National/States Consumer Disputes Redressal Commission Law & Legal News :


Maharashtra State Consumer Dispute Redressal Commission ruled, LIC can't repudiate a claim when medical report shows nothing dangerous



New Delhi, Oct. 09, 2017: The Maharashtra State Consumer Dispute Redressal Commission has ruled in the negative and has decided that if some results of the blood pathology are higher but not abnormal or show nothing dangerous, the insurer cannot repudiate a claim.

 

The Maharashtra State Consumer Dispute Redressal Commission rejected the appeal filed by the Life Insurance Corporation of India against the order of the Consumer Forum South Mumbai district, which it used to be directed to pay Rs 2.50 lakh to the complainant, spouse of the insured who died of dengue.

 

In the moment case, complainant Manju Sharma had approached the Consumer Forum South Mumbai district, towards the LIC’s denial to pay her the claimed sum.

 

She had submitted that her husband Vishwajeet Sharma had taken a Jeevan Mitra Tripple Cover Policy and insured an quantity of Rs. 2.50 lakh for the duration of April 28, 2004, to April 28, 2034. He had deposited an annual top class of Rs. 12,833. In September 2004, her husband suffered from dengue fever.

 

Subsequently, he suffered from renal failure and breathed his closing on April 21, 2007, following a cardio-respiratory arrest.

 

She made a declare sooner than the LIC, which used to be repudiated vide a letter dated February 28, 2008, forcing her to document a shopper criticism.

 

LIC contested her declare by means of filing that her deceased husband had given proposal shape on May 23, 2004, with a declaration that he’ll tell LIC about any exchange in his well being sooner than accepting first top class quantity.

 

LIC submitted that the primary top class of deceased Vishwajeet Sharma used to be authorised on May 24, 2004, and then he had gone through pathological checks which published that his creatinine stage used to be greater. However, he didn’t tell LIC about it.

 

While LIC came in appeal against the district forum’s order, Manju also moved an appeal saying she was entitled to get Rs. 7.50 lakh under the triple cover policy.

 

The LIC stated in enchantment that once accepting the primary top class, checks published that creatinine stage of her husband used to be up. “In view of declaration given by Vishwajeet Sharma, he was required to inform this fact to Life Insurance Corporation. If he would have informed this fact to opponent, either opponent would not have given policy to him or had taken more amount of premium from him,” LIC stated.

 

It stated because the deceased husband of complainant had suppressed subject material truth in recognize of his well being from the opponent, the opponent had rightly repudiated the declare of complainant.

 

It additionally contended that the husband of complainant had now not died in an coincidence and therefore, she used to be now not entitled to assert triple advantage of sum insured.

 

Hence, we are of the opinion that the Ld.District Forum had rightly considered that complainant is entitled to get amount of Rs.2,50,000/- only from opponent insurance company. Under such circumstances, we are of the opinion that appeal filed by complainant is also to be dismissed.


Hence, we proceed to pass the following orders:

 

(i) Appeal Nos.A/12/64 and A/12/171 are hereby dismissed.
(ii) Order passed by the Ld.District Forum is hereby confirmed.

 

 


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