Chennai: The Madras High Court has ruled in favor of a petitioner, ordering an insurance company to disburse a Rs 10 lakh claim after her husband’s sudden death. The court clarified that the suppression of certain medical details, such as the deceased’s history of medical leave, should not be grounds for denying an entire insurance claim.
The petitioner’s husband, who served as the Principal in charge at Government Arts and Science College, Manimedu, had a policy that assured a sum of Rs 10 lakh. He passed away on January 9, 2020, due to sudden cardiac arrest, despite chest pain. Following his death, the petitioner filed a claim, which was rejected by the insurance company based on the claim that the deceased had failed to disclose his medical history, including multiple hospitalizations and medical leaves.
The insurance company argued that when the policy was taken, the deceased had stated he had not consulted a doctor for over a week in the past five years and had not taken any medical leave. However, after reviewing the records, it was found that the deceased had indeed availed medical leave on several occasions and had been hospitalized in December 2016 for chest pain.
Upon hearing the case, the court determined that although the deceased had been hospitalized for chest pain in 2016, there was no evidence of chronic heart disease or surgery after that period. It was also noted that the deceased had not taken medical leave post-2016. The court emphasized that the suppression of these facts was not sufficient to deny the claim, as the sudden cardiac arrest occurred without prior treatment.
The court further remarked that the insurance proposal was filled out by an agent, without consulting the insured directly. Therefore, it could not be claimed that the insured had deliberately suppressed information regarding his medical leave or hospital admission.
As a result, the court directed the insurance company to pay the Rs 10 lakh sum to the petitioner.
