Consumer Forum Rejects Dual Defence of Insurer from Verification to Repudiation
Judgment dated 25.9.2026 of the District Consumers Disputes Redressal Commission – Kolkatta II, in Consumer Complaint No.DC/AB2/315/CC/45/2024 of Sri Deepak Kumar Singh Vs. IndiaFirst Life Insurance Company Limited
The mother, since deceased, purchased online one Individual Term Insurance Plan, namely, IndiaFirst Life Guaranteed Protection Plan, for an assured sum of Rs. 1,00,00,000/-. The policy was a non-linked, non-participating plan. The said policy was issued after medical examination and verification of financial documents. The
proposal was submitted online with a personal statement, and the first yearly premium of Rs. 58,509.12 was paid on or about 23.01.2022 through bank transfer. The next premium fell due on 24.01.2023.
On 1.2.2023, the mother of the complainant died. The causes of death recorded in the hospital record were severe sepsis, severe pancytopenia and acute kidney failure. The complainant contends that these ailments developed during hospitalisation and were not existing at the time of the proposal.
The claim was rejected on the ground that the financial documents submitted at the time of proposal in support of income and occupation were forged, tampered and that the claim had been filed to defraud. The policy was cancelled with forefeiture of premium. In subsequent reply to the legal notice the Insurer raised a fresh plea of pre-existing disease prior to the proposal.
The insurer’s own record showed that the policy was issued after only medical examination and through financial underwriting carried out by its own underwriter including a video pre-verification. Moreover, the allegations about forged income & occupation documents were mere assertion, wholly unsubstantiated.
The plea of pre-existing disease fares no better. This plea had surfaced for the first time only in reply to the legal notice. A repudiation of insurance shifts its ground in this manner adding a fresh and inconsistent basis at a belated stage, is itself an indicator of afterthought and cannot be countenanced. Even otherwise, the record shows that the conditions and admission in the hospital in the records show that they were of ten months after the proposal and do not establish that any disease existed prior to the proposal.
