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Judgment
1.THERE is a delay of five days in filing this appeal. Instead of ordering notice on the application filed for condonation of delay, we heard the appeal for admission.
THIS appeal is by the opposite party challenging the order of the DF allowing the complaint of the complainant. From the proceedings it is seen that the President and a Member has held that the repudiation of the claim by the Insurance Company is not correct, whereas, one Member of the DF agreed with the defence taken by the Insurance Company. Since the majority view is that the repudiation of the claim by the Insurance Company is not correct this appeal has been filed.
THE facts, in this case, are as follows: The wife of the complainant has taken a policy with effect from 26.7.2004. The assured sum under the policy is Rs. 1,00,000. The insured died on 15.9.2004 due to heart attack. After the death the husband of the complainant has filed a claim before the Insurance Company for payment of money due under the policy. The said claim has been repudiated by the Insurance Company on the ground that the insured had not disclosed that she has underwent a caesarian operation in the proposal form. This repudiation of the claim by the Insurance Company has made the complainant to file the complaint before the DF.
THE majority view of the DF is that the caesarian operation which the insured underwent is nothing to do with the cause of death and consequently allowed the complaint. This order is under challenge by the Insurance Company in this appeal. The learned Counsel appearing for the Insurance Company submitted that the insured ought to have disclosed the caesarian operation undergone by the insured in her proposal form. Non disclosure of the said fact amounts to suppression of fact and, therefore, the Insurance Company is right in repudiating the claim.
THE caesarian operation is only for the purpose of extracting the baby and it is one of the modes of delivery of a child and conducting such an operation cannot be considered as an operation for any disease. If that is so, non disclosure of the fact of caesarian operation cannot be considered as suppression of fact. Therefore, in our view, the DF is right in allowing the complaint of the complainant. In the result, we pass the following: ORDER
APPLICATION filed for condonation of delay and the appeal are dismissed.