*“Pay insured amount of Rs. 5 lakh to aged woman”*

*7-FEB-2012*

*MADURAI *: Life insurance companies cannot refuse to honour their
commitment by accusing policy holders of suppressing their ailments as it
is equally the duty of the insurer to verify the correctness of the
information provided through rigorous medical examination before issuing
the policy, the Madras High Court Bench here has held.

Justice T. Raja passed the ruling while directing Life Insurance
Corporation (LIC) of India to pay the insured amount of Rs. 5 lakh to an
aged woman, G. Muthupackiam of Nagercoil in Kanyakumari district, whose
doctor son P. Thanga Murugan died in September 2006 due to Multiple
Myeloma. He had taken the life insurance policy in May 2004.

*Nominee*

The doctor had named his mother as the nominee as he died within nine
months since he got married in November 2005.

However, the insurance company rejected the claim for the insurance amount
on the ground that the policy holder had suppressed his past history of
seizures since childhood and the medication taken by him for bipolar
disorder.

The insurance corporation also relied upon medical records obtained from a
private hospital here to claim that the doctor had taken treatment between
August 1991 and February 1993 when he was around 13 years old for poor
concentration, fatigue, disturbed sleep and jerky movements of limbs.

It also accused him of not disclosing these facts when the policy was
renewed in November 2005 after a gap of five months.

On the other hand, the petitioner's counsel S. Natarajan contended that the
alleged treatment taken by the policy holder at the age of 13 had no
relevance to his cause of death.

*Multiple Myeloma*

The doctor was diagnosed of Multiple Myeloma only in January 2006, the
lawyer claimed and stated that he died despite best possible treatment
given to him at private hospitals in Madurai and Thiruvananthapuram.

Agreeing with his submissions, the Judge said that as per Section 45 of the
Insurance Act, an insurance company could not question the insurance policy
after the expiry of two years from the date on which it was issued. In the
present case, the policy holder had died only after the lapse of two years
and a written order rejecting the claim was passed on March 30, 2007.

The Judge also pointed out that the deceased doctor would not have failed
to renew the policy for five months between May and November 2005 if he had
already known about his ailment. Further, doctors in the panel of LIC had
also examined him before the policy was issued.

“If this requirement was not followed properly, then the corporation (LIC)
has to blame itself and not the insured,” the Judge said.

http://www.thehindu.com/news/states/tamil-nadu/article2866642.ece

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