ORIENTAL INSURANCE COMPANY LTD. versus MUNIMAHESH PATEL

Citation: [2006] SUPP. 6 S.C.R. 30 · Decided: 12-09-2006 · Supreme Court of India · Bench: ARIJIT PASAYAT · Disposal: Appeal(s) allowed

Judgment (excerpt)

-' 
A 
ORIENTAL INSURANCE COMPANY LTD. 
v. 
MUNIMAHESHPATEL 
SEPTEMBER 12, 2006 
B 
[ARIJIT PASA YAT AND LOKESHWAR SINGH PANT A, JJ.] 
Insurance: 
Insurance policy-Death of insured-Claim refused by Insurance 
C Company on the ground of false statem7nt-Complaint before State Consumer 
Disputes Redressal Commission-Held, as complainant raised dispute about 
genuineness of documents produced by Insurance Company, and the factual 
position was required to be established by documents, matter should be 
examined by appropriate court of law and not by the Commission. 
D 
Proceedings before-Consumer Disputes Redressal Commission--Held, 
are essentially summary in nature--Adj:1dication of issues which involve 
disputed factual questions should be examined by appropriate court of law 
and not by the Commission. 
, E 
Wife of the complainant-respondent obtained a Jana ta Personal Accident 
Policy for a sum of Rs.5 lakhs. She fell into a well and died. The respondent 
claimed payment, but when the claim was not settled by the Insurance 
Company, the respondent filed a complaint before the State Consumer 
disputes Redressal Commission which dismissed the complaint leaving the 
complainant to take appropriate proceedings for establishing his claim in a 
F court of competent jurisdiction. The complainant filed an appeal before the 
National Consumer Disputes Redressal Commission, which allowed the claim. 
Aggrieved, the Insurance Company filed the present appeal. 
It was contended for the appellant that the complainant was not entitled 
G to any relief as he was guilty of making false statement in the proposal form. 
It was submitted that in a copy of the proposal form it was mentioned that 
respondent's wife, the insured, was a teacher, whereas in the actual copy of 
another form it was mentioned that she was a housewife. 
Allowing the appeal, the Court 
H 
30 
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' 
ORIENTALINSURANCECOMPANYLTD. v. MUNIMAHESHPATEL[PASAYAT,J.) 3 J 
HELD: Proceedings before the Commission are essentially summary A 
in nature and adjudication of issues which involve disputed factual questions 
should not be adjudicated. Complainant raised dispute about genuineness of 
the documents (i.e. proposal forms) produced by the appellant. The factual 
position was required to be established by documents. Commission was 
required to examine whether in view of the1disputed facts it would exercise B 
the jurisdiction. The Commission having accepted that there was wrong 
declaration of the nature of occupation of the person insured, should not have 
granted the relief in the manner done. The State Commission was right in 
its view that the complex factual position requires that the matter should be 
examined by an appropriate Court of Law and not by the Commission. 
[33-8-F) C 
CIVIL APPELLATE JURISDICTION : Civil Appeal No. 490 I of2006. 
~· 
From the Judgment and Order 19.5.2004 of the National Consumer 
Disputes Redressal Commissions, New Delhi in F.A. No. 82 of 2002. 
Vishnu Mehra and B.K. Satija for the Appellant. 
Sandeep S. Tiwari, Yogendra Kumar Dwivedi and D.N. Mishra for the 
Respondent. 
The Judgment of the Court was delivered by 
ARIJIT PASA Y AT, J. Leave granted. 
D 
E 
Appellant calls in question legality of the judgment rendered by the 
National Consumer Disputes Redressal Commission, New Delhi (in short the 
'Commission'). The Commission upset the order of the State Commission and F 
held that the appellant was liable to pay to the respondent (hereinafter 
referred to as the 'complainant') a sum of Rs.5 lakhs together with interest 
@ 6% p.a. from the date of the complaint. 
Factual position in a nutshell is essentially as follows: 
Smt. Lalitha Devi Patel wife of the complainant had obtained a Janata 
Personal Accident Policy for a sum of Rs.5 lakhs in August, 1998, for which 
a premium was paid and accepted and the policy was issued. The insured died 
on account of an accident by way of falling into a well and drowning. FIR 
G 
was lodged, autopsy was performed and appellant was informed. Various 
documents were also furnished claiming payment in spite of the policy. When H 
32 
SUPREME COURT REPORTS [2006] SUPP. 6 S.C.R. 
A the appellant-Company did not settle the claim, a complaint came to be filed 
before the Madhya Pradesh State Consumer Redressal Commission, Bhopal 
(in short 'the State Commission') alleging deficiency in service on the part of 
the appellant. State Commission after hearing the parties dismissed the 
complaint leaving the c

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