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NON-DISCLOSURE OF HEALTH EVENTS IS A VALID GROUND FOR REPUDIATING INSURANCE CLAIM: Supreme Court

Team SoOLEGAL 25 Apr 2019 3:52pm

NON-DISCLOSURE OF HEALTH EVENTS IS A VALID GROUND FOR REPUDIATING INSURANCE CLAIM: Supreme Court

The Appellant Manish Gupta had obtained a Mediclaim policy from Life Insurance Corporation of India. He had fill in the health details and medical information as required by the proposal form. The query was answered in the form whether the proposer had suffered from "cardiovascular disease" in negative.

He later underwent a Mitral Valve Replacement surgery and claimed insurance for the same. LIC repudiated his claim on the ground that he was already suffering from a pre existing illness. Such pre existence was confirmed by a registered doctor.

State Consumer Commission and District Forum allowed the appellant's complaint by making an observation that the doctor did not indicate that it had been recorded on the basis of the information furnished by the patient. Also, the National Consumer Commission affirmed their orders.

The LIC had filed an appeal in Supreme Court of India which was allowed by the Court. The holding of the Court was that the failure of the insured to disclose the past history of cardiovascular disease was a valid ground for repudiation. 



Tagged: Mediclaim   Life Insurance Corporation of India   Supreme Court   Insurance Policy   Claim  
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