Wife dies of heart attack 5 days after buying insurance cover, husband granted Rs 50 lakh

‘Insurer can’t disown liability’

• The commission held that the insurance company, having issued the policy, cannot disown its liability when a claim arises by taking shelter under exclusionary clauses without producing any evidence.
• The consumer body held that the repudiation of the claim was not only deficient in service but also amounted to an unfair trade practice.
• The commission noted that the woman died on March 15, 2025, allegedly after suffering a heart attack at home.
• It was further noted that the death occurred during continuance of the policy, which had a sum assured under the policy on death of Rs 50 lakh.
• The commission directed HDFC Life Insurance to pay the assured sum of Rs 50 lakh along with interest at the rate of 6 per cent per annum from March 15, 2025, till the date of realisation.
• The commission observed that fraudulent claims are leading to wastage of public money, but such issues cannot be addressed by consumer forums beyond the scope of the Consumer Protection Act.
• The insurance company was also directed to pay Rs 25,000 towards compensation and Rs 5,000 towards costs.
• The commission noted that the insurance company, instead of honouring the claim after the insured event, denied liability by issuing a letter, thereby compelling the complainant to approach the commission.
• It observed that the insurance company had not placed on record any evidence as to the basis for its conclusion that the information furnished in the proposal is incorrect.

Death within 5 days of buying policy

The complainant was the husband and nominee of the late Savara Radha, who died on March 15, 2025, due to a heart attack. During her lifetime, she had obtained an HDFC Life Smart Protect Plan policy on March 10, 2025, paying an annual premium of Rs 50,000.

It was added that the sum assured under the policy was Rs 50 lakh. The risk commenced on March 10, 2025, as per the policy. While so, after the death of the wife on March 15, 2025, HDFC Life Insurance sent a letter called “Confirmation of policy discontinuance” stating that, on investigation, it was established that the policy is cancelled due to misstatement and misrepresentation of material facts in the proposal form.

The husband claimed that as his wife died during the continuance of the policy, HDFC Life Smart Protect Plan is bound to pay the assured sum but issued a letter cancelling the policy without any valid and justifiable reason. Aggrieved by the same, the husband moved the consumer commission alleging deficiency in service on the part of HDFC Life Insurance. ‘

The husband was represented by advocate D Subrahmanyam in the matter.

‘Policy subject to terms, conditions’

The counsel appearing for HDFC Life Smart Protect Plan, advocate K Rama Kireeti contended that the policy in question was issued covering risk from March 10, 2025, receiving annual premium of Rs 50,000 within five days of commencement of risk.

It was added that the issuance of the policy is always subject to the terms and conditions of the contract, allegedly including the principle of utmost good faith, which places a mandatory obligation on the proposer to disclose all the material facts at the material stage.

It was contended that the policy in question was cancelled on April 10, 2025, on the ground of misrepresentation of profile, which constituted a material breach of policy conditions rendering the contract voidable at the instance of the insurer.

It was claimed that since the policy was cancelled during freelook/early period after due scrutiny of proposal particulars, no vested right accrues in favour of the woman’s husband.

HDFC Life Smart Protect Plan maintained that there is no deficiency of service on their part and prayed the commission to dismiss the complaint with exemplary costs.

Significance of ruling

This ruling highlights that insurers cannot avoid liability simply because the policyholder dies soon after taking the policy. Once a valid policy is in force, the insurer is bound to honour covered claims, and the right to receive compensation survives in favour of the legal heirs.

For consumer-related grievances, individuals may contact the consumer helpline in their respective states (Andhra Pradesh contact: 0866-2551431) or call the National Consumer Helpline at 1915 for assistance.