Sapna, 34, worked as a chartered accountant. Her husband, Deepesh, ran a mobile shop in Haryana’s Bahadurgarh. They had two daughters, their own flat in the city, and a housing loan they were steadily repaying.
Then, in October 2024, Deepesh suffered a cardiac arrest. Within days, after being taken to three hospitals, he died.
Sapna was left with two daughters to support and a housing loan that still had to be paid. “Everything was going fine… then it all fell apart,” she said.
The insurance policy she and Deepesh had taken with the loan was supposed to cover the outstanding liability if he died. Instead, when Sapna filed a death claim, the insurer rejected it.
The rejection set off a chain of financial troubles that continued for months. Sapna struggled to keep up with the EMIs while paying for her daughters’ school, rent, food and other household expenses. She eventually sold the family home and moved with her daughters into a small rented apartment in Bahadurgarh.
It was only after that that she decided to challenge the insurer before the consumer commission — and won.
On September 9, the South Delhi District Consumer Disputes Redressal Commission ruled in her favour, directing PNB MetLife to pay her over Rs 58 lakh.
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The policy
Sapna and Deepesh had taken a Rs 52 lakh housing loan from PNB Housing Finance’s Green Park branch in 2023, for a repayment period of 180 months. They mortgaged their home against the loan.
As part of the package, they also bought two loan-cover insurance policies, paying a combined premium of Rs 2.6 lakh. The premium was added to the loan, taking the total amount borrowed to Rs 54.6 lakh.
One of the policies was the PNB MetLife Complete Loan Protection Plan, for which they paid a Rs 2 lakh premium. The second was a TATA AIG Group EMI Protect policy, for which they paid Rs 60,000.
Sapna was the nominee under both policies.
When Deepesh died on October 28, 2024, Sapna filed a death claim under the PNB MetLife policy. In March 2025, the firm rejected it.
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Why the insurer rejected the claim
As part of its assessment of the death claim, PNB MetLife relied on an investigator’s report. Such an investigation can involve gathering information about the policyholder’s medical history and circumstances surrounding the death.
In this case, the investigator relied, among other things, on oral accounts from neighbours and a HbA1c test. The insurer used these to allege that Deepesh had diabetes that had not been disclosed when the policy was taken.
“They only told me that the claim was rejected because of diabetes,” Sapna said.
After rejecting the claim, the company refunded the Rs 2 lakh premium paid for one policy to Sapna on March 13, 2025.
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‘Rent, ration, school fees piled up’
With the claim denied, things unravelled quickly.
“It became so difficult for me… life is tough for a single woman,” she said.
“Things had reached a point where the bank was about to take physical possession of our home. We weren’t able to pay the EMIs for months. We survived on our savings, and even affording basic meals was a struggle.”
Rent, ration, school fees and electricity bills began piling up. “It was very difficult to manage. My husband’s friends helped out a little bit. My relatives also pitched in,” she said.
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She also struggled with her daughters’ school fees. “The school waived off the fees for some time after I requested them. I had to teach tuition at home in the meanwhile to make some money.”
Sapna said she also began selling things that the family could do without.
“I don’t know how to drive so I sold one car. We also sold two beds, we sold everything that wasn’t essential for us. It was a very difficult time.”
By September 2025, she was forced to make the hardest decision — she sold the house she and Deepesh had purchased.
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She takes on the insurer
It was around this time that Sapna decided to challenge the rejection before the consumer commission, with the help of advocate Paras Jain. “Someone suggested we try our luck,” she said.
Before the commission, Sapna argued on three main grounds:
-That Deepesh had died of cardiac arrest and that there was no direct link between his death and the alleged non-disclosure of elevated blood sugar levels.
-She also pointed out that PNB MetLife had not conducted any medical tests or examination of Deepesh before issuing the policy.
-She said the insurer had wrongly rejected the death claim, leaving her in severe financial hardship and putting the family home at risk.
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The commission held that the insurer could not deny the claim without establishing a direct link between the alleged pre-existing condition and the cause of death.
It pointed to medical reports from a day before Deepesh’s death, which showed that his heart was functioning normally. It also noted that PNB MetLife had never medically examined him before issuing the policy.
“It is settled law that the claim cannot be repudiated by the Insurance Company on the ground of pre-existing diseases of diabetes, hypertension when there is no direct nexus with the cause of death even if pre-existing diseases of diabetes, hypertension are not disclosed by insured at the time of taking insurance policy,” the commission noted in its order.
It added that “having elevated blood sugar levels at a given time may not mean having diabetes,” and that the insurer had produced no document connecting Deepesh’s sugar levels to his cardiac arrest.
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For Sapna, the ruling does not undo what happened over the past year.
“Nobody chooses to die by their own will… I had to look after my daughters alone. I lost my husband. I haven’t practiced accountancy for a decade. My income is very low now. We are just surviving. I just hope I can give my daughters a good life,” she said.
