Widow wins Rs 50 lakh insurance six years after SBI Life rejects claim over ‘old illness’

The State Consumer Disputes Redressal Commission in Chandigarh has ordered SBI Life Insurance to pay Rs 50 lakh to the family of a deceased chartered accountant, Raj Kumar, following a rejection of his insurance claim six years ago. The commission ruled that the insurer had failed to prove the deceased had intentionally concealed important health issues when he purchased the policy.

Raj Kumar, who was 36 years old, passed away on October 24, 2020, after experiencing sudden chest pain. SBI Life initially denied the claim in March 2021 due to Raj Kumar's past hospitalization for acute pancreatitis and delirium tremens, as well as an ultrasound report in December 2019 that showed a cirrhotic liver. The commission found that the insurer did not establish Raj Kumar's knowledge of these conditions at the time of purchasing the policy and did not provide sufficient evidence of a deliberate suppression of the facts.

The commission awarded Rs 75,000 to compensate the family for mental anguish, harassment, and litigation expenses. The full Rs 50 lakh sum assured will be paid to the widow, minor daughter, son, and another complainant, with interest applied if the payment is not made within 30 days.