A Haryana consumer commission has ordered a private insurer to pay Rs 5 lakh and additional damages after rejecting claims of concealed illness, highlighting a trend of courts scrutinising insurer denials lacking credible evidence.
A Haryana consumer commission has ordered a private life insurer to pay Rs 5 lakh to a man whose claim was rejected after his mother’s death, rejecting the company’s assertion that she had concealed a prior illness. The Panipat District Consumer Disputes Redressal Commission also directed the insurer to pay Rs 11,000 for harassment and mental agony, plus Rs 5,500 in litigation costs.
The bench, headed by president R K Dogra with members Rekha Chaudhar and Vineet Kaushik, said the insurer had offered only a general allegation in its written reply and had failed to place any medical records on the case file to show that the woman suffered from a previous disease when the policy was issued. In its order dated September 14, the commission said the company had not substantiated its claim with even a single document, making the repudiation unsustainable.
The ruling adds to a series of consumer forum decisions this year pushing back against insurers that have refused to settle claims on the basis of alleged non-disclosure. In a separate Haryana case, the District Consumer Disputes Redressal Commission in Karnal ordered Tata AIG General Insurance to reimburse a mediclaim after finding there was no adequate proof of a concealed illness. In Telangana’s Nizamabad, a consumer commission similarly told ICICI Prudential Life Insurance to pay a widow after rejecting a death claim on pre-existing disease grounds. The Assam Consumer Commission has also held HDFC Life liable in a case where a son was denied a claim after his father’s death.
The dispute in Panipat followed an unresolved legal notice, after which the son approached the consumer forum seeking the insurance amount with interest. The commission’s order again underlined a recurring theme in consumer disputes over insurance: a company may question a claim, but it must still back that challenge with credible evidence.
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