ORDER Dr. P.D. Shenoy, Member—Heard the learned counsel for petitioner. In this case the insured had taken policy of Rs. 50,000 on 20.12.1997 which lapsed on 21.1.2004 and was revived on 29.1.2004. The insured died on 15.5.2004. Accordingly the LRs of the insured complainant made a claim to the Life Insurance Corporation for Rs. 94,550 out of which Rs. 23,900 was paid. Therefore, claiming the balance amount of Rs.70,450, the complainant approached the District Forum. 2. The insured had stated his health was good at the time of revival. The District Forum was convinced by the pleadings of the LIC. Accordingly, the complaint was dismissed. The State Commission allowed the appeal of the complaint. The detailed reasons given by the State Commission for allowing the appeal are stated in extenso: “It is an admitted fact that the life assured had taken a policy which got lapsed and the same was got revived by submitting a statement of good health by the deceased. The perusal of the Form No.680 marked as Annnexure-1 goes to show that there is no column requiring the life assured to disclose whether he had been using alcohol or not. Therefore, there was no occasion for the life assured to give answer either in affirmative or in negative. The only relevant question mentioned in the Form is whether the policy holder after the proposal form had ever suffered from a disease, the treatment of which continued for more than a week. The reply given was in negative. The Insurance Company was required to prove that the life assured had suffered from liver cirrhosis before revival of policy and he had the knowledge of the same. It will not be out of place to mention here that no record has been produced to show that the life assured had ever taken the treatment of liver before the revival of policy. Bed head ticket also does not indicate whether the life assured had any knowledge about the ailment, he was suffering from at the time of revival of policy. The deceased could divulge the information only when he had the knowledge about the same. Suppression of a fact means that the person had a knowledge of a particular fact and he concealed that fact.
The deceased could divulge the information only when he had the knowledge about the same. Suppression of a fact means that the person had a knowledge of a particular fact and he concealed that fact. We feel that it cannot be inferred from the Bed Head Ticket that the life assured had the knowledge of the ailment and he intentionally suppressed the same while filling the form regarding state of his health. There is nothing on record to show that he had ever taken the treatment about the said ailment. The plea that the deceased was used to consume 1 to 2 litre of country liquor, since 10 to 15 years is also not acceptable. The Bed Head Ticket goes to show that the patient was brought with the history of unconsciousness for the last 20 days. The patient was in deep coma at the time of admission. The past history could not have been narrated by the patient himself in such a state of health. By whom this history was narrated is not known. In this regard the certificate of the doctor could have been obtained, who could mention about the person who had divulged the aforesaid information. The learned counsel for the Insurance Company has relied upon Panni Devi v. LIC of India [Revision Petition No. 1548/2000 (National Commission)], but the .facts of the case are different from the facts of the instant case. Firstly, the past history regarding the consumption of alcohol cannot be accepted in view of the above observations and secondly, even if it held that the deceased had been taking liquor before revival of the policy but the Form No. 680 does not require the life assured to disclose this fact while submitting the personal statement of good health. 3. Learned counsel to buttress his argument relied on the judgment of this Commission in Revision Petition No. 2050/2001 and 2051/2001 wherein the insured was admitted in the hospital on 8.6.1996 and where he breathed his last on 26.6.1996. He himself disclosed at the time of his death about his illness. This case is distinguishable because in this case insured was not in a position to make a statement about his medical history as he was brought in an unconscious state.
He himself disclosed at the time of his death about his illness. This case is distinguishable because in this case insured was not in a position to make a statement about his medical history as he was brought in an unconscious state. Further, the questionnaire given to the insured at the time of revival of the policy does not contain any question relating to the consumption of alcohol. If there was such a question and if the complainant had answered in the negative then perhaps there would have been some case to support the contention of the petitioner. 4. Therefore, the issue of suppression of material facts by the insured does not arise. The petitioner LIC’s counsel relied basically on the Bed Head Ticket wherein it is mentioned that the insured was consuming alcohol for a decade in high doses. This statement of history of the deceased was not given by the insured because insured was admitted in an unconscious state. There is no certificate to this effect by the Doctor indicating how he elucidated this information. 5. Accordingly, this record cannot be relied upon as admission of the insured that he was consuming too much alcohol for a decade. In the judgment of the Supreme Court in P.C. Chacko & Anr. v. Chairman, LIC & Ors., quoted by the learned counsel for the petitioner, the facts of the case are as follows: It now stands admitted that the insured had undergone an operation for adenoma thyroid. The particulars furnished by him while filling up the application form for obtaining the said policy were as under: (a) Did you ever any operation, accident or injury? The answer was ‘No’. (b) Have you remained absent from place of your work on ground of health during the last 5 years? To which answer was ‘No’. (c) What has been your state of health? The answer was ‘good’. The fact that the said answers were incorrect was not in dispute. The suit filed by the appellants, however, was decreed. 6. In this judgment the Hon’ble Apex Court had quoted Section 45 and its application in para 13 and 14 which are quoted below: “Section 45 postulates repudiation of such policy within a period of two years.
The fact that the said answers were incorrect was not in dispute. The suit filed by the appellants, however, was decreed. 6. In this judgment the Hon’ble Apex Court had quoted Section 45 and its application in para 13 and 14 which are quoted below: “Section 45 postulates repudiation of such policy within a period of two years. By reason of the aforementioned provision, a period of limitation of two years had, thus, been specified and on the expiry thereof the policy was not capable of being called in question, inter alia on the ground that certain facts have been suppressed which were material to disclose or that it was fraudulently been made by the policy holder or that the policy holder know at the time of making it that the statement was false. Statute, therefore, itself provides for the limitation for valid repudiation of an insurance policy. It takes into account the social security aspect of the matter. There are three conditions for application of second part of Section 45 of the Insurance Act which are: (a) the statement must be on a material matter or must suppress facts which it was material to disclose; (b) the suppression must be fraudulently made by the policy holder; and (c) the policy holder must have known at the time of making the statement that it was false or that is suppressed facts which it was material to disclose.” 7. In the P.C. Chacko’s case (supra) it was admitted that the insured that had undergone an operation for adenoma thyroid and he had answered in the negative to the question whether he had any operation while filling up the proposal form. Therefore, the facts of the P.C. Chacko’s case (supra) and the case on hand are distinguishable as they are dissimilar. Accordingly, petitioner cannot draw strength from the judgment of the Apex Court in P.C. Chaco’s case. Therefore, this revision petition is dismissed. There shall be no order as to costs. Revision petition dismissed. *******