MAX LIFE INSURANCE COMPANY LTD Vs. AMARAMA

JUDGEMENT

(1.) The State Commission of Karnataka has allowed CC no. 402 of 2018 filed by the respondent/ complainant holding that the appellant insurance company was deficient in its services by not reimbursing the claim of the complainant. The deceased husband of the complainant late Mr Veeresh aged about 49 years had acquired a Max Life Insurance Policy on 10/12/2014. He fell ill in the month of October 2016 and he died on 26/10/2016 due to aspiration problems as reported. The respondent/ complainant, being the nominee and widow of Mr Veeresh, requested for the reimbursement for the risk covered under the said policy, but the same was repudiated vide letter dtd. 31/3/2017, on the ground that the policy had lapsed due to nonpayment of renewal premium by the due date.

(2.) The complainant protested against the same that the payments had already been made and therefore, the policy had not lapsed with the grace period available and therefore the claim deserved to be reconsidered. The insurance Company took up the matter and vide letter dtd. 22/5/2017 intimated the complainant that her claim has been admitted for an evaluation.

(3.) On 27/6/2017 the final repudiation letter stated an all together different reason of nondisclosure of material facts about the pre-existing diseases of the insured and on that ground the claim was finally repudiated. The letter repudiating the claim dtd. 27/7/2017 is extracted herein as under: