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INDER SINGH MEHTA, PARTAP SINGH THAKUR, YOGITA DUTTA
PNB Metlife India Insurance Company Limited – Appellant
Versus
Nirmala – Respondent
ORDER
Instant appeal is arising out of the order dated 25.04.2024 passed by Learned District Consumer Commission, Hamirpur, in Consumer Complaint No.50/2018 titled Nirmala Devi Versus PNB Metlife India Insurance Co. Ltd. & Ors., whereby the complaint filed by the complainant was allowed and the opposite parties were jointly and severally directed to pay an amount of Rs.9,50,742/- to the complainant alongwith interest @ 9% per annum from the date of the complaint i.e.11.01.2018 till its realization. The opposite parties were jointly and severally directed to pay compensation to the complainant to the tune of Rs.20,000/-, besides litigation costs quantified as Rs.10,000/-.
Brief facts of Case:
2. Brief facts of the case are that on 22.06.2015, Shri Som Dutt Sharma (deceased life assured) husband of complainant purchased insurance policy No.21610585 from the opposite parties/insurance company for a sum of Rs.10.00 lakhs and paid yearly premium of Rs.99,999/-. The husband of complainant died on 12.01.2017. The complainant being nominee and legal heir of deceased Som Dutt Sharma, approached the opposite parties and lodged her claim, but claim of the complainant was repudiated by the insu
Repudiation of death claim on the ground of concealment of pre-existing ailment – Onus lies upon Insurance company to prove factum that at the time of taking insurance policy in question, deceased li....
Pre-existing disease – life assured has deliberately concealed the true facts about his state of health and suppressed his pre-existing disease.
Insurance—Repudiation of death claim on the ground of concealment of disease must be supported with reliable and cogent evidence.
Death – The death of the life assured within one month of obtaining the policy raises suspicious on its own.
Medical Examination – Insurance company is responsible for conducting a medical examination of the policyholder in advance.
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) 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....
Since medical insurance policy was issued after examination of insured, policy claim cannot be repudiated on ground of pre-existing disease.
Petitioners failed to point any illegality or irregularity in the order passed by the State Commission, warranting interference in exercise of revisional jurisdiction of this Commission.
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