Rejecting LIC's claim that a policy-holder lied about his health condition at the time of purchasing insurance, the national consumer forum has directed the firm to pay Rs 1.5 lakh along with bonus and interest to his widow.
The National Consumer Disputes Redressal Commission (NCDRC) asked LIC to pay the claim amount to Sunita Devi, the widow of policy holder Narendra Kumar Pandey, along with bonus and 9 per cent interest on the amount from 2007, when the complaint was filed.
The commission said in a recent order that there was no plea from the insurance company regarding concealment of any pre-existing disease by Pandey at the time of issuance of the policies.
"In the present case, there is no contention of the Insurance Company that at the time when the two insurance policies were taken by the insured, he was suffering with some disease and that he had fraudulently concealed this fact.
"The Respondents (LIC) are hereby directed to give sum assured in the policies and bonus thereon within two months along with interest at nine per cent per annum from the date of filing of the complaint to the date of actual payment to the complainant (Sunita Devi)," said a bench of commission's presiding member Deepa Sharma and its member C Vishwanath.
Devi's husband had purchased two policies of Rs 1 lakh and Rs 50,000 on November 25, 1997, which lapsed due to some monetary problem and was later revived on June 19, 2002. Her husband died on May 24, 2005.
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Devi, being his nominee, filed for claim for both the policies.
However, Life Insurance Corporation, approved only Rs 34,300 for the policy of Rs 1,00,000 and Rs 10,750 for the policy of Rs 50,000 on the ground that the insured had concealed the material facts relating to his health at the time of the revival of the policies.
She alleged in her complaint that her husband had undergone a kidney transplantation in the year 2000 for which claim was filed with the insurance company, however, it was rejected stating that kidney transplantation was not covered under the policies.
At the time of revival of the policies, which was done in 2002, the kidney transplantation of Pandey was very well known to the insurance company, Devi said.
The policies were revived after medically examining Pandey and being satisfied about his health condition, she said.