Content Provider | Supreme Court of India |
---|---|
e-ISSN | 30484839 |
Language | English |
Access Restriction | NDLI |
Subject Keyword | Consumer Protection Act 1986: Insurance claim – Repudiation of – Denial of renewal of policy |
Content Type | Text |
Resource Type | Law Judgement |
Jurisdiction | India |
Act(s) Referred | Consumer Protection Act, 1986 (68 of 1986) |
Case(s) Referred | Referred Case 0 Referred Case 1 |
Case Type | Appeal |
Court | Supreme Court of India |
Disposal Nature | Appeal Allowed |
Headnote | Consumer Protection Act, 1986: Insurance claim –Repudiation of – Denial of renewal of policy – On facts, pursuanceto the health insurance policy, the claimant incurred expenses onthe treatment of his wife for ovarian cancer – Claim forreimbursement of expenses made to the respondent-Insurancecompany, however, the same was repudiated on the ground of nondisclosureby the claimant that his wife was suffering from arheumatic heart disease – Filing of complaint – Allowed by theDistrict Forum and issuance of direction for renewal of the healthinsurance policy upon payment of premium – Upheld by the StateCommission – However, the National Commission though upheldthe directions as regards reimbursement of expenses incurredhowever, set aside the direction for renewal of the health insurancepolicy – Meanwhile, the claimant sought renewal of policy from07.07.2009, but the same was denied by the respondent on the groundof concealment of material facts – However, for the said period, policyrenewed in the year 2011 – Thereafter, for the period 2009 till 2011,claimant sought reimbursement of expenses incurred for the wife’streatment, however, the same was not allowed – In revision petition,the National Commission held that once the renewal of the policybeyond 06.07.2009 was not proper, no claim was admissible – Onappeal, held: Even the Insurance Company accepted the fact thatnon-mentioning of the disease from which the wife of the claimantsuffered at the time of purchasing the policy was not material, as thedeath was caused from a different disease all together – Both had norelation with each other – Insurance company cannot be permitted toraise same plea to deny renewal of insurance policy to the claimantfor the period from 07.07.2009 onwards – Moreover, the amountof premium charged by the insurance company for renewal ofpolicies has not been refunded – Meaning thereby the premium forrenewal of the policies for the said period stands paid – Once there is a valid insurance policy available in favour of the claimant, theclaim made by him for reimbursement of the expenses is justifiableand is to be paid to him – Thus, the impugned order passed by theNational Commission set aside. |
Judge | Hon'ble Mr. Justice Rajesh Bindal |
Neutral Citation | 2023 INSC 598 |
Petitioner | Om Prakash Ahuja |
Respondent | Reliance General Insurance Co. Ltd. Etc. |
SCR | [2023] 10 S.C.R. 83 |
Judgement Date | 2023-07-04 |
Case Number | 2769-2770 |
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