapsed policy, both medical and non-medical basis.  According to the Appellant, he had suppressed information that he was a chronic alcoholic and suffering from diabetes mellitus and hypertension.  Therefore, it repudiated the claim.

(4)          Admittedly, it is for the Insurance Company to justify such repudiation.  After carefully considering the material placed on record, we find that the insurance company failed to substantiate its statement that deceased late Ashok Sharma, the insured, was a chronic alcoholic and suffering from diabetes mellitus and hypertension and that such material information was fraudulently suppressed by him.  As observed by the Apex Court in the matter of Satwant Kaur Sandhu V/s. New India Assurance Company Ltd. [2009 CTJ 956 (Supreme Court)(CP)], the term “material fact” is not defined in the Insurance Act.  However, any fact which goes to the root of the contract of insurance and has a bearing on the risk involved would be “material”.

(5)          In the instant case, the death, admittedly, had taken place due to vehicle accident when the motor cycle driven by late Ashok Sharma slipped over the bride.  It is not a case of driving the vehicle under influence of alcohol.  In view of the conclusions reached above about failure of the Insurance Company to prove that any material fact is fraudulently suppressed by the deceased while reviving the policy and further failure of the Insurance Company to establish suppression of material fact, if any, as relevant to the risk involved, we find the repudiation of the Insurance claim by the Insurance Company was neither just nor proper and it is an arbitrary action on the part of the Insurance Company.  A useful reference on the point also can be made to observation of the Hon’ble National Consumer Disputes Redressal Commission, New Delhi, in the matter of Life Insurance Corporation of India V/s. Vinod Rani [2007 NCJ 454 (NC)].

(6)          Thus, we find no fault with the impugned order and therefore, the finding the appeal devoid of any substance, pass the following order:

O  R  D  E  R

     (i)       Appeal stands dismissed.

    (ii)       In the given circumstances, no order as to costs.