THE BRANCH MANAGER vs SMT.VIRUPAMA

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HC-KAR
NC: 2026:KHC:60514-DB
WP No. 32029 of 2025

CNR: KAHC010688762025




IN THE HIGH COURT OF KARNATAKA AT BENGALURU


TH
DATED THIS THE 30 DAY OF OCTOBER, 2026

PRESENT

THE HON'BLE MR. JUSTICE JAYANT BANERJI

AND

THE HON'BLE MRS. JUSTICE N.V.BHAVANI

WRIT PETITION NO.32029 OF 2025 (GM-CON)


BETWEEN:

THE BRANCH MANAGER
BAJAJ ALLIANZ LIFE INSURANCE CO. LTD.,
II ND FLOOR, AKSHAYA COMMERCIAL COMPLEX,
NO 26 VICTORIA ROAD,
BANGALORE – 560 047.

REPRESENTED BY ITS
AUTHORISED OFFICER
MR. M. ARAVINDA.
…PETITIONER






(BY SRI. JAGADISH J.R, ADVOCATE)

AND:

Digitally signed
by YASHODA K
L
Location: HIGH
COURT OF
KARNATAKA
SMT. VIRUPAMA
W/O. LATE DODDAPPA,
AGED ABOUT 44 YEARS,
OCC HOUSE HOLD,
R/O. SUGURESHWAR SAW MILL,
NEAR APMC, BAPPUR ROAD,
SINDHANOOR, RAICHUR DIST,
KARNATAKA – 584 128
…RESPONDENT

THIS WP IS FILED UNDER ARTICLE 226 AND 227 OF THE
CONSTITUTION OF INDIA PRAYING TO ISSUE A WRIT IN THE
NATURE OF CERTIORARI AND QUASH THE FINAL ORDER
DATED 17/01/2025 PASSED IN FIRST APPEAL NO.24/2011, BY
THE HONBLE NATIONAL CONSUMER DISPUTES REDRESSAL

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CNR: KAHC010688762025



COMMISSION WHICH IS PRODUCED AS ANNEXURE-A AND
CONFIRM THE FINAL ORDER DATED 11/11/2010 PASSED IN
COMPLAINT NO.115/2008, BY THE HONBLE KARNATAKA STATE
CONSUMER DISPUTES REDRESSAL COMMISSION, BENGALURU,
WHICH IS PRODUCED AS ANNEXURE-B AND ETC.,

THIS PETITION, COMING ON FOR PRELIMINARY
HEARING, THIS DAY, ORDER WAS MADE THEREIN AS UNDER:

CORAM: HON'BLE MR. JUSTICE JAYANT BANERJI
AND
HON'BLE MRS. JUSTICE N.V.BHAVANI
ORAL ORDER
(PER: HON'BLE MRS. JUSTICE N.V.BHAVANI)
This petition is filed assailing the order dated
17.01.2025 passed by the National Consumer Disputes
1
Redressal Commission in First Appeal No.24/2011 and for
confirming the final order dated 11.11.2010 passed by the
Karnataka State Consumer Disputes Redressal
2
Commission , Bangalore, in Complaint No.115/2008.

2. The parties are referred to as per their ranking
before the State Commission.


1
‘National Commission’
2
‘State Commission’

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3. The facts in a nutshell are that the
complainant’s husband (life insured) was hale and healthy
and was a businessman by profession and owning sawmill
at Sindhanoor, Raichur District. He was an Income Tax
Assessee by holding Pan Card No.ADQPD4800J. The said
Life Assured by knowing about the Opposite Party’s policy
in the market by name UNIT GAIN (regular plan), he
submitted a proposal form No.4638560 on 24.02.2006, for
an assured sum of Rs.30,00,000/- by opting for payment
of Rs.50,000/- as annual premium and the same was paid
through Cheque No.236360 dated 25.02.2006.

4. After the receipt of said proposal form, the
Opposite Party has faxed 3 letters to the life insured
through his agent for undergoing various medical
examination through their panel doctor H.S.Totad.
Accordingly, life insured underwent various medical
st rd th
examination on 21 , 23 and 24 of March 2006.
Thereafter, the said doctor submitted his medical

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examination report to the Opposite Party. Apart from this,
Opposite Party got fulfilled other requirements from life
insured and he offered policy for sum assured for
Rs.26,00,000/- by issuing premium receipt on 27.04.2006
by accepting the proposal form on 24.02.2006 and sent
the policy to the life assured on 13.05.2006.

5. It is stated that in the first week of August
2006, the life assured got admitted to Rajeev Gandhi
Super Specialty Hospital and inspite of best treatment, he
died on 15.08.2006 due to Cardio Respiratory Failure. The
death intimation was intimated by submitting claim form
to the Opposite Party by the complainant, but the Opposite
Party illegally repudiated the claim of the complainant
through its letter dated 04.12.2006, on the alleged ground
of non-discloser of material facts. In that letter dated
04.12.2006 the complainant wrote to the Opposite Party’s
Claim Review Committee for reconsidering her claim,
which went in vain. Being aggrieved by the rejection of

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CNR: KAHC010688762025



the claim, the complainant filed the complaint before the
State Commission in Complaint No.115/2008.

6. It is further stated that the State Commission
by its order dated 11.11.2010, dismissed the complaint.
Being aggrieved by the said order, the Complainant
approached the National Dispute Redressal Commission,
New Delhi, by filing First Appeal No.24/2011 and the said
appeal came to be allowed vide order dated 17.01.2025.

7. Being aggrieved by the said order dated
17.01.2025, the Opposite Party has preferred this writ
petition.

8. Heard the arguments of learned counsel for the
petitioner.

The sole submission of learned counsel for the
9.
petitioner is that the State Commission had considered the
complaint filed by the respondent and had dismissed the
complaint holding that there was no deficiency in service

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on part of the petitioner/opposite party in repudiating the
claim made by the complainant. It was observed that the
complainant had suppressed the disease, which he had
before obtaining the policy.

10. It is further stated that once the aforesaid
finding was recorded by the State Commission, the
National Commission ought not to have reversed the
finding and that too relying upon an opinion of another
doctor, which ran contrary to the opinion of the doctor of
the petitioner’s Insurance Company. His contention is that
the matter, since it required taking of evidence, the
complainant ought to have been relegated to the Civil
Court by filing a civil suit instead of proceeding to
adjudicate the appeal by the National Commission. No
other submission has been advanced.

REASONING :
11. First and foremost, we would like to answer the
contention of the learned counsel for the

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petitioner/Opposite Party that the complainant ought to
have been relegated to the Civil Court by filing the civil
suit instead of adjudicating the appeal before the National
Commission. In the instant case, admittedly, the Opposite
Party has issued the insurance policy after being fully
satisfied with medical examination of the insured and
therefore, repudiation of claim of the complainant by citing
non-disclosure of pre-existing diseases amounts to
deficiency of service as described under Section 2(1)(g) of
the Consumer Protection Act, 1986. The Consumer Forum
has the jurisdiction to examine whether there was
suppression of material facts and repudiation of claim was
in accordance with the policy or not. Thus, mere assertion
by the Opposite Party/ Insurance Company that there was
suppression of pre-existing diseases, does not oust the
jurisdiction of the Consumer Forum under the Consumer
Protection Act, 1986. Therefore, the contention of the
learned counsel for the petitioner that the Consumer Court
did not have the jurisdiction to entertain the complaint and

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the National Consumer forum ought to have referred the
matter to Civil Court, is unsustainable in the eye of law.

12. Secondly, in regard to the contention of the
learned counsel for the petitioner/Opposite Party that
there was no deficiency in the service on the part of the
petitioner/Opposite Party in repudiating the claim made by
the respondent/complainant is concerned, we would like to
refer to the findings of the National Commission based on
the medical report at paragraph Nos.8 to 11, which are
extracted hereunder:

8. The Medical Superintendent of ABV Institute of Medical
Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi
vide letter dated 01.07.2024 submitted the report of Dr.
P.K.Gupta Professor of Medicine and Dr. S. Murthy also a
professor of medicine of the said institute which is
extracted hereinunder:

“This is context to
Subject Virupamma Vs Branch Manager, Bajaj Allianz
life insurance company Ltd. first appeal no 24/2011,
receipt no-137716/2023/D&D-section, Dairy no- 381.
dated 29/05/2024.

It is to note that the same file was send to HoD
Medicine by Addl. MS Office of Professor M K Jha on
23/12/2023 file no. MKJ-423, received and send to
department of microbiology on 18/12/2023, file no.
HoD Medicine-995. The report and answer to the
query has been given by committee comprising of
HoD Medicine Professor Dr MPS Chawla and Dr
Shalini Malhotra (Consultant Microbiology) and the

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report was send back to office of HoD Medicine vide file
no. micro-56 on 30/12/2023 and that report is attached
along with.

Presently the committee comprising of Dr (Prof)
Pulin Kumar Gupta & Dr (Prof) S. Murthy are of
the opinion that .

1. The available documents of hospital are not
adequate to tell about since how long the patient
was HIV positive and what was the drug treatment
he was on.

2. Tridot being negative on 23/03/2006 and later
positive on 10/08/2006 can happen only if
patient acquired this infection during the period
between (23/03 till 10/08) or very rarely during
window period (1 day 1 month before the first
Tridot test on 23/03/2006).

3. Records of HIV/ART treatment should be procured
from Karnataka State AIDS Society.

Sd/-
Dr. Pulin Kumar Gupta
Professor, Medicine
ABVIMS, Dr. RML Hospital
New Delhi-110001

Sd/-
Dr. S.Murthy
Professor, Medicine
ABVIMS, Dr. RML Hospital
New Delhi-110001”


9. The said report is based on the report of another committee
as mentioned above comprising of the Head of the
department of medicine, Professor M.P.S Chawla and Dr.
Shalini Malhotra (Consultant Microbiology). The said report of
Dr. Chawla and Dr. Malhotra is extracted hereinunder:

"REPORT
Reference order dated 1.11.2023 delivered by the
National Consumer Disputes Redressal Commission
under CPA, 2019 regarding appeal NO.24/2011 against
the order dated 11th November 2010 in complaint
no.115/2008 of State Commission Karnataka. All
attached documents including the blood report dated

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23.03.2006 have been examined by the expert team at
RML Hospital and a report regarding the same is given
below:

In our Country, HIV testing guidelines are formulated
by GOI/NACO-National AIDS Control Organization
which keeps updating its guidelines from time to time
and hence all inferences will be based with
reference to these guidelines .

• First point is pertaining to the opinion expressed by
Dr. H.S. Totad in his examination dated 17.09.2009
whereby there is a mention of window period which
means the period between contracting the
infection & development of antibodies in blood of
a person and test result may show negative
report....( page 62 of the document received by RML
hospital from National consumer court). As per NACO
operational guidelines for integrated counselling and
testing centers for HIV July 2007 pg. no 17.(Annexure
1), Window period represents the period of time
between the initial HIV infection and the time
when HIV antibodies can be detected in blood (6-
12 weeks). A blood test performed during window
period may yield a negative test result for HIV
antibodies. These cases may require further
testing after 12 weeks . Thus the opinion expressed
by examining Doctor in his cross examination on
17.09.2009 has factually depicted the status of
blood examination report dated 23.03.2006.

• Second point is regarding the pathological test being
conducted as per protocol .......It is hereby indicated
that the protocols for the test in question i.e. HIV
testing are issued by NACO as already indicated earlier
and as per NACO guidelines for HIV testing March 2007
document. pg 39-40 (Annexure2) and pg. 37 of
Annexure 3, detection of anti HIV antibodies is
mainstay of testing and diagnosis of HIV. Tests to
detect specific HIV antibodies can be classified into:
Screening test (ELISA/EIA and Rapid test) and
supplemental test (ELISA/EIA and Rapid and
western blot). Supplemental test are performed
only on serum samples found reactive in
screening test for purpose of diagnosis of a person.
So in this case TRIDOT test was performed which
is a rapid test . A variety of rapid test are available
and NACO recommends use of rapid HIV test kits in an
ICTC (integrated Counselling and Testing Centre) which

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provide result in 30 min of test. The use of rapid test
which detects more than equal to 99.5% of all
HIV infected individuals and gives false positive
results in less than equal to 2% of all those who
are tested are recommended for use . (Annexure 1)

• A client who has negative result in one test is
declared to be HIV negative. So the pathological test
performed here was TRIDOT test which is a rapid
test and if it can be ascertained that it sufficed to
required sensitivity of more than equal to 99.5%
and specificity of more than equal to 98%, as per
requirements of first test kit by NACO document on
national testing, guidelines July 2015 page 38
(Annexure 3), then the test carried out was as per
protocol in an asymptomatic person. So this
information needs to be provided still .

• Third point with regard to matters which may emerge
in respect of such blood examination report, the
governing body to formulate these guidelines is NACO
and they may address this issue to consider inclusion of
certain more sensitive tests like nucleic acid based tests
for screening of insurance clients so as to cover
diagnosis of HIV during the window period
notwithstanding the fact that these tests also
become positive only after 7 to 14 days of
acquiring infection .”


10. A perusal of the said report therefore leaves no room for
doubt that the infection came to be detected later on
10.08.2006 and the negative test dated 23.03.2006 was in
accordance with the protocol as discussed in the report. It
was a Tri-dot test which is an accepted form of rapid test.


11. Thus, there was no knowledge to either the Complainant or
even to the Insurance Co. about the HIV infection and there
was no reason to apprehend the same when the report
conducted by the medical panel of the Insurance Co. itself
had found the Tri-Dot test to be negative.

13. The above finding of the National Commission
clearly demonstrates that it relied on the report conducted
by the medical panel of insurance company of the insured

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resulting in Tri-dot Test being negative on 23.03.2006 and
the expert opinion of the Head of Department of Medicine
that the Tri-dot Test is an accepted form of detecting the
symptom of HIV positive. On that basis, the National
Commission came to the conclusion that neither the
complainant nor the insurance company had any
knowledge about the HIV infection to the insured and
there is no reason to disbelieve the report of the insurance
company. Thus, the contention of the learned counsel for
the petitioner/Opposite Party that the National
Commission has relied upon the opinion of another doctor,
which ran contrary to the opinion of the doctor of the
petitioner’s Insurance Company, is without any substance
and contrary to their own set of facts.

14. At this juncture, it is relevant to note that the
State Commission in its order dated 11.11.2010 has only
referred to the judgment of the Apex Court and High
Courts without looking into the facts and circumstances as
to its applicability to the present case and blindly

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dismissed by not considering the medical report dated
23.03.2006 of the complainant’s husband undergone at
the instance of the Insurance Company prior to the
issuance of policy. In fact, the State Commission was
completely swayed away by the decision of Life
Insurance Corporation of India and Another V.
Sunita Hemnani reported in II (2009) CPJ 172 (NC) ,
wherein it was held that the deceased died within 8
months of the issuance of the policy. Hence, it is held that
the complainant is not entitled for any relief sought for.

15. The facts and circumstances of the case in
Sunita Hemnani as stated supra, refers where the life
insured has submitted incorrect answers to the questions
in the proposal form and acted contrary to documentary
evidence, which is not so in the present case. At the cost
of repetition, in the instant case, the complainant’s
husband has undergone the medical examination test at
the hands of the insurance company and after being fully
satisfied with the medical examination report of the

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insured, the insurance policy was issued and there is no
document produced by the insurance company to
substantiate that the insured had availed any treatment
prior to submission of the proposal form indicating that
there is suppression of material facts by the complainant
or complainant’s husband. Therefore, the order passed by
the State Commission is without any basis and application
of mind.

16. Further, it is noted that the judgment in the
case of Reliance Life Insurance Co. Ltd. & Another V.
Rekha Ben Naresh Bhai Rathod reported in (2019) 6
SCC 175
was placed by the insurance company before the
National Commission to emphasize the fact of non-
disclosure for repudiation of the insurance policy, but the
National Commission has justifiably distinguished the
aforesaid judgment on facts. Thus, the order of the
National Commission requires no interference. The
allegation of perversity in the order of the National
Commission is baseless.

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17. Under the facts and circumstances of the case,
the petition is dismissed .



SD/-
(JAYANT BANERJI)
JUDGE



SD/-
(N.V.BHAVANI)
JUDGE

DR,
List No.: 1 Sl No.: 1