MEENA RAMANATHAN, V. V. SESHUBABU
State Bank of India Life Insurance Co. Ltd. – Appellant
Versus
Challa Venkaiah – Respondent
ORDER
Meena Ramanathan, In-charge President—This is an appeal filed by the Appellant/Opposite Party U/s.15 of Consumer Protection Act,1986, praying this Commission to set aside the order dated 29.11.2019 passed in CC.No.30 of 2016 on the file of District Consumer Forum, Nalgonda and pass such other order or orders as this Commission deems fit and proper.
2. For the sake of convenience, the parties are described as arrayed in the complaint. The Appellant is the Opposite Party and the Respondents are the Complainants in CC.No.30/2015.
3. Briefly stated, the facts are that the wife of Complainant No.1 and mother of Complainant No.2 & 3 availed a policy vide No.49007122210 for sum assured being Rs.3,50,000/-. Date of commencement of the policy is 31.12.2012 and mode of premium opted was yearly. The Complainant’s wife paid a sum of Rs.1,50,000/- towards policy amount. She died on 29.07.2015 and all the necessary documents were submitted to Opposite Party for release of sum assured. The Opposite Party paid only Rs.1,50,000/- instead of the policy amount of Rs.3,50,000/-. The claim has been repudiated on unfair grounds without any valid reason and hence the present complaint is raised for
Insurance – Repudiation of death claim on the ground of suppression of pre-existing ailment cannot be sustained when medical reports are categorically denied.
Death – The death of the life assured within one month of obtaining the policy raises suspicious on its own.
(1) The “Three-Year Rule” (Section 45) – Under the amended Section 45, a policy cannot be questioned after three years from issuance or risk commencement on any ground.(2) Agent’s Responsibility – Th....
Mere filing of some hospital records was not sufficient to show that the policy holder was suffering from the ailment at the time of filing of proposal form.
Insurance—Repudiation of death claim on the ground of concealment of disease must be supported with reliable and cogent evidence.
(1) Proposal form – In filling up the proposal form, the agent normally, ceases to act as agent of the insurer but becomes the agent of the insured and no agent can be assumed to have authority from ....
The sufficient burden of proof lies with insurers to demonstrate suppression of material facts in insurance claims.
(1) Contract of Insurance – A contract of insurance is one of utmost good faith. A proposer who seeks to obtain a policy of life insurance is duty bound to disclose all material facts bearing upon th....
Life Insurance Policy – Repudiation of death claim on the ground of suppression of material facts – Mere existence of past medical records is insufficient unless knowledge on part of insured is prove....
(1) National Commission - National Commission in exercise of its revisional jurisdiction Commission is not required to re-assess and re-appreciate the evidence on record.(2) National Commission - Nat....
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