{"id":263636,"date":"2022-03-14T11:00:10","date_gmt":"2022-03-14T05:30:10","guid":{"rendered":"https:\/\/www.scconline.com\/blog\/?p=263636"},"modified":"2022-03-25T10:10:21","modified_gmt":"2022-03-25T04:40:21","slug":"if-a-person-conceals-facts-about-pre-existing-fatal-disease-at-the-time-of-taking-insurance-would-it-be-a-breach-of-insurance-contract","status":"publish","type":"post","link":"https:\/\/www.scconline.com\/blog\/post\/2022\/03\/14\/if-a-person-conceals-facts-about-pre-existing-fatal-disease-at-the-time-of-taking-insurance-would-it-be-a-breach-of-insurance-contract\/","title":{"rendered":"If a person conceals facts about pre-existing fatal disease at the time of taking insurance, would it be a breach of insurance contract? NCDRC explains"},"content":{"rendered":"<p style=\"text-align: justify;\"><strong>National Consumer Disputes Redressal Commission (NCDRC): <\/strong>The Coram of Dinesh Singh (Presiding Member) and Karuna Nand Bajpayee (Member) upheld the decision of the District Commission with respect to concealment of pre-existing fatal diseases at the time of taking insurance.<\/p>\n<p style=\"text-align: justify;\">A revision petition was filed challenging the State Commission\u2019s Order.<\/p>\n<p style=\"text-align: justify;\">The dispute was with respect to the repudiation of the claim on the death of the insured. The parties in the present matter are the insurance company i.e., the petitioner and nominee\/widow of the deceased insured was the respondent.<\/p>\n<p style=\"text-align: justify;\">Repudiation of the claim was on the ground of concealment of pre-existing fatal diseases at the time of taking the insurance.<\/p>\n<p style=\"text-align: justify;\"><em>Crux<\/em><\/p>\n<p style=\"text-align: justify;\">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.<\/p>\n<p style=\"text-align: justify;\">The President of District Commission 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.<\/p>\n<p style=\"text-align: justify;\">State Commission 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.<\/p>\n<p style=\"text-align: justify;\">Further, it was noted that, there was no evidence on record to show that the insured had knowledge that he was suffering from fatal diseases prior to taking the policy and there was inadequate evidence to support that he had deliberately suppressed his medical condition.<\/p>\n<p style=\"text-align: justify;\"><em>Decision of NCDRC<\/em><\/p>\n<p style=\"text-align: justify;\">Coram held that the State Commission\u2019s decision was well appraised reasoned order, and no perversity was found for interference.<\/p>\n<p style=\"text-align: justify;\">The Commission agreed with the counsel for the insurance company that suppression of material facts about pre-existing disease\/medical condition would undoubtedly be a breach of the insurance contract, which was of utmost good faith.<\/p>\n<p style=\"text-align: justify;\">In the present matter, the onus of establishing the fact that there was a deliberate suppression of material facts was on the insurance company which onus it failed to discharge by adducing the adequate evidence to substantiate such contention.<\/p>\n<p style=\"text-align: justify;\">In view of the above discussion, the petition was dismissed.<\/p>\n<p style=\"text-align: justify;\">Therefore, the award by the District Commission was upheld by the State Commission and has been confirmed. [LIC of India v. Mamta Sipani, <a href=\"http:\/\/www.scconline.com\/DocumentLink\/tLwjV8HB\"><b>2022 SCC OnLine NCDRC 41<\/b><\/a>, decided on 2-3-2022]<\/p>\n<hr \/>\n<p style=\"text-align: justify;\"><strong>Advocates before the Commission:<\/strong><\/p>\n<p style=\"text-align: justify;\">For the Petitioner: Mr. Jai Vardhan, Advocate for Ms. Harvinder Kaur, Advocate<\/p>\n<p style=\"text-align: justify;\">For the Respondent: Mr. Yashvir Singh Kadiyan, Advocate<\/p>\n","protected":false},"excerpt":{"rendered":"<p>National Consumer Disputes Redressal Commission (NCDRC): The Coram of Dinesh Singh (Presiding Member) and Karuna Nand Bajpayee (Member) upheld the decision of <\/p>\n","protected":false},"author":8808,"featured_media":199533,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[3,11],"tags":[48855,14601,2707,29785,42768,3095],"class_list":["post-263636","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-casebriefs","category-tribunals_commissions_regulatorybodies","tag-breach-of-insurance-contract","tag-consumer","tag-Insurance","tag-law","tag-legal-updates","tag-NCDRC"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v26.4 (Yoast SEO v26.4) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>If a person conceals facts about pre-existing fatal disease at the time of taking insurance, would it be a breach of insurance contract? 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Earlier, complainant who\u2026","rel":"","context":"In &quot;Case Briefs&quot;","block_context":{"text":"Case Briefs","link":"https:\/\/www.scconline.com\/blog\/post\/category\/casebriefs\/"},"img":{"alt_text":"National Consumer Disputes Redressal Commission","src":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=350%2C200&ssl=1","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=350%2C200&ssl=1 1x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=525%2C300&ssl=1 1.5x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=700%2C400&ssl=1 2x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=1050%2C600&ssl=1 3x"},"classes":[]},{"id":99271,"url":"https:\/\/www.scconline.com\/blog\/post\/2017\/01\/13\/repudiation-of-claim-by-insurance-company-on-the-ground-of-failure-of-written-intimation-of-theft-of-vehicle-held-proper\/","url_meta":{"origin":263636,"position":1},"title":"Repudiation of claim by insurance company on the ground of failure of written intimation of theft of vehicle, held proper","author":"Saba","date":"January 13, 2017","format":false,"excerpt":"National Consumer Disputes Redressal Commission (NCDRC): \u00a0NCDRC has held that failure of the insured to give immediate information of theft in writing to the insurance company would entitle the insurance company to repudiate the claim. While observing this, NCDRC upheld the repudiation of insurance claim by Reliance General Insurance Co.\u2026","rel":"","context":"In &quot;Case Briefs&quot;","block_context":{"text":"Case Briefs","link":"https:\/\/www.scconline.com\/blog\/post\/category\/casebriefs\/"},"img":{"alt_text":"National Consumer Disputes Redressal Commission","src":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=350%2C200&ssl=1","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=350%2C200&ssl=1 1x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=525%2C300&ssl=1 1.5x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=700%2C400&ssl=1 2x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=1050%2C600&ssl=1 3x"},"classes":[]},{"id":33921,"url":"https:\/\/www.scconline.com\/blog\/post\/2016\/01\/28\/repudiation-of-policy-claim-on-the-ground-of-non-disclosure-of-material-facts-declared-improper-2\/","url_meta":{"origin":263636,"position":2},"title":"Repudiation of policy claim on the ground of non-disclosure of material facts, declared improper","author":"Sucheta","date":"January 28, 2016","format":false,"excerpt":"National Consumer Disputes Redressal Commission (NCDRC):\u00a0\u201cHypertension is a common ailment and it can be controlled by medication and it is not necessary that a person suffering from hypertension would always suffer a heart attack,\u201d observed NCDRC while rendering relief to a person whose insurance cover for Bypass Surgery was repudiated\u2026","rel":"","context":"In &quot;Case Briefs&quot;","block_context":{"text":"Case Briefs","link":"https:\/\/www.scconline.com\/blog\/post\/category\/casebriefs\/"},"img":{"alt_text":"National Consumer Disputes Redressal Commission","src":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=350%2C200&ssl=1","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=350%2C200&ssl=1 1x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=525%2C300&ssl=1 1.5x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=700%2C400&ssl=1 2x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=1050%2C600&ssl=1 3x"},"classes":[]},{"id":6382,"url":"https:\/\/www.scconline.com\/blog\/post\/2015\/02\/18\/repudiation-of-claim-on-ground-that-complainant-failed-to-prove-that-cause-of-death-was-a-result-of-accidental-injuries-upheld\/","url_meta":{"origin":263636,"position":3},"title":"Repudiation of claim on ground that complainant failed to prove that cause of death was a result of accidental injuries, upheld","author":"Sucheta","date":"February 18, 2015","format":false,"excerpt":"National Consumer Disputes Redressal Commission (NCDRC): NCDRC has upheld a repudiation of claim by an insurance company on the ground that complainant failed to prove that the cause of death of the insured was the injury caused by the accident. Earlier, complainant\u2019s mother obtained insurance cover from HDFC Ergo General\u2026","rel":"","context":"In &quot;Tribunals\/Commissions\/Regulatory Bodies&quot;","block_context":{"text":"Tribunals\/Commissions\/Regulatory Bodies","link":"https:\/\/www.scconline.com\/blog\/post\/category\/casebriefs\/tribunals_commissions_regulatorybodies\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2015\/10\/scc-blog_Page_9.jpg?resize=350%2C200&ssl=1","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2015\/10\/scc-blog_Page_9.jpg?resize=350%2C200&ssl=1 1x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2015\/10\/scc-blog_Page_9.jpg?resize=525%2C300&ssl=1 1.5x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2015\/10\/scc-blog_Page_9.jpg?resize=700%2C400&ssl=1 2x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2015\/10\/scc-blog_Page_9.jpg?resize=1050%2C600&ssl=1 3x"},"classes":[]},{"id":34231,"url":"https:\/\/www.scconline.com\/blog\/post\/2016\/02\/01\/repudiation-of-claim-by-insurance-companies-on-the-ground-of-delay-in-intimation-of-theft-of-vehicles-upheld\/","url_meta":{"origin":263636,"position":4},"title":"Repudiation of claim by insurance companies on the ground of delay in intimation of theft of vehicles, upheld","author":"Sucheta","date":"February 1, 2016","format":false,"excerpt":"National Consumer Disputes Redressal Commission (NCDRC):\u00a0While observing that the theft of a vehicle is required to be reported to the insurance company immediately after the theft is detected otherwise the insurer is not liable to reimburse the insured for such a loss, NCDRC upheld the repudiation of insurance claim by\u2026","rel":"","context":"In &quot;Case Briefs&quot;","block_context":{"text":"Case Briefs","link":"https:\/\/www.scconline.com\/blog\/post\/category\/casebriefs\/"},"img":{"alt_text":"National Consumer Disputes Redressal Commission","src":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=350%2C200&ssl=1","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=350%2C200&ssl=1 1x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=525%2C300&ssl=1 1.5x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=700%2C400&ssl=1 2x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=1050%2C600&ssl=1 3x"},"classes":[]},{"id":213425,"url":"https:\/\/www.scconline.com\/blog\/post\/2019\/04\/09\/ncdrc-claim-for-insurance-not-maintainable-where-the-insured-does-not-prescribe-to-terms-of-the-insurance-policy\/","url_meta":{"origin":263636,"position":5},"title":"NCDRC | Claim for insurance not maintainable where the insured does not prescribe to the terms of insurance policy","author":"Bhumika Indulia","date":"April 9, 2019","format":false,"excerpt":"National Consumer Disputes Redressal Commission (NCDRC): Justice V.K. Jain (Presiding Member) dismissed an appeal filed by a jeweller, assailing repudiation of his claim for insurance. The complainant\/appellant obtained a Jewellers Block Policy from the respondent company for Rs 48 lakhs. During the period of the policy, some burglars entered their\u2026","rel":"","context":"In &quot;Case Briefs&quot;","block_context":{"text":"Case Briefs","link":"https:\/\/www.scconline.com\/blog\/post\/category\/casebriefs\/"},"img":{"alt_text":"National Consumer Disputes Redressal Commission","src":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=350%2C200&ssl=1","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=350%2C200&ssl=1 1x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=525%2C300&ssl=1 1.5x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=700%2C400&ssl=1 2x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2018\/08\/NCDRC_.jpg?resize=1050%2C600&ssl=1 3x"},"classes":[]}],"amp_enabled":true,"_links":{"self":[{"href":"https:\/\/www.scconline.com\/blog\/wp-json\/wp\/v2\/posts\/263636","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.scconline.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.scconline.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.scconline.com\/blog\/wp-json\/wp\/v2\/users\/8808"}],"replies":[{"embeddable":true,"href":"https:\/\/www.scconline.com\/blog\/wp-json\/wp\/v2\/comments?post=263636"}],"version-history":[{"count":0,"href":"https:\/\/www.scconline.com\/blog\/wp-json\/wp\/v2\/posts\/263636\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.scconline.com\/blog\/wp-json\/wp\/v2\/media\/199533"}],"wp:attachment":[{"href":"https:\/\/www.scconline.com\/blog\/wp-json\/wp\/v2\/media?parent=263636"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.scconline.com\/blog\/wp-json\/wp\/v2\/categories?post=263636"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.scconline.com\/blog\/wp-json\/wp\/v2\/tags?post=263636"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}