Consumer panel tells insurance cos to pay claims in 3 separate cases

After the death of both these people,their insurance claims were refused by the respective companies on the grounds that they were suffering from diabetes. The stand taken by the companies was not accepted by the commission. The insurance claim of Aggarwal’s family was upheld on the ground that the insured was not suffering from diabetes mellitus at the time of taking the policy. Similarly,the insurance claim of the heirs of Kewal Krishan was upheld on the ground that he was not suffering from kidney failure when he took the policy. In the third case,the insurance claim of the legal heirs of Narinderjit Kaur,a resident of Ajnala,has been allowed by the commission. The mediclaim of Rs 1 lakh had been refused by LIC on the ground that she had hidden the fact that she was suffering from rheumatic heart disease while taking the policy. The commission held that the woman died of hepatitis and not due to a heart problem. Hence,her claim could not be repudiated by the insurance company.

Commission President Justice S N Aggarwal and members Lt Col Darshan Singh (Retd) and Amarpreet Sharma relied upon the judgment of the Supreme Court that if a person is suffering from hypertension or diabetes,the insurance claim of the legal heirs could not be repudiated on the ground that the person had suppressed this information from the company.

The Supreme Court had observed that hypertension or diabetes were not fatal in themselves. If a proper check was maintained,a person suffering from either of these problems could live a long and healthy life. In this light,the commission directed the companies to pay the insurance claim to the legal heirs of the insured persons,with interest from the date on which it was to be paid.