Insurance – Death due to sudden cardiac arrest during Covid-19

The petitioner’s husband had taken loan of Rs.40 lakhs from the respondent no.4 and another loan of Rs.31 lakhs.  He had insured his life for both the loan amounts with respondent no.2 ICICI Lambard General Insurance Company.

On 10.5.2021, the husband of the petitioner died due to sudden cardiac arrest in pandemic.  As such post-mortem was not conducted.

Respondent No. 2 had repudiated the claim by the order dated 20.12.2021 on the ground that no investigations were done and no post mortem was done.   The cause of death was not known. The claimant can seek remedy before Insurance Ombudsman if she has any grievance.

HELD that the death was during peak of Covid-19 second wave in May 2021.  Although the deceased was not tested Covid-19 he died due to cardiac arrest in pandemic.   In the medical certificate cause of death was given.   The claim was rejected only on the ground that the cause of death was not covered under the policy.   However, on perusal of the policy the occurrence for the first time of heart attack of specified severity is covered.  The documents asked by the Insurer were beyond the control of the claimant to procure and furnish

Judgment dated 29.4.2024 of the Madras High Court in W.P.No.26233 of 2022 of N.Lakshmi Vs. The Insurance Regulatory and Development Authority of India and others with connected matter.