Insurance Policy (Consumer Case)
The complainant’s husband held a life insurance policy that lapsed in 2012 but was revived after payment of premiums. After is sudden death, the insurer rejected the claim, alleging that the deceased had concealed a prior heart condition when taking out and reviving the policy.
The complainant denied this, asserting the deceased was healthy. The District Commission ruled in favor of the complainant, ordering the insurer to pay ₹1,00,000 with interest, compensation, and litigation costs. The insurer, dissatisfied, appealed the decision before the State Commission of Telangana.
The State Commission noted that the life assured had truthfully stated in the proposal from that he had no prior treatment or serious health conditions. Although the insurer relied on an admission record (Ex.B3) from Kamineni Institute suggesting a history of chest pain and diabetes, the complainant denied any treatment at that hospital and maintained the deceased was healthy.
Since the insurer failed to prove that, Ex.B3 belonged to the life assured and did not present hospital testimony to verify the medical records, the Commission ruled that the claim of non-disclosure was unfounded. The appeal was dismissed, and the District Commission’s order was upheld.
Source: – Live Law
By: – Rajat Ranjan
