The New Delhi District Consumer Disputes Redressal Forum observed that LIC had "misdirected itself" by not showing any evidence that the deceased was suffering from asthma prior to availing the policy and had not "applied its mind" while denying his claim.
The LIC had denied the claim saying the woman was an asthma patient and had not disclosed her illness while taking the policy. It had relied on a discharge summary of 2004 to reject the claim.
"The discharge summary of 2004 is of no use. It shows trouble for 4-5 days in 2004 and not before taking policy in 2003. Opposite party has not applied its mind. We hold it guilty of deficiency in service by arbitrarily repudiating the claim," a bench presided by C K Chaturvedi said.
It directed LIC to pay the sum insured of Rs 50,000 along with "punitive damages" of Rs 50,000 to Delhi resident Dev Raj whose wife had died in December 2005.
Raj, in his complaint, had said that his wife had obtained the policy for Rs 50,000 from LIC in 2003 and under it she was covered till 2005, but the insurance firm had rejected his claim on the ground that she was an asthma patient.