Lawstreet Journal

Proposer Duty Bound to Report Pre-existing Ailments to the Insurance Provider: SC [READ JUDGMENT]

Lawstreet Journal 24 Oct 2020 2:53am

Image courtesy: Lawstreet Journal Judiciary Proposer Duty Bound to Report Pre-existing Ailments to the Insurance Provider: SC [READ JUDGMENT]

In a recent case, the form of the insurance proposal included questions relating to the health and medical history of the proposer and required detailed disclosure as to whether the proposer had experienced any disease, hospitalization, or treatment, as well as a declaration of good health. The proposer replied to the questions in the negative, which indicated that he had not received any medical care or hospitalization and that he had no sickness or disease.

Acting on the basis of the request presented by the proposer, he was issued with an insurance policy. The insured died one month later. On the basis of the inquiry findings, the insurance argument made by his mother was repudiated, which stated that the deceased had suffered from a stomach ailment and vomiting of blood near death, as a result of which he had taken advantage of the hospital care.

The complaint lodged by the complainant was permitted by the District Consumer Forum. The State Consumer Disputes Redressal Commission rejected the first appeal submitted by the insurance company. Although rejecting the Revision Petition, the National Consumer Disputes Redressal Commission held that the death had occurred due to natural causes and there was no fair connexion between the cause of death and the failure to report the disease.

The bench of the Apex Court, consisting of Justices DY Chandrachud, Indu Malhotra, and Indira Banerjee, observed that the medical reports obtained during the investigation clearly indicate that the deceased suffered from a significant pre-existing medical condition that was not reported… Continue Reading...

Tagged: Supreme Court of India  
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