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Judgment
Dr. S. M. Kantikar, Presiding Member
These two (02 nos.) Revision Petitions under Section 21(b) of the Act 1986 are in challenge to the Order dated 05.02.2013 of the State Commission in Appeals No. 04 and No. 05 of 2013 arising out of the Order dated 28.08.2012 of the District Commission in Complaints No. 86 and No. 87 of 2011. The Revision Petitions were dismissed, with reasoned judgment to follow. This Order gives the reasons.
We heard the learned Counsel for the parties and perused the record.
The matter relates to repudiation of insurance claims relating to two (02 nos.) policies. Individual Complaints (02 nos.) were filed by the two nominees, who were the sons of the deceased insured.
The District Commission vide its Order dated 28.08.2012 dismissed the Complaints, inter alia making the following observations:
“In the present complaint, in view of the aforesaid Judgment passed by the Hon'ble Apex Court, the Insured had suppressed his heart disease in the proposal form and obtained the policy by giving Certificates of his wrong age and income and also at the time of taking Policy suppressed that he was holder of BPL Card hence in such circumstances the complainant is not entitled to the insured amount under policy. In such circumstances we come to the conclusion that the opposite parties repudiated the claim of the complainant on reasonable ground. Hence, in this background the both complaints of the complainant are dismissed.”
Being aggrieved, the Complainants filed two (02 nos.) separate Appeals before the State Commission. The State Commission dismissed the Appeals on limitation, inter alia making the following observations:
“In such circumstances, we are not inclined to hold that the appellant were prevented from sufficient cause in presenting their appeal in time. So, we do not find any merit in this petition to condone the delay and thereby to admit the petition. ---- The appeal thus, stands dismissed after rejecting the prayer for condonation of delay.”
Being aggrieved still, the two Complainants filed these instant Revision Petitions before this Commission.
The Revision Petitions have been filed with delay. However, in the interest of justice, to give fair opportunity to the Petitioners, in order to decide the matter on merit rather than to dismiss it on the threshold of limitation, the delay in filing the Revision Petitions is condoned.
Briefly, as evinces from the appraisal made by the District Commission and the material on record, the deceased insured took one policy on 21.10.2009 for sum assured of Rs. 4 lakh and premium of Rs. 25,500/-. He took another policy on 10.11.2009 for sum assured of Rs. 4 lakh and premium of Rs. 26,421/-. He expired within a few months on 05.04.2010. The claims were investigated by the insurance co. and it came out that the deceased insured had obtained the policies by suppressing his pre-existing disease and giving wrong information regarding his income and age. He was suffering from heart disease on 12.08.2009 with an enlarged heart (Cardiomegaly) but did not disclose this in the proposal form. He was a BPL Card Holder with annual income less than Rs. 36,000/- but gave his income as Rs. 72,000/- in the proposal form. He submitted fake age proof as there was no school by the name from which he purportedly procured the certificate. The Insurance Co. repudiated the claims on ground of willful suppression of material facts. The Insurance Ombudsman also dismissed the case.
The District Commission made its examination on the merits and dismissed the Complaints, agreeing with the Insurance Co. that in this particular case there was suppression of material facts relating to pre-existing disease, income and age.
The State Commission dismissed the Appeals on limitation, finding that sufficient cause to condone the delay was not visible.
We have examined the Orders of the two fora below and do not find any jurisdictional error or material irregularity therein. The evidence clearly shows that there was in fact willful concealment of material facts and as such the District Commission’s Order cannot be faulted. Sufficient cause to condone the delay in filing the Appeals was not forthcoming and as such the State Commission’s Order too cannot be faulted. We also do not find any miscarriage of justice having been occasioned since one of the two fora below has examined the case on its merits and we notice no error on its part. As such nothing warrants interference in the exercise of the revisional jurisdiction of this Commission.
In view of the above discussion, both Revision Petitions fail and stand dismissed as such. No order as to costs.