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Insurer Denies Claim Despite Disclosed Habits
4 Sep
Summary
- Life insurer ordered to pay over Rs 50 lakh to widow.
- Claim rejected despite deceased disclosing alcohol consumption.
- Hypertension and diabetes ruled as lifestyle diseases.
A consumer commission has mandated Edelweiss Tokio Life Insurance to disburse over fifty lakh rupees to a widow. This ruling came after the company rejected her husband's insurance claim, a decision the commission deemed a deficiency in service. The insurer's rejection was based on the deceased's disclosed alcohol consumption, pre-existing hypertension, and diabetes.
The commission highlighted that the policyholder had openly declared alcohol usage before purchasing the policy. Furthermore, it was noted that hypertension and diabetes are recognized as lifestyle diseases, and according to Supreme Court precedents, these conditions alone should not invalidate a claim if disclosed.
The claimant's husband had bought the policy in April 2021, and tragically passed away on January 26, 2023. When the widow submitted her claim, the insurance firm not only rejected it but also cancelled the policy, offering a refund. The commission's final order mandates the payment of the Rs 50 lakh claim amount, plus 9% annual interest from September 30, 2023, along with Rs 10,000 for harassment and Rs 10,000 for litigation costs.
