Man dies 25 days after buying insurance policy, Punjab and Haryana High Court upholds Rs 14.22 lakh payout to wife

Justice Jagmohan Bansal noted that Bharti AXA Life Insurance Co Ltd. had alleged that the said policyholder concealed a pre-existing cancer diagnosis.

The high court found that the man died on April 25, 2018, while hearing the plea filed by the insurance company seeking to set aside the Permanent Lok Adalat’s April 2, 2025, order.

Death within 1 month of policy

• It was placed on record that Samundar Singh, the husband of the woman, obtained a life insurance policy from Bharti AXA Life Insurance Company Limited on March 23, 2018. It was claimed that the sum insured was Rs 7.11 lakh with a death benefit of Rs 14.22 lakh. 
• He paid the first premium of Rs 63,172 and died on April 25, 2018, due to a sudden heart attack.
• The death occurred within 25 days of the issuance of the policy. Subsequently, the insurer repudiated the claim by a letter dated March 31, 2019, alleging that the insured was suffering from squamous cell carcinoma.
• It was alleged that he was receiving treatment for the said disease from February 2017, and there was suppression of material pre-existing disease. 
• Aggrieved by the same, the woman approached the permanent lok adalat, which allowed the claim by an order dated April 2, 2025. 

‘Insurance company had doubts’

The high court noted that the insurance company is doubting the said order on the sole ground that there was suppression of fact. 

The court observed that the insurer had failed to prove the allegation through reliable evidence. It noted that the Permanent Lok Adalat had found deficiencies in the investigation report and the medical documents relied upon by the insurer.

The high court further noted that the Permanent Lok Adalat had recorded findings that the photocopy of the medical report did not bear the signature of any doctor, had not been duly attested by the competent hospital authority, and contained discrepancies regarding the CR numbers.

The court also noted that the insurer had failed to establish any connection between the alleged ailment and the actual cause of death. According to the material on record, the man had died due to a heart attack.

Finding no manifest factual or legal infirmity in the award passed by the Permanent Lok Adalat, the Punjab and Haryana High Court declined to interfere and dismissed the petition. 

Arguments 

Appearing for the Bharti AXA Life Insurance, advocate Jasmine Garg argued that the man was suffering from cancer, which is a life-threatening disease. 

It was added that the said disease could not be detected at the time of medical examination, and the man did not disclose the same in the proposal form. 

On the other hand, representing the woman, advocate Nikhil Vats pointed to the findings recorded by the Permanent Lok Adalat that the insurer had failed to prove that the deceased was suffering from cancer.

He further submitted that the photocopy of the medical report relied upon by the insurer did not bear the signature of any doctor.

It was also argued that the document had not been attested by the competent hospital authority or any authorised official of the insurance company. Further, different CR numbers appeared on the scanned copy of the medical record.