PNB METLIFE INDIA INSURANCE COMPANY LTD. & ANR. NEW REGISTERED OFFICE (W.E.F FROM 1.5.2016) UNIT NO. 701, 702 & 703, 7TH FLOOR, WEST WING, RAHEJA TOWERS, 26/27, M G ROAD, BANGALORE Vs. SUNITA GOYAL & 2 ORS. W/O. LATE SH. ASHOK KR. GOYAL, R/O. SARAWATI SONS, BASTI BALOCHAN WALI, INSIDE AMRITSARI GATE, FEROZEPUR PUNJAB

JUDGEMENT

(1.) Late Shri Ashok Kumar Goyal obtained a money back policy, for 10 years from the petitioner company, for a sum assured of Rs. 10 lakhs on 5.3.2013. The annual premium payable by him was fixed at Rs. 95832.46/-. Shri Ashok Kumar Goyal expired on 22.11.2014 more than one and a half year after the policy was issued. Being his legal heirs, the complainants submitted a claim for payment in terms of the policy, which the deceased had taken in his life time. The claim was, however, rejected on the ground that the insured was a known case of DM and a chronic alcoholic and smoker for last 30 years. Being aggrieved from the rejection of the claim, the complainants approached the concerned District Forum by way of a consumer complaint.

(2.) The complaint was resisted by the insurer primarily on the ground that the insured had obtained the policy by a misrepresentation of material facts as regards the state of his health since he was a known patient of DM for the last 9 to 15 yeas, besides being a chain alcoholic and smoker for last 30 years.

(3.) The District Forum vide its order dated 23.11.2015 allowed the complaint and directed the insurer to pay a sum of Rs. 10 lakhs to the complainants along with interest @ 9% p.a. from the date of repudiation of the claim and the cost of litigation quantified at Rs. 10,000.00