BIRLA SUNLIFE INSURANCE COMPANY LIMITED Vs. SUNIL YADAV

JUDGEMENT

(1.) The petitioner is an insurance company and has filed the present petition impugning the award dated 21.05.2009 passed by the Insurance Ombudsman (hereinafter referred to as the 'impugned order '). By the impugned order, the claim made in respect of life insurance policy issued by the petitioner to Mamchand Yadav (hereinafter referred to as the 'policy holder ') has been allowed.

(2.) BRIEF facts of the case are that the father of the respondent - Lt. Sh. Mamchand Yadav approached the petitioner for issuance of an insurance policy under the Dream Plan Policy, on 10.08.2007, for an assured sum of Rs.10,93,834 vide application/proposal form bearing No. A7069913. After a medical examination of the policy holder, the application was accepted by the petitioner and, on 05.09.2007, a policy being No.0001157621 was issued to the policy holder. The Policy holder met with an unfortunate motor vehicle accident on 17.10.2007 and was admitted in hospital with a head injury and a leg injury. The policy holder succumbed to his injuries on 20.10.2007. After the demise of the policy holder, the respondent being the nominee under the policy, submitted a claim for the insured amount on 14.03.2008, which was received by the petitioner on 19.03.2008.

(3.) IT is contended on behalf of the petitioner that the life insurance policy issued to the policy holder was void as the policy holder had misrepresented the medical information in the application form. It is contended that the medical information provided by the policy holder was incorrect inasmuch as the policy holder has responded to the following questions in the negative: -