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Company to pay Rs 1.1 lakh for wrongly rejecting insurance claim

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  • Holding Max New York Life Insurance guilty of wrong repudiation of a claim, the UT Consumer Dispute Redressal Forum has directed the company to pay the complainant Rs 1.1 lakh along with litigation cost of Rs 5,000.

    According to the complainant Navjot Singh, his father Ravinder Singh died due to dengue fever on October 12, 2008. He had taken a life insurance policy from Max New York Life Insurance on September 26, 2008.

    Accordingly, a claim was filed with the company but it was repudiated on the pretext that deceased suffered from hypertension and type-II diabetes, which the company claimed was not disclosed to them. It was also stated that after going through the attending physician’s statement and certificate of hospital treatment, it was found that the deceased was in fact suffering from Type-II Diabetes Mellitus and hypertension for the past one year.

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    The complainant averred that his father enjoyed goods heath before his death and was not suffering from any such disease nor died as a result thereof.

    In its orders on Thursday, the forum observed: “The basic question to be determined is whether the information in respect of hypertension and diabetes was material in view of the circumstances of the case or not. If the death had occurred due to hypertension or diabetes or was aggravated due to these diseases then certainly the non-disclosure, or concealing correct information thereof would make the contract of insurance void.”

    Directing the company to pay the claim, forum observed: “Hypertension and diabetes are quite common these days and can no more be called diseases. These are curable and have not led to death of the deceased.”

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