Landmark judgements

LAW ON COVERAGE OF POLICY WHEN LOANEE DIES BEFORE MEDICAL EXAMINATION (NO POLICY EXIST)

LAW ON COVERAGE OF POLICY WHEN LOANEE DIES BEFORE MEDICAL EXAMINATION (NO POLICY EXIST)

 

 

I (2017) CPJ 649 (NC)

NATIONAL CONSUMER DISPUTES

REDRESSAL COMMISSION, NEW DELHI

Hon’ble Mr. Justice Ajit Bharihoke, President, Hon’ble Mr. Justice K.S. Chaudhari, Presiding Member & Mr. Prem Narain, Member

SBI LIFE INSURANCE CO. LTD.—Appellant

versus

D. SRINIVAS & ORS.—Respondents

First Appeal No. 560 of 2012 against Order dated 26.7.2012 in Complaint No. 63/2011 of Andhra Pradesh State Consumer Disputes Redressal Commission—Decided on 3.2.2017

Justice Ajit Bharihoke (Majority view)

(i) Consumer Protection Act, 1986 — Sections 2(1)(g), 2(1)(r), 20(1)(iii) — Insurance — Housing loan — Death of loanee — Coverage under policy disputed — Proposal pending for medical examination — Claim repudiated — Alleged deficiency in service — Acceptance of premium before the mandatory medical examination not amounts to unfair trade practice — Non-compliance of 15 days period for processing of proposal by Insurance Company will not come in way of Insurance Company to repudiate insurance claim — Repudiation justified.

[Paras 9, 10, 14]

Case referred:

Life Insurance Corporation of India v. Raja Vasireddy Komalavalli Kamba & Others, 1984 (SLT SOFT) 240(Relied)

[Para 10]

Justice K.S. Chaudhari (Majority view)

(ii) Consumer Protection Act, 1986 — Sections 2(1)(g), 21(a)(ii) — Insurance — Housing loan — Death of loanee — Coverage under policy disputed — Proposal pending for medical requirements — Claim repudiated — Alleged deficiency in service — State Commission allowed complaint — Hence appeal — No insurance policy was issued by appellant infavour of deceased — In absence of insurance policy, no concluded contract comes into force between deceased and appellant — Merely on basis of delay in considering proposal by appellant for want of medical check-up of deceased, liability cannot be fastened on appellant for payment of housing loan — Repudiation justified.

 

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