The National Consumer Disputes Redressal Commission observed that mere non-disclosure of lifestyle diseases does not become a ground for denial of insurance claim to the insured. However, such non-disclosure may result in reduced claims.
The said judgment was passed by the NCDRC in the matter of Neelam Chopra Vs. Life Insurance Corporation of India & Anr., Revision Petition No. 4461 of 2012 decided on 08.10.2018.
In the present facts, the husband of the complainant had submitted a proposal form for insurance of his own life. He was medically examined by approved doctors of the respondents. After examining the above documents, the respondents issued him a life insurance policy covering risk w.e.f. 25.12.2002 to 25.6.2026. The insured person i.e. the husband of the complainant died on 7.1.2004. The Petitioner submitted the claim form in connection with the claim under the policy along with certificate of hospital, discharge summary, medical certificates with the opposite parties. However, the opposite parties repudiated the claim of the petitioner on the ground that the deceased had supressed material information regarding his health at the time of effecting the policy and also on the ground that claim has become time barred.
The Petitioner made a complaint with the concerned district forum alleging that the act and conduct of the opposite parties in repudiating the claim amounted to unfair trade practice & deficiency in service on their part due to which the complainant suffered great harassment, inconvenience & mental torture. The main defence of the respondents was that the insured was diabetic patient since five years and he was suffering from LL Hansen disease. The District Forum allowed the complaint, however, the State Commission reversed the order.
On the issue of the insured suffering from diabetes for 3-4 years, the NCDRC mentioned that so far as the life style diseases like diabetes and high blood pressure are concerned, Hon’ble High Court of Delhi had taken a view in Hari Om Agarwal Vs. Oriental Insurance Co. Ltd., W.P.(C) No.656 of 2007 that insurance claim cannot be denied on the ground of these life style diseases that are so common. However, it does not give any right to the person insured to suppress information in respect of such diseases. The person insured may suffer consequences in terms of the reduced claims. Moreover, the non-disclosure of information in respect of this life style disease of diabetes, will not totally disentitle the complainant for indemnification of the claim.