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Jodhpur, 2 November (HS). Permanent Lok Adalat, Jodhpur Metropolitan, while accepting the complaint, has said that if a person is suffering from a minor illness and does not give insurance or rejects the claim on the basis of hiding it in the insurance proposal form, the insurance business itself will be ruined. Court Chairman Sukesh Kumar Jain and members Jethmal Purohit and Manaklal Chandak directed Max Life Insurance Company to pay the claim amount of Rs 51 lakh 23 thousand 574 with 8 percent interest and complaint expenses of Rs 5 thousand within two months, otherwise 8 percent additional interest. Will have to pay.
Reena Rajesh Mehta filed a complaint through advocate Anil Bhandari saying that her husband took a housing loan from Axis Bank in October 2020, in return for which he took a life insurance policy worth Rs 56 lakh 72 thousand 353 from Max Life Insurance. On 16 October 2021, he underwent chest lump surgery at Kokila Ben Hospital and later died on 18 November at AIIMS Hospital, Jodhpur. The insurance company rejected her claim saying that her husband was admitted for a day in 2018 due to stomach ulcer and he had this disease since 2010, but he had hidden it in the proposal form while getting the insurance.
While arguing, Advocate Bhandari said that a person suffers from common diseases like blood pressure, diabetes, stomach related diseases many times in life and a person does not even remember many minor diseases. He said that the death of the insured was not due to stomach ulcer or gas, so the complaint should be accepted. The insurance company said that no matter what the cause of death may be, not declaring the illness in the proposal form is sufficient ground for rejection of the claim.
While accepting the complaint, the Permanent Lok Adalat said that even if there is a fatal disease like cancer, kidney, heart disease or liver disease, if this disease is hidden then it would be considered a deliberate or fraudulent action and it is understandable to reject the claim on this basis. But if the insurance company starts rejecting claims or refuses to provide insurance due to suffering from minor diseases, the insurance business itself will be ruined.
He said that the insured had stomach gas or general digestive system disease in the past, which was not a fatal disease but he died due to some other disease. He said that in such a situation there could be a 10 percent reduction in the claim amount. He directed Max Life Insurance Company to pay Rs 51 lakh 23 thousand 574 along with 8 percent interest and complaint expenses, the outstanding installment of Rs 5 thousand to Axis Bank within two months and pay the remaining amount to the complainant. If payment is not made within two months, the insurance company will also have to pay 8 percent additional interest.