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LIC Insurance claim – Repudiation – Suppression of Material Facts

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By the judgment dated 18.4.2024 in F.A.No.350 of 2016, the National Consumer Disputes Redressal Commission, New Delhi, allowed the complaint of the respondent for recovery of insurance claim of Rs.20 lakhs for death of insured.

The insured – complainant who had taken life policy from 2011 to 2026 had passed away on 20.9.2012.  The claim was repudiated on 1.3.2013 on the ground that material information of health condition was withheld.

The State Commission had dismissed the complaint, whereas the National Commission allowed the same.

LIC contended that in the proposal form the insured had given it was mentioned that she had diabetes for one year, whereas, the history of the Consultation sheet of KEM Hospital shows that she was suffering from diabetes from 15 to 20 years.

However, the said consultation sheet was refuted and clarificatory affidavit was filed by the brother explaining the circumstances leading to incorrect recording of information. This was not controverted by the petitioner.    No material or medical reports to substantiate adverse medical condition of insured and its suppression is brought on record.

Judgment dated 28.6.2024 of the Bombay High Court in Writ Petition No.5628 of 2024 of Life Insurance Corporation of India and others  Vs. Mohd. Sikander Mohd. Maulana

 

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