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‘No relief to policy holder for non-disclosure’

National Consumer Commission has upheld the rejection of a mediclaim of person, who suffered a heart attack within a week of taking an insurance policy, saying he failed to disclose the past history of the disease to the company.



New Delhi: The National Consumer
Commission has upheld the rejection of a mediclaim of person,
who suffered a heart attack within a week of taking an
insurance policy, saying he failed to disclose the past
history of the disease to the company.

"It is well settled that principle of insurance is
fundamental to utmost good faith which must be observed by the
contracting parties and good faith forbids either party from
non-disclosure of the fact which the parties know," the
Commission said.

It passed the order on a petition of United India
Insurance Corporation Limited (UIICL) challenging the
direction of the Madhya Pradesh State Consumer Commission to
pay the mediclaim along with the cost of Rs 500 to policy
holder Subhash Chandra.

Chandra suffered a heart attack within a week of
taking the policy. His claim was repudiated on the ground of
non-disclosure of the pre-existing disease to the UIICL.

"It would be too much of a coincidence to argue that
within a week of the complainant taking the policy, he had a
sudden heart attack and from the available records, we cannot
but hold that he had a past history which was not disclosed
for reasons best known to him," the Commission said.

It said that Chandra had a history of diabetes
mellitus and hypertension.

Earlier, the policy holder contended that he had not
concealed any fact by stating clearly that he had a previous
history of diabetes in the proposal form.

The company said that Chandra suppressed the material
fact by not informing it that he was suffering from
hypertension and chest pain.

-PTI

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