The Life Insurance Corporation has been directed to settle a claim of Rs 19.75 lakh of a Mulund resident due in 2011 after her husband’s death. The LIC had rejected the claim on the pretext that the policyholder, Dr Shankar Shetty, had concealed certain medical facts. Dr Shetty’s wife Shubhalaxmi will now get the insurance claim with 9% interest, which itself stands at over Rs21 lakh.
An additional Rs10,000 has been awarded towards litigation charges by the National Consumer Dispute Redressal Commission (NCDRC), which upheld the 2019 verdict of the State Commission.
Dr Shetty was a renowned medical practitioner and proprietor of Shetty’s Endoscopic and Surgical Centre. His wife said he had purchased two life insurance covers – Jeevan Tarang and Samridhi Plus. He was diagnosed with lung cancer in September 2011. Until November that year, he was treated at Tata Memorial Hospital. In February 2012, he got admitted to Fortis Hospital. However, he passed away on February 29, 2012.
A few days later, when Shubhalaxmi approached LIC for the Jeevan Tarang claim which was valid till 2025, she was turned away on the pretext that he was also suffering from diabetes and had undergone a procedure for gallbladder removal in 2007. The ex-gratia of Rs2.75 lakh under the other policy was approved.
Shubhalaxmi then approached the consumer commission and said that her husband was not on medication for diabetes and managed it through diet and exercise. She also said that he was treated for gallbladder inflammation and not removal.
After going through evidence, the commission said that Dr Shetty passed away within two years of buying the policy due to complications arising from lung cancer. “The repudiation of the policy was on grounds that the insured failed to disclose diabetes and an earlier operation for removal of gallbladder (cholecystectomy) in 2007. He was diagnosed with cancer in November 2011 whereas the policy was obtained in July 2010, which is after the policy was approved,” said the commission, asking LIC to pay the insurance amount along with interest amount.
