Pnb Metlife India Insurance Company Limited and Another v. Mandeep Devi and Another

o CWP-24937-2025o(O&M)ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo1oooooooooooooooooooooooooooo o INoTHEoHIGHoCOURToOFoPUNJABo&oHARYANAoATo CHANDIGARHooo ooo Sr.oNo.112oooooooooooooooooooooooooooooooooooooooooooooooooooooCWP-24937-2025o(O&M)oo oDateoofodecision:o27.08.2025oo o o PNBoMetlifeoIndiaoInsuranceoCompanyoLimitedoandoanothero o o o o o o o o ooooooooooooooooooooooo.....oPetitionersoo o VERSUSo o MandeepoDevioandoanothero oo ooooooooo oooo ooooooooooo.....oRespondentso o CORAM:oooHON'BLEoMR.oJUSTICEoGURVINDERoSINGHoGILLo HON'BLEoMR.oJUSTICEoDEEPINDERoSINGHoNALWAoo o Present:oo Ms.oJasmine,oAdvocateoforoo Mr.oSanjeevoGoyal,oAdvocate,oo forotheopetitioners.oo o *****o o DEEPINDERoSINGHoNALWA,oJ.oo o

1.o o Challengeo ino theo presento writo petitiono iso too theo impugnedo orderodatedo21.05.2025o(AnnexureoP-1)opassedobyotheoNationaloConsumero DisputesoRedressaloCommission,oNewoDelhio(hereinafteroreferredotooasotheo 'NCDRC')owhereby,otheoorderodatedo14.05.2018o(AnnexureoP-8)opassedo byotheoDistrictoConsumeroDisputesoRedressaloForum,oKarnalo(hereinaftero referredotooasotheo'DCDRF')oandoorderodatedo23.02.2024o(AnnexureoP-9)o passedobyotheoStateoConsumeroDisputesoRedressaloCommission,oHaryana,o Panchkulao (hereinaftero referredo too aso theo 'SCDRC')o haso beeno upheldo whereby,orespondent-complainantowasoheldoentitledotootheoinsuredoamounto ofoRs.14,20,000/-.oAofurtherodirectionowasoalsooissuedotootheopetitionersotoo o CWP-24937-2025o(O&M)ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo2oooooooooooooooooooooooooooo o payoanoamountotootheotuneoofoRs.5,500/-oonoaccountoofomentaloagony,o harassmentosufferedobyotheocomplainantoandolitigationoexpenses.o

2.o o Briefofactsoofotheopresentocaseoareohereunder:-o ThatoSh.oRameshwaro(sinceodeceased),ofatherooforespondent-complainanto purchasedo ao Lifeo Insuranceo Policyo No.21888607o "Meto FamilyoIncomeoProtectoPlus"oono27.4.2016oforoaosumoofoRs.14,20,000/-o fromotheopetitionersoandohadopaidoannualopremiumoofoRs.8,212/-oatoKarnalo Branch.ooRespondent-complainantowasotheonomineeoinotheosaidopolicy.ooAto theo timeo ofo issuanceo ofo insuranceo policy,o fathero (deceased/insured)o ofo respondent-complainanto waso haleo ando hearty,o buto unfortunatelyo ono

27.05.2016,otheofatherooforespondent-complainantonaturallyodiedodueotoo suddeno hearto attack.o Aftero deatho ofo theo fathero (deceased/insured)o ofo respondent-complainant,obeingonominee,osheosubmittedodeathoclaimoaftero completingoallotheonecessaryoformalities.ooo

3.o o Theopetitionersovideoletterodatedo31.12.2016,oorepudiatedotheo deathoclaimooforespondent-complainantoonotheogroundothatoherofatherowaso sufferingo fromo cancero prioro too theo issuanceo ofo theo policy.o Aggrievedo againsto theo abovesaido letter,o respondent-complainanto filedo ao complainto undero Sectiono 12o ofo theo Consumero Protectiono Act,o 1986o beforeo theo DCDRF.ooInotheocomplaint,otheocaseooforespondent-complainantowasothato ato theo timeo ofo insurance,o theo insuredo iso o examinedo byo theo empanelledo Doctoroandoonlyothen,otheoinsuranceopolicyoisoissued.oAsothereowasonoo o CWP-24937-2025o(O&M)ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo3oooooooooooooooooooooooooooo o adverseo reporto fromo theo concernedo doctoro witho regardo too theo insured,o therefore,oletterodatedo31.12.2016ovideowhich,otheoclaimooforespondent-complainantowasorepudiatedowasoillegal,oarbitrary,onulloandovoidoandoiso liableotoobeosetoaside.oItowasoalsootheocaseooforespondent-complainantothato herofatherowasonotosufferingofromotheoallegedodiseaseoi.e.ocancer,oasosuch,o thereowasoodeficiencyoinoserviceoonopartoofotheopetitioners.oo

4.o o Upononotice,otheopetitionersofiledoaowrittenostatementobeforeo theo DCDRF.o o Ito waso theo caseo ofo theo petitionerso thato theo fathero (deceased/insured)o ofo respondent-complainant,o aftero completelyo understandingo theo termso ando conditionso ofo theo insuranceo policyo hado offeredotoopayopremium.ooItowasotheocaseoofotheopetitionersothatoproposalo formo waso explainedo too fathero (deceased/insured)o ofo respondent-complainantoandoheohadogivenoaodeclarationostatingothatoheohasofurnishedo theo informationo aftero fullyo understandingo theo contentso ofo theo proposalo formoandoafterounderstandingotheotermsoandoconditionsoofotheopolicy/plan,o heoappliedoforotheosame.ooItowasoalsootheocaseoofotheopetitionersothatofathero (deceased/insured)o ofo respondent-complainanto hado appliedo foro theo policy/planoafteromakingotrueoandoaccurateodisclosureoofoallotheofactsoando hadonotowithheldoanyonecessaryoinformation.ooFurther,ouponoreceiptoofotheo dulyofilledoupoproposaloformoandobelievingotheoinformationoprovidedobyo theo fathero (deceased/insured)o ofo respondent-complainant,o aso true,o theo petitionerso evaluatedo ando processedo theo proposalo formo ando issuedo theo policyo ono 27.04.2016o too theo fathero (deceased/insured)o ofo respondent-o CWP-24937-2025o(O&M)ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo4oooooooooooooooooooooooooooo o complainant.o Ito waso alsoo theo caseo ofo theo petitionerso thato ifo anyo untrueo statementowasocontainedoinotheoproposaloform,otheopolicyocontractoshallobeo nullo ando voido ando theo moneyo whicho waso paido byo theo fathero (deceased/insured)o ofo respondent-complainanto shallo stando forfeitedo too PNBoMetoLifeoIndiaoInsuranceoCompanyoLimited.ooItowasoalsootheocaseoofo theo petitionerso thato aso ito waso ano earlyo claim,o aso theo fathero (deceased/insured)o ofo respondent-complainanto hado diedo withino ao shorto spanoofoonlyo30odays,othereoisoaoprocedureotoocarryooutoanoinvestigationotoo settleotheoclaim.oDuringotheocourseoofoinvestigationoandoassessmentoofotheo claim,oasoperotheopetitioners,oitowasorevealedothatofathero(deceased/insured)o oforespondent-complainantodidonotoprovideotrueoandocorrectoinformationoino regardo too medicalo historyo whileo fillingo upo hiso proposalo formo datedo

26.04.2016.ooItowasorevealedothatofathero(deceased/insured)ooforespondent-complainantowasosufferingofromocanceropriorotootheoissuanceoofotheopolicy.oo Thus,o theo petitionerso haso rightlyo repudiatedo theo claimo ofo respondent-complainanto video lettero datedo 31.12.2016o ono theo groundo thato falseo informationoasotootheomaterialofactsowithorespectotoomedicalohistoryowaso furnishedobyotheofathero(deceased/insured)ooforespondent-complainantoato theotimeoofofillingoupoofoproposaloform.oIfomaterialofactowasodisclosedobyo theo fathero (deceased/insured)o ofo respondent-complainant,o dueo policyo wouldonotohaveobeenoissuedoonoexistingotermsoandoasosuch,othereoisonoo deficiencyoinoserviceoonotheopartoofotheopetitionersoandotheocomplaintofiledo byorespondent-complainantowasoliableotoobeodismissed.oo o CWP-24937-2025o(O&M)ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo5oooooooooooooooooooooooooooo o

5.o o Ono considerationo ofo theo evidenceo ledo byo theo respectiveo parties,o theo DCDRF,o Karnalo video ordero datedo 14.05.2018o allowedo theo complainto filedo byo respondent-complainanto witho ao directiono too theo petitionersotoopayosumoofoRs.14,20,000/-otoorespondent-complainant,owitho aofurtherodirectionotoopayoanoamountotootheotuneoofoRs.5,500/-oonoaccounto ofo mentalo agony,o harassmento sufferedo byo hero ando foro theo litigationo expenses.oTheoabovesaidoorderowasotoobeocompliedowithinoaoperiodoofo30o daysofromotheodateooforeceiptoofocopyoofotheoorder.oRelevantoextractoofo orderodatedo14.05.2018oisoreproducedobelow:-o "Fromo theo pleadings,o evidenceo ando submissionso ofo theo parties,o ito iso clearo thato theo claimo ofo theo complainanto haso beeno repudiatedobyotheoOPsovideoletterodatedo31.12.2016oEx.R10owhicho runsoasounder:-o Subject:-oclaimounderopolicyoNo.21888507oonotheolifeoofolateo Mr.oRameshwaro "Thisoisowithoreferenceotootheoclaimomadeounderotheoaboveo mentionedopolicyoonotheolifeoofoLateoMr.oRameshwar.o Weohaveoreviewedoandoevaluatedotheoclaimoandowishotoobringo tooyouroattention,othatoduringotheocourseooforeviewingotheoclaim,oweo haveo receivedo medicalo recordso whicho Indicateo thato Lateo Mr.o Rameshwaro waso sufferingo fromo Cancero prioro too policyo issuance.o However,o theo concernedo questiono ino theo applicationo formo datedo

26.04.2016,oseekingoinsuranceocoverounderothisopolicyowasoansweredo aso"NO"obyoLateoMr.oRameshwar.oo Weowishotoostateothatotheoaboveomentionedofactowasoaomaterialo facto foro theo purposeso ofo underwritingo ofo theo risko ando thato ifo thiso materialofactowasodisclosedotoousoinotheoapplicationoform,oweowouldo notohaveoissuedotheopolicyoonoexistingoterms.oAsoyouomayobeoaware,o Insuranceo contractso areo basedo ono theo principleo ofo "utmosto goodo o CWP-24937-2025o(O&M)ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo6oooooooooooooooooooooooooooo o faith"oandotheopoliciesoareoissuedobasedoonotheorepresentationsomadeo inotheoapplicationoformoandoanyonon-disclosureooromisrepresentationo ino theo applicationo form,o whicho areo materialo foro theo purposeso ofo underwritingotheorisk,orendersotheocontractovoidableoatotheooptionoofo theoinsurer.o Therefore,othroughothisoletter,oweoregretotooInformoyouothatoweo areo unableo too admito liabilityo foro theo aboveo claimo dueo too non-disclosureoofomaterialofacts,oasohighlightedohereinoabove,oasoperotheo termsoandoconditionsoofotheoinsuranceopolicy."oo

8.oFromotheorepudiationoletteroitoisoclearothatotheorepudiationo hasobeenomadeoonotheogroundoofonon-disclosureoofomaterialofactso regardingopre-existingodiseaseoasotheoOPsoallegedothatotheoDLAowaso sufferingofromocanceropriorotootheoissuanceoofotheopolicy,otherefore,o theoonusotooproveothatotheoDLAowasosufferingofromoCanceropriorotoo theo issuanceo ofo theo policyo waso upono theo OPs.o Theo OPso haveo producedoinotheiroevidenceodocumentsoEx.R1otooEx.R10.oandoaffidavito Ex.RW1/A.oItoisopertinentotoomentionohereothatotheomatterowasogoto investedobyotheoOPsofromoInvestigatoroi.e.oSAoAssociates.oTheoreporto ofo theo investigatoro iso Ex.R7.o Theo investigatoro haso specificallyo mentionedo ino hiso reporto thato weo wereo noto providedo anyo medicalo paperofromotheonomineeoandotheohospital.oTheoinvestigatorohasonoto attachedowithohisoreportoEx.R7oanyomedicalorecordoregardingotheo treatmentoofotheoDLAovideowhichoitocanobeoprovedothatotheoDLAowaso sufferingofromoCancer,owhatotoosaidothatotheoDLAowasosufferingofromo Cancero prioro too theo policy.o Theo OPso haveo noto placedo anyo othero evidenceoonotheofile,ofromowhichoitocanobeosaidothatotheoDLAowaso sufferingofromoCanceropriorotootakingotheopolicy.oo

9.oTheocomplainantohasoproducedotheotwooauthoritieso(i)otheo copyo ofo theo decisiono datedo 26.08.2011o ofo theo Hon'bleo Supremeo Courto ofo Indiao ino Civilo appealo no.7437o ofo 2011o (Arisingo outo ofo Specialo Leaveo Petition,o (c)o no.35382o ofo 2010o titledo aso P.Vankato Naiduo Versuso Brancho Manager,o Lifeo Insuranceo Corporationo ofo India,oKurnooloandoAnotherowhereinoitohasobeenoheldothatosinceotheo respondentsohadocomeooutowithotheocaseothatotheodeceasedodidonoto o CWP-24937-2025o(O&M)ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo7oooooooooooooooooooooooooooo o discloseo correcto factso relatingo too hiso illness,o ito waso foro themo too produceocogentoevidenceotooproveotheoallegation.oHowever,oasofoundo byotheoDistrictoForumoandotheoStateoCommission,otheorespondentso didonotoproduceoanyotangibleoevidenceotooproveothatotheodeceasedo hadowithheldoInformationoaboutohisohospitalizationoandotreatment.o Therefore,otheoNationaloCommissionowasonotojustifiedoinointerferingo withotheoconcurrentofindingorecordedobyotheoDistrictoForumoandotheo StateoCommissionobyoaskingoaowildoguessworkothatotheodeceasedohado suppressedotheofactsorelatingotoohisoillness.oInotheoresult,otheoappealoiso allowed.o

10.oTheootheroauthorityoisotheocopyoofoorderodatedo17.08.2016o passedo byo Hon'bleo Stateo Commissiono Haryanao ino o firsto appealo no.528o ofo 2016o titledo aso Lifeo Insuranceo Corporationo ofo Indiao VersusoSarojinioandoanotherowhichoisoalsooonotheosameofooting.oBotho theseoauthoritiesoareofullyoapplicableotootheofactsoofotheopresentocase.o So,o ino viewo ofo theo aforesaido authoritieso aso wello aso theo factso ando circumstancesoofotheocase,oweoareoofotheoconsideredoviewothatotheo OPsohaveofailedotooproveothatotheocomplainant,owasosufferingofromo cancero prioro too issuanceo ofo theo policy,o therefore,o theo OPso haveo committedoaomistakeoinorepudiatingotheoclaimoofotheocomplainant.o Hence,o theo OPso areo deficiento ino providingo serviceso too theo complainant."o o

6.o o AoperusaloofotheoorderopassedobyotheoDCDRFowouldoshowo thato takingo intoo considerationo theo reporto ofo theo investigatoro datedo

14.12.2016o (Ex.R7),o ito waso heldo thato noo evidenceo waso ledo byo theo petitionerso too showo thato fathero (deceased/insured)o ofo respondent-complainantowasosufferingofromoallegedodiseaseoi.e.ocancer.oo

7.o o Aggrievedoagainstotheoorderodatedo14.05.2018opassedobyotheo DCDRF,oKarnal,otheopetitionersofiledoanoappealobeforeotheoSCDRC.oo o CWP-24937-2025o(O&M)ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo8oooooooooooooooooooooooooooo o

8.o o Ito waso theo caseo ofo theo petitionerso beforeo theo SCDRCo thato fathero (deceased/insured)o ofo respondent-complainanto hado concealedo theo materialo facto witho regardo too hiso previouso medicalo historyo ofo beingo sufferingofromocanceropriorotootheoissuanceoofotheopolicyoinoquestion.oAso such,o theo claimo submittedo byo respondent-complainant,o whoo waso theo nomineeoofotheodeceasedounderotheopolicy,owasorightlyorepudiated.oItowaso theocaseoofotheopetitionersothatotheoDCDRFohadonotoappreciatedotheofactsoino righto perspectiveo ando haso ignoredo theo investigator'so reporto datedo

14.12.2016o (Ex.R7).o Theo appealo waso alsoo dismissedo video ordero datedo

23.02.2024.oTheorelevantoextractoofotheoorderoisoreproducedobelow:-o "9. Learnedocounseloforotheoappellantsohasourgedothatothereo wasoactiveoconcealmentoofomaterialofactsobyodeceased-lifeoassuredo Rameshwaro witho regardo too hiso previouso medicalo historyo ofo beingo sufferingofromocancer,opriorotooissuanceoofopolicyoinoquestion.oItoiso urgedo thato claimo ofo complainant,o whoo waso nomineeo ofo deceasedo undero policyo haso beeno rightlyo repudiated.o Learnedo Districto Consumero Commissiono haso noto appreciatedo thiso facto ino righto perspectiveoandohenceoimpugnedoorderodatedo14.05.2018odoesonoto carryo anyo credence.o Ito iso urgedo thato learnedo Districto Consumero Commissiono haso illegallyo ignoredo theo investigatoro reporto datedo

14.10.2016-Ex.R-7.o

10.o Refutingo theseo contentionso learnedo counselo foro theo complainant/respondento haso supportedo impugnedo ordero datedo

14.05.2018o passedo byo learnedo Districto Consumero Commissiono byo urgingo thato ito iso outcomeo ofo propero appreciationo ofo factso ando evidenceobyoitoandosameodoesonotowarrantoanyointerference.o

11.o Admittedly,o Rameshwaro waso deceased-lifeo assuredo whoo hado obtainedo policyo No.o 21888607o fromo OPso witho risko commencemento dateo fromo 27.04.2016.o Admittedly,o complainant-o CWP-24937-2025o(O&M)ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo9oooooooooooooooooooooooooooo o daughteroofodeceased/life-assuredowasohisonomineeounderopolicy.oAso peropleaoofocomplainant;odeceasedolifeoassuredohadosufferedonaturalo deathoono27.05.2016odueotoosuddenoheartoattackoandocomplainant,oino herocapacityoofonominee,osubmittedodeathoclaimounderopolicyotooOPs.o SoleogroundotoojustifyorepudiationoofodeathoclaimobyoOPsoisothat:o deceasedolifeoassuredohadopassedomedicalohistoryoofobeingosufferingo fromocancer,opriorotooissuanceoofopolicyoinoquestion,oinohisoname.oIno proposaloform,oheohadonotoindicatedoanythingowithoregardotoohisopasto medicalohistory.oo

12.oLawoonoexclusionoofoinsurerofromopolicyoisonoomoreoreso integra.oItois,obyonowowellosettledolegalopropositionothatoifoinsurero invokesoexclusionofromopolicy;othenoito(insurer)oaloneohasotooleado specifico positiveo evidenceo ino ordero too establisho itso exclusion.o Reliance,oinothisoregardocanobeoplacedouponoratiooofolawolaidodowno byoHon'bleoApexoCourtoino caseo ofoNationaloInsuranceoCompanyo Limitedo Vs.o Vedico Resortso ando Hotelso Pvt.o Ltd.o ino Civilo Appealo No.4979oofo2019odecidedoono17.05.2023:owhereinoitohasobeenoheldo thato"Itoisotriteotoosayothatowhereverosuchoanoexclusionaryoclauseoiso containedoinoaopolicy,oitowouldobeoforotheoinsurerotooshowothatotheo caseofallsowithinotheopurviewoofosuchoclause"oo

13.oTooomuchoofoemphasisoinopresentoappeal,ohasobeenolaidobyo insurer/appellantsoonoinvestigatororeportodatedo14.12.2016o-Ex.oR-7.o Even,o thiso reporto willo noto sub-serveo anyo majestico causeo ofo insurer/appellantsotoosailothemooutofromoconsequencesoflowingofromo policyoissuedobyoitoinofavoroofoRameshwaro(deceased-lifeoassured).o Materialoaspectoofothisoreportoreadsoasounder:-o "Vicinityo Survey:o Weo dido strongo vicinityo surveyo ando meto severalopersonsowithoutoaskingotheironameoandocontactonumberoforo wantoofovitaloclue.oTheyoallostatedothatoLAodiedodueotoothroatocancer.o Alloknowsohimoveryowell.oo PGI,oRohtak-o Weovisitedohospitaloandometo MRDoin-chargeo andoaskedohimotootraceorecordowhetherothereoisoentryoinotheonameoofo LA.oWeovisitedohospitaloandometoMRDoin-chargeoandoaskedotootraceo o CWP-24937-2025o(O&M)ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo10oooooooooooooooooooooooooooo o recordowhetherothereoisoentryoinotheonameoofoLAobutowithoutoIPDo numberoheoshowedousoinabilityotracingorecordoofoanyopatient.oo Doctorsoofovillage,oo Dr.oRajesh-9050234681-oBalbehra,oo Dr.oJeela-09813063305-oBalbehra,oo Weo meto aboveo mentionedo doctorso ando askedo abouto LAo whetherotheyotreatedoLAobeforeoinoanyomanner.oTheyostatedothatotheyo doonotoknowoLAoandoneverotreatedohimobeforeoinoanyomanner".oo

14.oInvestigator'soreport-Ex.oR-7oalsooreflectsothat:ointerviewso wereotakenofromoneighbours/friends/workmatesoandotheirostatementso wereorecorded.oInothisoprocess,oasoperothisoreportoEx.R-7odeceasedo sufferedo fromo throato cancero ando tooko treatmento from-PGI-Chandigarh.oHeosufferedooperationoofothroatoino2014.oHowever,oasoito isoclearofrom.oglancingoatothisoreportoEx.R-7othat:oneitheroanyorecordo fromo PGI-Rohtako concerningo treatmento ofo deceasedo lifeo assuredo couldobeosecured,onoroanyorecordofromoPGI-Chandigarhoregardingo throatocancerotreatmentoofodeceasedolifeoassuredocouldobeosecured.o Hado theo investigatoro beeno apprisedo byo neighbourers/friendso ando workmatesothatodeceasedoobtainedotreatmentoofothroatocancerofromo PGI-Chandigarhoandohadooperationoofothroatoinoyearo2014,othenoato least,oitowasoexpectedofromoinvestigatorotoomakeoanoeffortotoolayohiso hando ono aboveo qualityo medicalo recordo fromo PGI-Chandigarho concerningolifeoassured,obutoheofailedoinothatoarena.oMucholessothano thatotwoodoctorsoofovillageoofodeceasedolifeoassuredohadorevealedotoo investigatoro thato theyo nevero treatedo deceasedo lifeo assuredo ino anyo manneroandothereoisonoospecificoreferenceoofoperson(s),obyohis/theiro name,o addresso etc.o whoo revealedo too investigatoro thato lifeo assuredo diedodueotoothroatocancer.oCollectively,oInvestigatororeportoEx.R-7oiso unambiguouso ando uncertaino witho regardo allegedo pasto historyo ofo deceasedo lifeo assuredo beingo ao cancero patient,o prioro too obtainingo policyo fromo OPs/appellants.o Thiso beingo so,o ito iso establishedo ando provedo thato insurer/appellantso hado noto ledo anyo cogento ando convincingoevidenceoinoorderotooproveoitsopleadedocaseothatodeceasedo lifeoassuredohasopastomedicalohistoryoofobeingoaopatientoofocancer.o o CWP-24937-2025o(O&M)ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo11oooooooooooooooooooooooooooo o Hon'bleoApexoCourtoinocaseotitledoasoP.oVankatoNaiduoVs.oBrancho Manager,oLIC,oKurnooloandoanotheroinoCiviloAppealoNo.7437oofo 2011odecidedoono26.08.2011ohasoheld:-o "sinceotheorespondentsohadocomeooutowithotheocaseothatotheo deceasedodidonotodiscloseocorrectofactsorelatingotoohisoillness,oitowaso foro themo too produceo cogento evidenceo too proveo theo allegation.oo However,oasofoundobyotheoDistrictoForumoandotheoStateoCommission,o theorespondentsodidonotoproduceoanyotangibleoevidenceotooproveothato theodeceasedohadowithheldoinformationoaboutohisohospitalizationoando treatment.ooTherefore,otheoNationaloCommissionowasonotojustifiedoino interferingo witho theo concurrento findingo recordedo byo theo Districto ForumoandotheoStateoCommissionobyoaskingoaowildoguessworkothato theodeceasedohadosuppressedotheofactsorelatingotoohisoillness.ooInotheo result,otheoappealoisoallowed.ooooo o

15.o Ino opiniono ofo thiso Commission,o aboveo citedo judgmentso squarelyocoverothisocaseoandoonoapplyingotheoratioolaidodownotoothiso case,otheoonlyoinescapableoconclusionoisothatoappellants/insurerohaveo failedotooproveoitsocaseowithoregardotooitsoexclusionsofromopolicy.oItoiso establishedo thato appellantso cannoto avoido theiro liabilityo too payo theo insuredo amounto ofo Rs.o 14,20,000/o too complainanto (nomineeo ofo deceased-lifeo assured)o undero policy.o Directiono too payo amounto ofo Rs.5500/-otoocomplainantoalsoodoesonotowarrantoanyointerference.o LearnedoDistrictoConsumeroCommissionohasometiculouslyoanalyzedo allo relevanto facetso ofo controversyo ando haso rightlyo non-suitedo insurer/appellantso througho ordero datedo 14.05.2018.o Thereo iso noo fallacyoinotheoapproachoofolearnedoDistrictoConsumeroCommission.o Impugnedo ordero datedo 14.05.2018o iso upheld,o maintainedo ando affirmed.oPresentoappealobeingodevoidoofomeritsoisoherebyodismissed.oooo o

9.o o Ao perusalo ofo theo ordero datedo 23.02.2024o passedo byo theo SCDRCowouldoshowothatotheoSCDRCohasoheldothatoifotheoinsureroinvokeso exclusionofromotheopolicyoinothatocase,otheoinsureroaloneohasotooleadotheo o CWP-24937-2025o(O&M)ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo12oooooooooooooooooooooooooooo o specificopositiveoevidenceoinoorderotooestablishoitsoexclusion.ooItowasoheldo thatoasonoocogentoandoconvincingoevidenceowasoledobyotheopetitionersotoo proveo thato fathero (deceased/insured)o ofo respondent-complainanto waso sufferingofromocancerobeforeodueoissuanceoofotheopolicy.ooAsosuch,othereo wasonooillegality,oandoinfirmityoinotheoorderopassedobyotheoDCDRF.oo

10.o o Aggrievedoagainstotheoorderodatedo23.02.2024opassedobyotheo SCDRC,otheopetitionersofiledoanoappealobeforeotheoNCDRC.ooTheosaido appealowasoalsoodismissedobyotheoNCDRCovideoorderodatedo21.05.2025.oo Ao perusalo ofo theo ordero passedo byo NCDRCo wouldo showo thato theo investigator'so reporto datedo 14.12.2016o (Ex.R7)o waso dulyo takeno intoo consideration,oasothereowasonoorecordsotraceableowithoregardotootheoallegedo ailmento i.e.o cancero ofo fathero (deceased/insured)o ofo respondent-complainant,oasosuch,onooerrorooroperversityowasofoundoinotheoorderopassedo byotheoDCDRF.oRelevantoextractoofotheoorderopassedobyotheoNCDRCoiso reproducedobelow:-oo "Theo Stateo Commissionorecordedo findingso ino paragraphso 13oando14oandodismissedotheoappeal.oParagraphso13oando14oofotheo orderoareoextractedohereunder:o "13.oTooomuchoofoemphasisoinopresentoappeal,ohasobeenolaido byo insurer/appellantso ono investigatoro reporto datedo 14.12.2016-Ex.R-7.oEven,othisoreportowillonotosub-serveoanyomajesticocauseoofo insurer/appellantso too sailo themo outo fromo consequenceso flowingo fromo policyo issuedo byo ito ino favoro ofo Rameshwaro (deceased-lifeo assured).oMaterialoaspectoofothisoreportoreadsoasounder:-o "VicinityoSurvey:oWeodidostrongovicinityosurveyoandometo severalopersonsowithoutoaskingotheironameoandocontactonumberoforo o CWP-24937-2025o(O&M)ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo13oooooooooooooooooooooooooooo o wanto ofo vitalo clue.o Theyo allo statedo thato LAo diedo dueo too throato cancer.oAlloknowsohimoveryowell.oo PGI,oRohtak-oWeovisitedohospitaloandometoMRDoin-chargeo andoaskedohimotootraceorecordowhetherothereoisoentryoinotheonameo ofoLA.oWeovisitedohospitaloandometoMRDoin-chargeoandoaskedotoo traceorecordowhetherothereoisoentryoinotheonameoofoLAobutowithouto IPDonumberoheoshowedousoinabilityotracingorecordoofoanyopatient.o Doctorsoofovillageo Dr.oRajesh-9050234681-Balbehraoo Dr.oJeela-09813063305-Balbehrao Weo meto aboveo mentionedo doctorso ando askedo abouto LAo whetherotheyotreatedoLAobeforeoinoanyomanner.oTheyostatedothato theyo doo noto knowo LAo ando nevero treatedo himo beforeo ino anyo manner."o

14.o Investigator'so report-Ex.o R-7o alsoo reflectso that:o interviewsowereotakenofromoneighbours/ofriends/oworkmatesoando theirostatementsowereorecorded.oInothisoprocess,oasoperothisoreporto Ex.oR-7odeceasedosufferedofromothroatocanceroandotookotreatmento fromoPGI-Chandigarh.oHeosufferedooperationoofothroatoino2014.o However,oasoitoisoclearofromoglancingoatothisoreportoEx.R-7othat:o neithero anyo recordo fromo PGI-Rohtako concerningo treatmento ofo deceasedolifeoassuredocould-beosecured,onoroanyorecordofromoPGI-Chandigarhoregardingothroatocancerotreatmentoofodeceasedolifeo assuredocouldobeosecured.oHadotheoinvestigatorobeenoapprisedobyo neighbourers/friendso ando workmateso thato deceasedo obtainedo treatmento ofo throato cancero fromo PGI-Chandigarho ando hado operationoofothroatoinoyearo2014,othenoatoleast,oitowasoexpectedo fromo investigatoro too makeo ano efforto too layo hiso hando ono aboveo qualityo medicalo recordo fromo PGI-Chandigarho concerningo lifeo assured,o buto heo failedo ino thato arena.o Mucho lesso thano thato twoo doctorso ofo villageo ofo deceasedo lifeo assuredo hado revealedo too investigatorothatotheyoneverotreatedodeceasedolifeoassuredoinoanyo mannero ando thereo iso noo specifico referenceo ofo person(s),o byo o CWP-24937-2025o(O&M)ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo14oooooooooooooooooooooooooooo o his/theironame,oaddressoetc.owhoorevealedotooinvestigatorothatolifeo assuredo diedo dueo too throato cancer.o Collectively,o Investigatoro reportoEx.R-7oisounambiguousoandouncertainowithoregardoallegedo pastohistoryoofodeceasedolifeoassuredobeingoaocanceropatient,oprioro too obtainingo policyo fromo OPs/appellants.o Thiso beingo so,o ito iso establishedoandoprovedothatoinsurer/appellantsohadonotoledoanyo cogentoandoconvincingoevidenceoinoorderotooproveoitsopleadedocaseo thato deceasedo lifeo assuredo hasopasto medicalo historyo ofo beingo ao patientoofocancer.oHon'bleoApexoCourtoinocaseotitledoasoP.oVankato NaiduoVs.oBranchoManager,oLIC,oKurnooloandoanotheroinoCivilo AppealoNo.o7437oofo2011odecidedoono26.08.2011ohasoheld:-o "sinceotheorespondentsohadocomeooutowithotheocaseothatotheo deceasedodidonotodiscloseocorrectofactsorelatingotoohisoillness,oito wasoforothemotooproduceocogentoevidenceotooproveotheoallegations.o However,o aso foundo byo theo Districto Forumo ando theo Stateo Commission,o theo respondentso dido noto produceo anyo tangibleo evidenceo too proveo thato theo deceasedo hado withheldo informationo aboutohisohospitalizationoandotreatment.oTherefore,otheoNationalo Commissionowasonotojustifiedoinointerferingowithotheoconcurrento findingorecordedobyotheoDistrictoForumoandotheoStateoCommissiono byoaskingoaowildoguessworkothatotheodeceasedohadosuppressedotheo factsorelatingotoohisoillness.oInotheoresult,otheoappealoisoallowed."o Whatoweofindoisothatonoomaterialowasoplacedoeitherobeforeo theo Districto Commissiono oro beforeo theo Stateo Commissiono too supportotheorecitaloofoanyomedicalorecordsoavailableotooestablisho theopreviousoailmentoofotheoInsuredoasoallegedobyotheoInsuranceo Company.oWhenotheoInsuranceoCompanyohasotakenoaostandoonotheo basisoofoitsoInvestigator'soreportotoorepudiateotheoclaimothenotheo burdenoliesoonotheoInsuranceoCompanyotooproveoitotootheohilt.o Theoissueoofodischargeoofoburdenoofoproofohasobeenoveryo recentlyodealtowithobyotheoApexoCourtoinotheocaseoofoMahakalio Sujathao Vs.o Brancho Manager,o Futureo Generalio Indiao Lifeo Insuranceo Co.o Ltd.o &o ANR.,o (2024)o 8o SCCo 712,o ando theno o CWP-24937-2025o(O&M)ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo15oooooooooooooooooooooooooooo o subsequentlyo ino theo caseo ofo Mahaveero Sharmao Vs.o Exideo Lifeo Insuranceo Co.o Ltd.o ando Anr.o 2025o SCCo OnLineo SCo 435.o Ao perusalo ofo theo saido judgmentso wouldo alsoo indicateo thato ifo theo InsuranceoCompanyohasoreliedoonosomeomaterial,othenotheoonuso layoonothemotoodischargeotheoburdenoofoproof.o Weo haveo onceo againo reado theo Investigator'so reporto aso extractedoinoparagraph-13oofotheoStateoCommission'soorderoando quotedohereinabove.oItoisoevidentothatonoorecordsowereotraceableo witho regardo too theo allegedo ailmento and,o aso notedo above,o theo Insuranceo Companyo dido noto eveno fileo theo affidavito ofo theo Investigatoro regardingo theo saido allegation.o Thus,o thereo waso ao completeoabsenceoofoanyoproofoofopastoailmentoasoallegedobyotheo InsuranceoCompanyoandothereforeoweodoonotofindoanyoerrorooro perversityoinotheofindingsorecordedobyotheoDistrictoCommissionooro theoStateoCommissionoonothisocount.o Inotheoexerciseooforevisionalojurisdiction,oweodoonotofindoanyo suchomaterialoirregularityooroillegalityosooasotoointerfereowithotheo aforesaidofindingsoofofactoinotheoabsenceoofoanyosuchoevidence.oAso aomatteroofofact,othereoisonoosuchomaterialoplacedoevenobeforeothiso Commissionotootakeoaoviewotootheocontrary.o Learnedo counselo foro theo Insuranceo Companyo urgedo thato beforeotheoStateoCommissionotheyohadomovedoanoapplicationoforo summoningoofotheorecordofromotheoPGI.oItoisosubmittedothatotheo StateoCommissionofailedotooexerciseoitsodiscretionotherebyocausingo prejudiceo too theo petitioners/Insuranceo Companyo whoo hado alsoo unableotooacquireotheoinformationofromotheohospitaloinospiteoofo havingomovedoanoRTIoapplication.oTheoStateoCommissionoisonoto supposedotoopermitotheofillingoupoofoanyolacunaoorotoogenerateoanyo evidenceoforotheobenefitoofotheoInsuranceoCompanyowhereoitodoeso notoexist.oTheoInvestigator'soreportothereforeodidonotoinspireoanyo confidenceoasotheoInvestigatorohimselfohadonotofiledoanyoaffidavito indicatingoasotoohowoheohadomadeoanoattemptotooobtainotheorecordo fromo theo hospital.o Theo Insuranceo Companyo thereforeo waso o CWP-24937-2025o(O&M)ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo16oooooooooooooooooooooooooooo o completelyolackingothisoobligationotooproveotheocaseoofotheoallegedo suppressiono ofo pasto ailmento ando ino sucho circumstanceso theo argumentoraisedoonobehalfoofotheoInsuranceoCompanyocannotobeo countenanced.oo Theorevisionopetitionohasonoomeritsoandoforoallotheoreasonso giveno hereinaboveo theo revisiono petitiono iso dismissed.o Pendingo application,oifoany,oalsoostandsodisposedoof."oooooo o

11.o o Aggrievedoagainstotheoorderodatedo21.05.2025opassedobyotheo NCDRC,otheopetitionersohaveofiledotheopresentowritopetition.ooo

12.o o Learnedocounseloappearingoonobehalfoofotheopetitionersohaso arguedothatoasothereowasoanoactiveoconcealmentoofomaterialofactobyotheo fathero (deceased/insured)oofo respondent-complainanto witho regardo too hiso previousomedicalohistoryoofobeingosufferingofromocanceropriorotooissuanceo ofo theo policyo ino question,o aso such,o theo actiono ofo theo petitionerso ino repudiatingotheodeathoclaimooforespondent-complainantovideoletterodatedo

31.12.2016o(AnnexureoP5)owasolegaloandovalid.ooNoootheroargumentohaso beenoraised.oo

13.o o Weohaveoheardotheolearnedocounseloappearingoonobehalfoofotheo petitionersoandogoneothroughotheodocumentsoavailableoonotheorecord.oo

14.o o Aoperusaloofotheofactsoofotheocaseowouldoshowothatotheodeatho claimoasoclaimedobyorespondent-complainantowasorepudiatedovideolettero datedo 31.12.2016o ono theo groundo thato theo falseo informationo aso too theo materialofactsowithorespectotoomedicalohistoryoofofathero(deceased/insured)o ofo respondent-complainanto waso concealedo ato theo timeo ofo fillingo upo ofo o CWP-24937-2025o(O&M)ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo17oooooooooooooooooooooooooooo o proposalo form.o Relevanto extracto ofo theo lettero datedo 31.12.2016o iso reproducedobelow:-o "Subject:-oClaimounderopolicyoNo.21888607oonotheolifeoofo LateoMr.oRameshwaro "Thisoisowithoreferenceotootheoclaimomadeounderotheoaboveo mentionedopolicyoonotheolifeoofoLateoMr.oRameshwar.o Weohaveoreviewedoandoevaluatedotheoclaimoandowishotoobringo tooyouroattention,othatoduringotheocourseooforeviewingotheoclaim,oweo haveo receivedo medicalo recordso whicho indicateo thato Lateo Mr.o Rameshwaro waso sufferingo fromo Cancero prioro too policyo issuance.o However,o theo concernedo questiono ino theo applicationo formo datedo

26.04.2016,oseekingoinsuranceocoverounderothisopolicyowasoansweredo aso"NO"obyoLateoMr.oRameshwar.oo Weowishotoostateothatotheoaboveomentionedofactowasoaomaterialo facto foro theo purposeso ofo underwritingo ofo theo risko ando thato ifo thiso materialofactowasodisclosedotoousoin,otheoapplicationoform,oweowouldo notohaveoissuedotheopolicyoatoall.oAsoyouomayobeoaware,oInsuranceo contractsoareobasedoonotheoprincipleoofo"utmostogoodofaith"oandotheo policieso areo issuedo basedo ono theo representationso madeo ino theo applicationoformoandoanyonon-disclosureooromisrepresentationoinotheo applicationo form,o whicho areo materialo foro theo purposeso ofo underwritingotheorisk,orendersotheocontractovoidableoatotheooptionoofo theoinsurer.o Therefore,othroughothisoletter,oweoregretotooinformoyouothatoweo areo unableo too admito liabilityo foro theo aboveo claimo dueo too non-disclosureoofomaterialofacts,oasohighlightedohereinoabove,oasoperotheo termsoandoconditionsoofotheoInsuranceopolicy."oo o

15.oo o Aoperusaloofotheoletterodatedo31.12.2016owouldoshowothatoaso perotheopetitioners,oifotheomaterialofactowasodisclosedotootheopetitionersoino regardotooallegedodiseaseobeingosufferedobyofathero(deceased/insured)oofo o CWP-24937-2025o(O&M)ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo18oooooooooooooooooooooooooooo o respondent-complainanto beforeo issuanceo ofo insuranceo policy/plan,o theo insuranceopolicyowouldohaveonotobeenoissuedoonotheoexistingotermsoando conditionsoandoanyonon-disclosureooromisrepresentationoinotheoapplicationo form,o whicho wereo materialo foro theo purposeo ofo underwritingo theo risk,o renderedo theo contracto voidable.o Investigator'so reporto datedo 14.12.2016o (Ex.R7)owasotakenointooconsiderationowhileorepudiatingotheoclaimoofotheo respondent-complainant.oItoisoaowellosettledolawothatoifoinsureroinvokeso exclusiono fromo policy,o theno insurero aloneohaso too leado specificopositiveo evidenceoinoorderotooestablishoitsoexclusion.oAoperusaloofotheoinvestigator'so reportodatedo14.12.2016o(Ex.R7)owouldoalsooshowothatoinformationowaso takenofromotheoneighbourers,ofriendsoandoworkmatesoandotheirostatementso wereoalsoorecorded.ooAsoperotheoinformation,ofathero(deceased/insured)oofo respondent-complainanto sufferedo fromo cancero ando tooko treatmento fromo PGI,oChandigarhoandoPGI,oRohtak.oo

16.o o Aoperusaloofotheoinvestigator'soreportowouldoalsoorevealothato thereo waso noo evidenceo too proveo thato fathero (deceased/insured)o ofo respondent-complainantowasosufferingofromotheoallegedoailmentoi.e.ocancero beforeoissuanceoofoinsuranceopolicy/plan.ooThereowereonoohospitalorecordso availableooroanyodoctor'soprescriptionothatopre-dateotheoinsuranceopolicyoino ordero too proveo thato theo fathero (deceased/insured)o ofo respondent-complainantowasosufferingofromocancer.oInotheoabsenceoofoanyoevidenceo ledo byo theo petitionerso too proveo thato fathero (deceased/insured)o ofo respondent-complainantowasosufferingofromocancer,oitocannotobeoheldothato o CWP-24937-2025o(O&M)ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo19oooooooooooooooooooooooooooo o theo fathero ofo respondent-complainanto waso sufferingo fromo theo allegedo ailmento ofo cancerobeforeo issuanceo ofo insuranceopolicy/plan.o o Ito iso wello settledolawothatoaoperson/insuredomayobeoentitledotooclaimoprovidedothato thereoisonooevidenceotooproveodirectolinkobetweenotheodiseaseoandotheocauseo ofodeath.ooAoperusaloofotheocaseowouldoshowothatonooevidenceowasoledobyo theopetitionersotooproveothatothereowasoaolinkoofoallegedodiseaseowhicholedo toodeathoofofathero(deceased/insured)oofotheorespondent-complainantoo

17.o o TheoHon'bleoSupremeoCourtoinoMahakalioSujataoVs.oTheo Brancho Manager,o Futureo Generalio Indiao Lifeo Insuranceo Companyo Limitedoandoanother,o2024o(2)oRCRo(Civil)o554,oohasocategoricallyoheldo thatoitoisoforotheoinsurerotooproveobeforeotheoCourtothatotheoinsuredohado suppressedotheoinformationoaboutotheopreviousopoliciesooroanyomaterialo fact.ooTherefore,oburdenoofoproofohasotoobeodulyodischargedobyotheoinsurer.oo Theorelevantoextractsoareoreproducedoherein:-o "41.oAtothisostage,oweomayoalsoodilateoonotheoaspectoofoburdeno ofoproof.oThoughotheoproceedingsobeforeotheoConsumeroForaoareoino theonatureoofoaosummaryoproceeding.oYetotheoelementaryoprincipleso ofoburdenoofoproofoandoonusoofoproofowouldoapply.oThisoisorelevanto foro theo reasono thato noo corroborativeo evidenceo too whato haso beeno deposedoinotheoaffidavitoisoletoinobyotheoinsuranceocompanyoinoordero too establisho ao valido repudiationo ofo theo claimo ino theo instanto case.oSectiono 101oofo theo Evidenceo Act,o 1872o stateso thato whoevero desiresoanyoCourtotoogiveojudgmentoasotooanyolegalorightooroliabilityo dependentoonotheoexistenceoofofactsowhichoheoasserts,omustoproveothato thoseofactsoexist.oWhenoaopersonoisoboundotooproveotheoexistenceoofo anyofact,oitoisosaidothatotheoburdenoofoproofoliesoonothatoperson.oThiso Sectionoclearlyostatesothatotheoburdenoofoprovingoaofactorestsoonotheo o CWP-24937-2025o(O&M)ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo20oooooooooooooooooooooooooooo o partyowhoosubstantiallyoassertsotheoaffirmativeoofotheoissueoandonoto uponotheopartyowhoodeniesoit;oforoaonegativeoisousuallyoincapableoofo proof.oSimplyoput,oitoisoeasierotooproveoanoaffirmativeothanoaonegative.o Inootherowords,otheoburdenoofoprovingoaofactoalwaysoliesouponotheo personowhooassertsotheosame.oUntilosuchoburdenoisodischarged,otheo otheropartyoisonotorequiredotoobeocalledouponotooproveohisocase.oTheo courtohasotooexamineoasotoowhetherotheopersonouponowhomoburdeno liesohasobeenoableotoodischargeohisoburden.oFurther,othingsowhichoareo admittedoneedonotobeoproved.oWhetherotheoburdenoofoproofohasobeeno dischargedobyoaopartyotootheolisooronotowouldodependouponotheofactso andocircumstancesoofotheocase.oTheopartyoonowhomotheoburdenolieso haso too stando ono hiso owno ando heo cannoto takeo advantageo ofo theo weaknessooroomissionsoofotheooppositeoparty.oThus,otheoburdenoofo provingoaoclaimoorodefenceoisoonotheopartyowhooassertsoit.o

42.oSectiono 102oofo theo Evidenceo Act,o 1872o provideso ao testo regardingoonowhomotheoburdenoofoproofowouldolie,onamely,othatotheo burdenoliesoonotheopersonowhoowouldofailoifonooevidenceowereogiveno ono eithero side.o Whenevero theo lawo placeso ao burdeno ofo proofo upono aoparty,oaopresumptionooperatesoagainstoit.oHence,oburdenoofoproofo ando presumptionso haveo too beo consideredo together.o Thereo areo howeveroexceptionsotootheogeneraloruleoasotootheoburdenoofoproofoaso enunciatedoinoSectionso101oando102oofotheoEvidenceoAct,o1872,oi.e.,o ino theo contexto ofo theo burdeno ofo adducingo evidence:o (i)o wheno ao rebuttableopresumptionoofolawoexistsoinofavouroofoaoparty,otheoonusoiso onotheootherosideotoorebutoit;o(ii)owhenoanyofactoisoespeciallyowithino theoknowledgeoofo anyoperson,otheoburdenoofoprovingo itoisoonohimo (Sectiono106).oInosomeocases,otheoburdenoofoproofoisocastobyostatuteo onoparticularopartieso(Sectionso103oando105).oo

43.oThereoisoanoessentialodistinctionobetweenoburdenoofoproofo andoonusoofoproof;oburdenoofoproofoliesouponoaopersonowhoohasotoo proveotheofactoandowhichoneveroshiftsobutoonusoofoproofoshifts.oSuchoao shiftingo ofo onuso iso ao continuouso processo ino theo evaluationo ofo evidence.oForoinstance,oinoaosuitoforopossessionobasedoonotheotitle,o onceo theo plaintiffo haso beeno ableo too createo ao higho degreeo ofo o CWP-24937-2025o(O&M)ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo21oooooooooooooooooooooooooooo o probabilityo soo aso too shifto theo onuso ono theo defendant,o ito iso foro theo defendanto too dischargeo hiso onuso ando ino theo absenceo thereof,o theo burdeno ofoproofolyingoonotheoplaintiffo shallobeoheldotoohaveobeeno dischargedo soo aso too amounto too proofo ofo theo plaintiff'so titleo videoRVEoVenkatachalao Goundero vs.o Arulmiguo Viswesaraswamio andoVPoTemple,o(2003)o8oSCCo752.o

44.oIno ao claimo againsto theo insuranceo companyo foro compensation,owhereotheoappellantsoinotheosaidocaseohadodischargedo theoinitialoburdenoregardingodestruction,odamageoofotheoshowroomo andotheostocksothereinobyofireoandoriotoinosupportoofotheoclaimoundero theoinsuranceopolicy,oitowasoforotheoinsuranceocompanyotoodisproveo suchoclaimowithoevidence,oifoany,ovideoShobikaoAttireovs.oNewoIndiao AssuranceoCo.oLtd.,o(2006)o8oSCCo35.o

45.oSectiono 103oofo theo Evidenceo Act,o 1872o stateso thato theo burdenoofoproofoasotooanyoparticularofactoliesoonothatopersonowhoo wishesotheoCourtotoobelieveoinoitsoexistence,ounlessoitoisoprovidedobyo anyolawothatotheoproofoofothatofactoshallolieoonoanyoparticularoperson.o Thiso Sectiono enlargeso theo scopeo ofo theo generalo ruleo inoSectiono 101othato theo burdeno ofo proofo lieso ono theo persono whoo assertso theo affirmativeoofotheoissue.oFurther,oSectiono104oofotheosaidoActostateso thatotheoburdenoofoprovingoanyofactonecessaryotoobeoprovedoinoordero tooenableoanyopersonotoogiveoevidenceoofoanyootherofactoisoonotheo personowhoowishesotoogiveosuchoevidence.oTheoimportoofothisoSectiono isothatotheopersonowhooisolegallyoentitledotoogiveoevidenceohasotheo burdenotoorenderosuchoevidence.oInootherowords,oitoisoincumbentoono eachopartyotoodischargeotheoburdenoofoproof,owhichorestsouponohim.o Inotheocontextoofoinsuranceocontracts,otheoburdenoisoonotheoinsurerotoo proveotheoallegationoofonon-disclosureoofoaomaterialofactoandothatotheo non-disclosureowasofraudulent.oThus,otheoburdenoofoprovingotheofact,o whichoexcludesotheoliabilityoofotheoinsurerotoopayocompensation,olieso onotheoinsureroaloneoandonoooneoelse.o

46.oSectiono 106oofotheoEvidenceoAct,o1872ostatesothatowheno anyofactoisoespeciallyowithinotheoknowledgeoofoanyoperson,otheoburdeno ofoprovingothatofactoisouponohim.oThisoSectionoappliesoonlyotoopartieso o CWP-24937-2025o(O&M)ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo22oooooooooooooooooooooooooooo o tootheosuitooroproceeding.oItocannotoapplyowhenotheofactoisosuchoasotoo beocapableoofobeingoknownoalsoobyopersonsootherothanotheoparties.o (Source:o Sarkar,o Lawo ofo Evidence,o 20tho Edition,o Volume-2,o LexisNexis).o

47.oInolightoofotheoaforesaidodiscussionoonoburdenoofoproof,oito haso too beo analysedo ifo theo respondento ino theo presento caseo haso adequatelyo dischargedo hiso burdeno ofo proofo abouto theo facto ofo suppressionoofopreviousolifeoinsuranceopoliciesoofotheoinsured.oo

48.o Theo respondento insuranceo companyo haso producedo noo documentaryo evidenceo whatsoevero beforeo theo Districto Forumo too proveoitsoallegationothatotheoinsuredohadotakenomultipleoinsuranceo policiesofromodifferentocompaniesoandohadosuppressedotheosame.oTheo Districto Forumo hado thereforeo concludedo thato thereo waso noo documentaryo evidenceo too showo thato theo deceased-lifeo insuredo hado takeno variouso insuranceo policieso excepto ano avermento ando ono thato basiso theo repudiationo waso heldo too beo wrong.o Beforeo theo Stateo Commission,o theo respondento hado providedo ao tabulationo ofo theo 15o differento policieso takeno byo theo insured-deceased,o amountingo too Rs.71,27,702/-.oTheosameohasobeenoextractedoabove.oHowever,otheo saido tabulationo waso noto supportedo byo anyo othero documentaryo evidence,o likeo theo policyo documentso ofo theseo othero policies,o oro pleadingso ino courts,o oro sucho othero corroborativeo evidence.o Theo respondentosoughtotoomarkoaobunchoofodocumentsobeforeotheoStateo Commission,owhichorelatedotootheopolicyopapersoofotheoinsuredowitho anotheroinsurer,oi.e.,oKotakoLifeoInsurance.oHowever,otheorespondento wasonotograntedopermissionobyotheoStateoCommission,oasotheosaido documentsowereo neitherooriginal,onorocertified,onoroauthenticated.o Apartofromothis,othereowasonooeffortomadeobyotheorespondentotoobringo anyoauthenticatedomaterialoonorecord.oThus,oinotheoabsenceoofoanyo evidenceo too proveo thato theo insured-deceasedo possessedo someo insuranceo policieso fromo othero insuranceo companies,o theo Stateo Commissiono upheldo theo decisiono ofo theo Districto Forumo ino settingo asideotheorepudiationoofotheoclaimobyotheorespondent.o o CWP-24937-2025o(O&M)ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo23oooooooooooooooooooooooooooo o

49.oBeforeotheoNCDRC,otheorespondentoagainoprovidedotheo aforesaido tabulationo ofo policieso ofo theo insured-deceased.o Theo respondentsoinotheiroaffidavitostatedothatotheoinsured-deceasedohado takenomultipleoinsuranceopoliciesobeforeotakingotheopolicyofromothem.o Theo NCDRCo howevero acceptedo theo avermento ofo theo respondents,o withoutodemandingocorroborativeodocumentaryoevidenceoinosupporto ofotheosaidofact.oTheoNCDRC,oonotheocontrary,oalsooheldothatotheofacto aboutomultipleopoliciesowasonotodealtowithobyotheoappellantoinohero complaintooroevidenceoaffidavitoandothisothereforeoprovedothatotheo insuredohadoindeedotakenotheopoliciesofromomultipleocompaniesoaso claimedobyotheorespondents.o

50.oTheoaforesaidoapproachoadoptedobyotheoNCDRCois,oinoouro view,onotocorrect.oTheocardinaloprincipleoofoburdenoofoproofoinotheo lawo ofo evidenceo iso thato "heo whoo assertso musto prove",o whicho meansothatoifotheorespondentsohereinohadoassertedothatotheoinsuredo hadoalreadyotakenofifteenomoreopolicies,othenoitowasoincumbentoono themo too proveo thiso facto byo leadingo necessaryo evidence.o Theo onuso cannoto beo shiftedo ono theo appellanto too dealo witho issueso thato haveo merelyo beeno allegedo byo theo respondents,o withouto producingo anyo evidenceotoosupportothatoallegation.oTheorespondentso haveomerelyo providedoaotabulationoofoinformationoaboutotheootheropoliciesoheldobyo theo insured-deceased.o Theo saido tabulationo alsoo haso missingo informationowithorespectotoopolicyonumbersoandoissuingodatesoando bearsodifferentodatesoofobirths.oFurther,othisoinformationohasn'tobeeno supportedo witho anyo othero documentso too proveo theo avermento ino accordanceowitholaw.oNooofficeroofoanyootheroinsuranceocompanyo wasoexaminedotoocorroborateotheotableoofopoliciesosaidotoohaveobeeno takenobyotheodeceasedopolicyoholder,ofatheroofotheoappellantoherein.o Moreover,otheotableoproducedoisoincompleteoandocontradictoryoasofaro asotheodateoofobirthoofotheoinsuredoisoconcerned.oTherefore,oinoouro view,otheoNCDRCocouldonotohaveoreliedouponotheosaidotabulationoando putotheoonusoonotheoappellantotoodealowithothatoissueoinoherocomplainto andotherebyoconsideredotheosaidoavermentoasoprovedooroproceededotoo proveotheostanceoofotheooppositeoparty.oAofactohasotoobeodulyoprovedo o CWP-24937-2025o(O&M)ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo24oooooooooooooooooooooooooooo o asoperotheoEvidenceoAct,o1872oandotheoburdenotooproveoaofactorestso uponotheopersonoassertingosuchoaofact.oWithoutoadequateoevidenceotoo proveotheofactoofopreviousopolicies,oitowasoincorrectotooexpectotheo appellantotoodealowithotheosaidofactoherselfoinotheocomplaintoorotheo evidenceoaffidavit,osinceoasoperotheoappellant,othereodidonotoexistoanyo previousopolicyoandothus,otheoonusocouldn'tohaveobeenoputoonotheo appellantotooproveowhatowasonon-existentoaccordingotootheoappellant.o

51.oTheorespondents,ovideotheirocounteroaffidavitobeforeothiso court,ohaveosoughtotooproduceosomeodocumentsotoosubstantiateotheiro claimoofootheroexistingoinsuranceopoliciesoofotheoinsured-odeceased,o butotheosameocannotobeopermittedotoobeoexhibitedoatothisostage,othato too,oinoanoappealofiledobyotheocomplainantowhooisotheobeneficiaryo underotheopoliciesoinoquestion.oAnyodocumentaryoevidenceosoughtotoo beoreliedouponobyotheorespondentooughtotoohaveobeenoledobeforeotheo DistrictoForumobutotheosameowasonotodone.oItowasobeforeotheoDistricto Forumothatotheoevidenceowasoledoandoexaminedoandoatothatostage,otheo respondento dido noto takeo adequateo stepso too leado anyo oralo oro documentaryo evidenceo too proveo theiro assertion.o Theiro attempto too annexo documentso ino supporto ofo theiroclaimo beforeo theo Stateo Commissiono waso alsoo declinedo dueo too theo presentationo ofo unauthenticatedo documents.o Therefore,o ito cano beo safelyo concludedo thatotheorespondentsohaveofailedotooadequatelyoproveotheofactothatotheo insured-deceasedohadofraudulentlyosuppressedotheoinformationoabouto theoexistingopoliciesowithootheroinsuranceocompaniesowhileoenteringo intoo theo insuranceo contractso witho theo respondentso hereino ino theo presentocase.oTherefore,otheorepudiationoofotheopolicyowasowithouto anyobasisoorojustification."o ooo

18.o o AoHighoCourtowhileoexercisingoitsopoweroofojudicialoreviewo againstotheoorderopassedobyotheoNCDRC,oexercisesoaolimitedorevisionalo jurisdictiono ando interfereo onlyo ino theo caseso where,o thereo iso ano erroro o CWP-24937-2025o(O&M)ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo25oooooooooooooooooooooooooooo o apparentoinolawoorothereoisoanoillegality,oimproprietyooroperversityoinotheo impugnedoorder.oo

19.o o SinceonoodefectoinotheoorderopassedobyotheoNCDRCohasobeeno pointedooutoduringotheocourseoofoargumentsoandothereoisonooevidenceotoo holdothatotheoordersosuffersofromoanyoillegality,oimproprietyooroperversityo oroincorrectoappreciationoofotheoevidenceobroughtoonorecord,oweofindothato thereoareonoosufficientogroundsoexistingoinotheopresentowritopetitionotoocallo foroanyointerferenceoinotheoorderodatedo21.05.2025o(AnnexureoP-1)oopassedo byo theo NCDRC,o ordero datedo 23.02.2024o (Annexureo P-9)o passedo byo SCDRCoandoorderodatedo14.05.2018o(AnnexureoP-8)opassedobyoDCDRF.oo Accordingly,otheopresentowritopetitionoisodismissedoinolimine.ooo o o Pendingo miscellaneouso application(s),o ifo any,o alsoo stand(s)o disposedoof.ooo o oooooooo(GURVINDERoSINGHoGILL)ooooo(DEEPINDERoSINGHoNALWA)o o oooooooooooooooooJUDGEooooooooooooooooooooooooooooooooooooooooooooJUDGEo o o

27.08.2025ooo RamandeepoSinghoooooo o o o Whetherospeakingo/oreasonedo o o o o ooYesoo o WhetheroReportableooo o o o ooooooooooooo oooYesoo