Case Law Details
Life Insurance Corporation of India Vs Dr. Nilam Hetalkumar Patel & 4 Ors. (NCDRC Delhi)
Repudiation of Insurance claim not maintainable as no connection was established between depression and cardiovascular arrest resulting into death
Conclusion: In present facts of the case, the National Commission dismissed the Revision Petition filed by the Insurance Company and have upheld the Order of State Commission wherein it was held that the deceased insured before taking the policies was suffering from major depression but he died due to cardiovascular arrest and therefore, the repudiation of the claim made by the Insurance Policy was not legal and valid as there was no nexus between the disease and the cause of death.
Facts: In present facts of the case, the Revision Petition have been filed by the Petitioner – LIC against Respondents under section 21 (b) of Consumer Protection Act 1986, against the order dated 25.01.2019 of the State Consumer Disputes Redressal Commission Gujarat. The Complainants have also filed separate Consumer Complaint before the State Commission due to the pecuniary jurisdiction.
Brief facts of the case are that husband of complainant no.1 who is also father of Complainant nos. 2 and 3 and son of Complainant nos. 4 and 5 had taken nine different Life Insurance Policies from the Opposite Party (OP). The husband of Complainant no.1, however, died within two years of taking the insurance policies due to heart attack. The claim was filed before the OP by the Complainants. The OP repudiated the claim on the ground that deceased at the time of taking the policies, had not disclosed the material facts. Being aggrieved of the repudiation of the claim, the complainants filed complaint before the District Forum, which partly allowed the complaints. Being aggrieved by the decision of the District Forum, OP filed Appeals before the State Commission which were dismissed. Hence the OP is before this Commission in the present RPs.
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