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J. RAJENDRA, ANOOP KUMAR MENDIRATTA
Kanta – Appellant
Versus
Life Insurance Corporation – Respondent
JUDGMENT
AVM J. Rajendra AVSM VSM (Retd.), Presiding Member—The present Consumer Complaint has been filed under Section 21 of the Consumer Protection Act, 1986 (for short ‘the Act’) against the Opposite Parties seeking to direct the OPs:—
‘(a) The Opposite Parties be directed to pay a total sum of Rs.1 crore along with Interest @18% pa on the said amount from the date of death till actual realization to the Complainants on account of unfair trade practice and deficiency in service,
(b) Rs.10 Lacs as compensation on account of mental harassment and agony suffered by the Complainants,
(c) Rs.50,000/- as litigation costs.’
2. Brief facts, as per the complaint, are that on 16.04.2017, the Complainant’s husband (Life Assured) submitted a Proposal Form to the OP, Insurer seeking a Life Insurance Policy for Rs.1 Crore on an annual premium @ Rs.18,400/- for a period of 20 years. The risk under the policy commenced from 18.05.2017. As per the Proposal Form, he maintained good health with sober habits (non-smoker and nonalcoholic). On 29.04.2017, The OP’s empanelled doctors conducted ECG and Treadmill Tests at Jaipur, and all parameters were reported to be normal. Later, a Medical Examiner’
Law imposes duty of uberrima fides [utmost good faith], on Proposer to disclose material facts truthfully in order to enable Insurer to exercise discretion to enter into contract of insurance.
The nominee in an insurance policy can claim as a consumer even without direct contract; full disclosure of material facts is crucial in insurance underwriting.
(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....
Insurers can reject life insurance claims for non-disclosure of previous policies, highlighting the necessity for utmost good faith in insurance contracts.
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) Medical condition – There is a good possibility that the DLA was not aware of his medical condition prior to filling the Proposal Form and OP has not established anything to the contrary.(2) Duty....
(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....
Insurers have the right to repudiate life insurance policies for suppression of material facts, emphasizing the duty of utmost good faith in insurance contracts.
1) Per Sec. 45 of Insurance Act, claim can be repudiated, if it is proved that the assured knowingly and fraudulently suppressed the material facts.2) Contractual duty so imposed on the Insured is su....
(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....
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