Insurance firm fined Rs 8.6 lakh for repudiating death claim : The Tribune India

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Insurance firm fined Rs 8.6 lakh for repudiating death claim

AMRITSAR: The District Consumer Disputes Redressal Forum has directed an insurance company to pay Rs 4,61,240 along with rider benefit worth Rs 4,00,000 to the nominee of an insured who died within days of purchasing a policy.



Manmeet Singh Gill

Tribune News Service

Amritsar, March 17

The District Consumer Disputes Redressal Forum has directed an insurance company to pay Rs 4,61,240 along with rider benefit worth Rs 4,00,000 to the nominee of an insured who died within days of purchasing a policy. The company has also been asked the firm to pay Rs 5,000 as litigation expenses.

The insurance company had denied the claim while raising questions on the date of death of the insured. Bikramjeet Singh, a resident of Ajnala, had filed a complaint against Exide Life Insurance stating that his father had obtained a life insurance policy from the opposite party which commenced from November 5, 2014 and the sum assured was Rs 4,62,240 along with rider benefit of Rs 4,00,000.

He stated that his father Gurnam Singh died due to sudden heart attack at home on November 15, 2014. After the death, he submitted his claim along with the requisite documents and death claim form. He said that the opposite party rejected the death claim, holding that the life assured died before proposal.

The opposite party, in its reply, submitted that a life Insurance policy is a contract of utmost good faith wherein the life assured is under legal obligation to disclose all the facts and information pertaining to his age, income, habit and previous illness details in proposal form for accepting the life risk coverage for Life Insurance, especially when it is non-medical policy. It further stated that the father of the complainant had submitted a proposal for life insurance with the opposite party on November 5, 2014 and had confirmed that his health was sound on the date of proposal form. It added that after receiving the claim within a short time, they had referred the case for investigation which revealed that the insured had died on November 5, 2014, the same day on which the proposal form was submitted.

It added that the policy was submitted by furnishing incorrect details with fake documents at the time of obtaining insurance policy and played fraud against the opposite parties.

The forum observed that they do not agree with this plea of the opposite parties as to prove the death of life assured, complainant has submitted death certificate issued by local registrar along with a receipt of the cremation ground. The forum stated that the documents produced by the complainant proved that Gurnam Singh had died on November 15, 2014.

Later, the insurance company argued that the complainant had to produce succession certificate which, too, was rejected by the forum stating that the insurance company couldn’t deny claim to a person who had been made nominee in the policy.

The case

A man had purchased an insurance policy from Exide Life Insurance on November 5, 2014 and the sum assured was Rs 4,62,240 along with rider benefit of Rs 4,00,000. He died of cardiac arrest 10 days later. His son filed his claim but repudiated by the firm that accused the insured of concealing some information. The District Consumer Disputes Redressal Forum asked it to pay Rs 4,61,240, rider benefit worth Rs 4,00,000 along with Rs 5,000 as litigation expenses.

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