Legal

Ambiguous Insurance Proposal & Questions Cannot Justify Repudiation

The claim was repudiated for failure to disclose existence of another police of different insurance company. 

However, it was found that the proposer had said “NO” in answer to the point no.9 “Do you have an existing HDFC Life Policy.

On page 3 under the “previous policy details, the proposed said “NO” to the questions – (i) whether he had submitted any simultaneous applications for the life insurance which were pending or likely to revive lapsed policies and (ii) whether he had any existing insurance cover of premium paying or paid-up policies accepted at standard rates or otherwise”.

In that context, it was HELD that a careful reading of the proposal form reveals that the questions are not framed so as to elicit a definite and unambiguous disclosure from the proposer.   In particular, Point No.9 Is confined only to existing policies with HDFC Life Insurance Company and does not extend to policies obtained from other insurers.  Likewise, the questions under “Previous Policy Details” are couched in a composite and technical manner, lacking a clear and direct query such as – whether the proposer holds any existing life insurance policies with other companies.

In the absence of a specific, simple and unequivocal questions calling upon the disclosure of all existing policies of other companies, the answers of proposer cannot be readily construed as deliberate or fraudulent suppression of material facts.

The ambiguity in the questions of the proposal form coupled with the absence of any clear, specific and direct query, requiring disclosure of existing insurance policies with other insurers, disentitles the opponents from attributing fraudulent suppression.

In view of Section 45 of the Insurance Act, mere non disclosure or inaccurate answers in the absence of clear, specific and unambiguous questions, cannot be elevated to the level of fraudulent suppression.

Any ambiguity in terms or questions framed by the insurer must be construed against it, particularly when such ambiguity forms the very basis of repudiation.

According to the opponents, the policy was issued on the information given by the insured and had the insured policies been disclosed, the instant policy would not have been issued.

Judgment dated 1.6.2026 of the District Consumer Disputes Redressal Commission, Kurnool in Consumer Complaint No.29 of 2025 of BonthalaSindhuja  Vs.  The Manager, HDFC Life Insurance Company Limited and another

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