INSUBCONTINENT EXCLUSIVE:
AHMEDABAD: Non-disclosure of ailments like depression should not be a basis for denying insurance claims in cases of death due to a heart
attack, the National Consumer Dispute Redressal Commission (NCDRC) has ruled, while ordering LIC to honour nine insurance policies purchased
by a resident of Gujarat's Nadiad.The commission said LIC's produced medical literature did not classify depression as a serious ailment.It
also noted that there was no record indicating that depression could lead to heart failure
"There is no nexus between the ailment and the cause of death, i.e
heart failure," it declared, directing LIC to honour the insurance amounts.Anil Patel acquired the LIC policies in 2010 and died of a heart
However, when his grieving family sought to claim insurance benefits, they faced rejection from the insurer, asserting Patel had concealed
his struggle with depression when he purchased the policies.Undeterred by the denial, Patel's family approached the Kheda district consumer
forum, which mandated LIC to fulfil the insurance claims
Despite LIC contesting the forum's orders, the Gujarat State Dispute Redressal Commission upheld the decision in 2019.LIC escalated the
dispute to the national commission, arguing that their rejection adhered to Insurance Regulatory and Development Authority (IRDA) guidelines
They claimed Patel failed to disclose his medical history and treatment, a requirement under the contract.Patel's family countered LIC's
They pointed out that LIC's empanelled doctors conducted medical tests on Patel, leading to an additional premium payment due to his excess
This, they argued, contradicted any notion of information suppression.The family asserted that depression had no correlation with the heart
attack that claimed Patel, a viewpoint endorsed by both the state commission and the district forum.
