Insurer denies woman’s death claim over ‘hidden illness’, son secures Rs 5 lakh payout

A Haryana consumer commission has ordered a private life insurer to pay a man Rs 5 lakh after it denied his claim following his mother's death. The insurer had refused to pay the claim, citing a pre-existing illness, but provided no medical proof to support their allegation. The commission ruled the insurer's denial illegal and ordered Rs 11,000 for harassment and mental agony, plus Rs 5,500 for legal expenses.

The son, as the nominee, submitted the mother's death certificate and required documents to claim the insured amount. The insurer argued that the deceased had misrepresented facts in the application form, but failed to provide any medical evidence to back their claim. The commission stated that the insurer could not reject the claim based solely on allegations of concealed pre-existing illnesses, and must provide supporting evidence.

The ruling emphasizes the importance of insurers backing up such allegations with documentary or medical proof and protects nominees from unsupported repudiation of valid policies.