IN THE DELHI STATE CONSUMER DISPUTES REDRESSAL COMMISSION Date of Institution: 05.04.2024 Date of Hearing: 29.10.2025 Date of Decision: 14.11.2025 FIRST APPEAL NO. 247/2024 IN THE MATTER OF MRS. SHYAMA RAZDAN, W/O MR. T. K. RAZDAN, R/O A-117, SARITA VIHAR, NEW DELHI–110076.

(Through: Mr. Manish K. Choudhary & Kanchan Prashant K. Jha, Advocates) …Appellant VERSUS LIFE INSURANCE OF INDIA, THROUGH MANAGER LEGAL, 4^TH FLOOR, JEEVAN PRAKASH BUILDING, 25, KASTURBA GANDHI MARG, NEW DELHI–110001.

(Through: Mr. Abhishek Nanda, Advocate)

…Respondent CORAM:

HON’BLE JUSTICE SANGITA DHINGRA SEHGAL (PRESIDENT)

HON’BLE MS. BIMLA KUMARI, MEMBER (JUDICIAL)

Present: Mr. Prashant K. Jha and Mr. Manish Kumar Chaudhary, Counsel for the Appellant, E-mail: manish.juris@gmail.com.

None for the Respondent.

PER: HON’BLE JUSTICE SANGITA DHINGRA SEHGAL, PRESIDENT

JUDGMENT

1. The facts of the case as per the District Commission record are:

“1. The complaint pertains to deficiency in service on the part of OP in repudiating the claim of the complainant.

2. Brief facts are stated in the complaint are that the son of complainant has taken an Life bearing no. 115232143 for sum assured of Rs. 8,00,000/-. The said policy was for 21 yo Insurance Policy from OP namely Jeevan Anand (with profits) (with accident benefit) starting from 28.09.2007 and the last premium was to be paid on 28.03.2018. The complainant is the sole nominee in the said policy.

3. On 15.02.2010, the policy holder i.e. the complainant's son expired due to cardiac arrest Batra Hospital. On 02.12.2010, the complainant informed OP about the demise of her son and requested for settlement of claim. The complainant sent a reminder letter to OP on 07.02.2011.

4. OP repudiated the claim vide letter dated 28.07.2011 on ground of the deceased withholding material information regarding his health. It was alleged by OP that the complainant had a single kidney and suffered from chronic kidney disease since 2004.

5. The complainant denied all these allegations vide letter dated 24.08.2011. The complainant clarified that it was rightly mentioned in her son's proposal form that he had neither taken any medication nor suffered from any disease in the last five years. The complainant and her son came to know about the existence of solitary kidney in November, 2007, after taking the policy when he was hospitalized in Batra Hospital for treatment of a lump in his right armpit. They were informed by the doctor that the deceased had a single kidney since childhood and for which doctor suggested 2-3 hours dialysis every week. The complainant's son recovered his health and attended his office regularly thereafter.

6. The complainant had enclosed a certificate dated

22.10.2010 issued by Batra hospital. The complainant approached the Insurance Ombudsman. The complainant was informed vide complainant's case and decided to uphold the earlier repudiation decision. The complainant OP letter dated 13.12.2011 that the Zonal Office Claims Review Committee reviewed the appealed against this order in Central Office, Claims Review Committee vide letter dated 02.02.2012. The complainant has also relied on an order of a Consumer Commission in complaint case no.478/08 titled as Mr. Vikrant Razdan Vs National Insurance Co. Ltd. wherein the court has categorically held that the complainant therein was not suffering any ailment before October, Central Office Reviewing Committee.

7. The complainant prays for insurance claims amounting Rs.8,00,000/- with interest @18%, Rs.2,00,000/- towards compensation for sufferance of actual mental agony, stress, anxiety, harassment and physical strain and Rs.40,000/- as litigation cost.

8. OP in its reply submits that the deceased son of the complainant, Mr. Vikram Razdan, had taken an insurance policy bearing no. 115232143 for a sum assured of Rs.8,00,000/- for a premium of Rs.21640/-half yearly. The said policy was for 21 years starting from 28.09.2007. The complainant's son died on 15.02.2010 due to a cardiac arres