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GAUTAM CHOURDIYA, PRAMOD KUMAR VARMA
Branch Manager, SBI Life Insurance Co. Ltd. – Appellant
Versus
Savitri Salam – Respondent
ORDER
Gautam Chourdiya, President—This appeal is filed under section 41 of the Consumer Protection Act 2019 (hereinafter referred to as “the Act” for short) against order dated 14.08.2024 passed by District Consumer Disputes Redressal Commission, Kanker (C.G.) (hereinafter called “District Commission” for short) in complaint case No.CC/02/2024, whereby the complaint was allowed and the opposite parties/ appellants herein were directed to pay the amount of insurance claim of death of insured husband of the complainant/ respondent Rs.50,00,000/- (Fifty Lacs) along with simple interest @ 7% p.a. from the date of filing complaint 27.12.2023 within one month, failing which the interest was directed to be paid @ 9% p.a. The opposite parties/ appellants were further directed to deposit within one month penalty of Rs.10,000/- (Ten Thousand) in the Consumer Welfare Fund and to pay Rs.10,000/- (Ten Thousand) to the complainant/ respondent towards compensation for mental agony and sufferings along with cost of litigation Rs.3,000/- (Three Thousand).
2. In nutshell the facts of the case, as stated in the complaint, are that the complainant/ respondent’s husband Shravan Kumar Salam had taken tw
Insurance—Repudiation of death claim on the ground of concealment of disease must be supported with reliable and cogent evidence.
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....
Medical Examination – Insurance company is responsible for conducting a medical examination of the policyholder in advance.
(1) Full Knowledge – DLA had the full knowledge of pre-existing ailments at the time of filling the proposal form and there was a nexus with preexisting disease and the cause(s) of death.(2) Proposal....
(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....
(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 ....
Suppression of material facts by an insured can render an insurance claim voidable, impacting the insurer's liability.
Pre-existing disease – life assured has deliberately concealed the true facts about his state of health and suppressed his pre-existing disease.
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