SBI LIFE INSURANCE COMPANY LTD Vs. SOSAN
SBI LIFE INSURANCE COMPANY LTD
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(1.) Late Shri Mohan Lal, husband of the complainant took an insurance cover under group cover life of the petitioner company. He having died on 07.10.2015 within two years of taking the policy, a claim for payment in terms of the said insurance policy was lodged by the complainant with the petitioner bank. The claim was rejected vide letter dated 11.02.2016, which to the extent it is relevant reads as under:
"Late Mohan Lal, while applying for enrolment under the SBI Rin Raksha Home Loan Scheme had agreed 'Declaration of Good Health' when mentions that he was of sound health and was not suffering or had never suffered from any Critical Illness or any condition requiring medical treatment for illness, as on date of enrolment.
As per the medical treatment papers dated May 2014 available with us, Late Mohan Lal was suffering from Chronic Obstructive Pulmonary Disease with Pneumonia prior to the date of enrolment of policy.
The deceased Life Assured had given a false Good Health, Declaration and had not disclosed material fact at the time of entry it to the scheme the claim has repudiated."
Being aggrieved from the repudiation of the claim, the complainant approached concerned District Forum by way of a consumer complaint.
(2.) The complaint was resisted by the petitioner primarily on the ground that while taking the insurance cover, the complainant had suppressed material fact with respect to the state of his health since he didn't disclose that he was suffering from Chronic Obstructive Pulmonary Disease with Pneumonia before he had applied for the insurance cover on his health.
(3.) The District Forum having allowed the consumer complaint, the petitioner approached the concerned State Commission by way of an appeal. The State Commission having dismissed the appeal, the petitioner is before this Commission by way of this Revision Petition.;
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