The District Consumer Disputes Redressal Forum has directed an insurance firm to pay Rs 13 lakh to the widow of an insured person, who had died after paying two instalments of the annual premium.
The forum has also directed the company to pay interest on the amount from the date of the filing of complaint along with Rs 2,000 as litigation expenses.
Earlier, Sunita Rani, a resident of Khalra village had filed a complaint against PNB Metlife India Insurance Company stating that her husband Bhushan Kumar had bought an insurance policy for a period of 15 years commencing from October 21, 2011, having an annual premium of Rs 99,006.
She said on completion of 15 years, the insured was to get maturity amount of Rs13 lakh and in the event of death of policy holder during the continuation of the policy, the nominee appointed by him was to get the entire maturity amount.
She said her husband had paid two annual premiums for 2011 and 2012. Her husband died on April 8, 2013, and when she claimed the insurance firm amount, the claim was denied, she added.
The insurance company in its reply stated that during the investigation of the death claim, it surfaced that Bhushan Kumar was suffering from hypertension from 3 years, diabetes mellitus for last 10 to 12 years and was on insulin prior to applying for the said policy.
The company said the insured that deliberately concealed the facts regarding his health at the time of purchase of the policy and as such the company was not liable to pay.
The forum observed that the patient was 60-year-old when he was given the insurance policy by the company and he must have been medically examined by the empanelled doctors of the company.
The forum said the opposite party could not produce any treatment record of Bhushan Kumar prior to inception of the policy. The forum held the company deficient in service and directed it pay the sum insured.
Curated from Insurance firm told to pay Rs13 lakh to complainant