Suppressing existence of common diseases does not disentitle the claimant completely of the insurance claim

National Consumer Disputes Redressal Commission (NCDRC): A Single Member Bench of Prem Narain, (Presiding Member), allowed a revision petition filed against the order of State Consumer Disputes Redressal Commission, Haryana.

The main issue that arose before the Commission was whether suppression of a fact pertaining to diabetes precludes the family members of the insured to claim the benefits of insurance policy.

The Commission, in this case, observed that on the date of filing the proposal form the insured was not suffering from the disease which caused his death. As far as the claim of the respondent company that the insured had suppressed the fact that he was suffering from diabetes was concerned, the Commission referred to the case of Hari Om Agarwal v. Oriental Insurance Co. Ltd., 2007 SCC OnLine Del 1278, and observed that insurance claim cannot be denied on the ground of lifestyle diseases that are so common. The Commission further observed that even though insurance claims cannot be denied on the ground of lifestyle diseases but that doesn’t give the insured a right to suppress information from the insurance company and if the person does so then he must suffer in the form of reduced claims. The Commission also referred to the case of Sulbha Prakash Motegaonkar v. LIC of India, Civil Appeal No. 8245 of 2015 and observed that suppression of information regarding any pre-existing disease, if it has not resulted in death or has no connection to cause of death, would not disentitle the claimant for the claim.

The Commission held that the primary reason of death in the instant case was not diabetes. The insured had died due to some other disease and he was not suffering from that disease at the time when he had bought the insurance policy. The Commission allowed the petition and set aside the order of the State Commission. [Neelam Chopra v. Life Insurance Corporation of India, Revision Petition No. 4461 of 2012, order dated 08-10-2018]

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