HDFC LIFE INSURANCE COMPANY Vs. JYOTHI MADHAVAN

JUDGEMENT

(1.) The writ petition is filed by HDFC Life Insurance Company Limited, challenging the award dtd. 7/11/2024 passed by the Insurance Ombudsman, Ernakulam, on a complaint preferred by the respondent herein. The petitioner is hereinafter referred to as 'the insurer' and the late husband of the respondent is hereinafter referred to as 'the insured' for brevity.

(2.) The brief facts necessary for disposal of the writ petition are as follows:-

(3.) The main contentions rendered by the insurance company were that the insured has deposited the first premium along with the proposal form and in the said proposal form, it is specifically mandated that the company will be at risk in pursuance of this proposal for insurance only after the risk under the proposal form is accepted by the company and such acceptance is communicated to the petitioner in writing by the company and further that the company has the right either to accept or reject the proposal without giving reasons thereto. It is also mandated that if the proposal of insurance is not accepted by the company, the aforesaid deposit shall be refunded without interest. Also, the company has requested the insured to appear for a medical examination, which is mandatory for the issuance of the policy under proposal No.20924808, but he did not turn up for the same. Since the insured has not satisfactorily furnished the necessary declarations as required by the insurer, including the underwriting requirements, the proposal was not accepted. It is also admitted that an amount of Rs.57,931.00, which was deposited, has not been appropriated towards the premium. The said amount could be appropriated towards the premium only after a medical examination and after determining the premium based on the medical report of the petitioner's husband. The proposal was not considered for want of a Medical Examination Report, which was a prerequisite for considering the proposal. It is also stated that the amount of Rs.57,931.00, was refunded, which was lying in the suspense account, to the wife of the insured through NEFT.