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NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION
HON'BLE MR. JUSTICE A. P. SAHI, PRESIDENT, HON'BLE MR. BINOY KUMAR, MEMBER
MAX LIFE INSURANCE COMPANY LTD. – Appellant
Versus
AMARAMA & ANR. – Respondent
| Table of Content |
|---|
| 1. insurance claim repudiation due to policy lapse. (Para 1 , 2 , 3) |
| 2. claim protest and legal notice issued. (Para 4 , 5) |
| 3. state commission's analysis of evidence. (Para 6 , 7) |
| 4. evaluation of medical evidence and burden of proof. (Para 12 , 13 , 14) |
| 5. burden of proof and material non-disclosure. (Para 18 , 19 , 20) |
| 6. assessment of health status at policy issuance. (Para 21 , 22 , 24 , 25) |
| 7. conclusion on the validity of the claim. (Para 26 , 27 , 28) |
| 8. final dismissal of the appeal. (Para 29 , 30) |
ORDER
PER A P SAHI, PRESIDENT
1. The State Commission of Karnataka has allowed CC no. 402 of 2018 filed by the respondent/ complainant holding that the appellant insurance company was deficient in its services by not reimbursing the claim of the complainant. The deceased husband of the complainant late Mr Veeresh aged about 49 years had acquired a Max Life Insurance Policy on 10.12.2014. He fell ill in the month of October 2016 and he died on 26.10.2016 due to aspiration problems as reported. The respondent/ complainant, being the nominee and widow of Mr Veeresh, requested for the reimbursement for the risk covered under the said policy, but the same was repudiated vide le
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