Page 55 - Insurance Times May 2024

Insurance Caselaws

Denial Of Insurance Claim, Bihar State ("Complainant") spouse, who designated the Complainant
as the policy's nominee. When he applied for the coverage,
Commission Dismisses Appeal By he gave his age as 47 years old. But the complainant's
Reliance Nippon Life Insurance. spouse passed away in less than two months. The
Complainant filed a claim with the Insurance Company and
Reliance Nippon Life Insurance Co. Ltd. vs included all necessary supporting documentation. But the
Gharohari Devi Insurance Company refused to resolve the claim despite
several efforts to do so and failed to provide a good
Summary
explanation for their actions. The Complainant lodged a
The State Consumer Disputes Redressal Commission in Bihar consumer complaint with the District Consumer Disputes
dismissed an appeal by Reliance Nippon Life Insurance
Redressal Commission in Motihari, East Champaran, Bihar,
Company, claiming the policyholder misrepresented their citing feelings of aggravation.
age when obtaining the policy. The Commission found that
the Insurance Company had not met its burden of proof, as The Complainant's husband lied about his age while obtaining
the advisor completed the proposal form after confirming an insurance policy, according to the Insurance Company,
the policyholder's age. The Complainant filed a complaint which is why the claim was rejected. Two documents were
with the District Commission, citing aggravation. The included: a copy of the voter list and a certificate from a
District Commission accepted the case and awarded the Panchayat Samiti member stating that the deceased
complainant compensation of Rs. 1,00,000/- and Rs. 5,000/ husband was '78 years old'. The District Commission
- to cover legal expenses. The Commission emphasized that accepted the case and gave the complainant compensation
an individual's age can be determined by observing their face of Rs. 1,00,000/-along with Rs. 5,000/-to cover legal
and physical characteristics. expenses.

About the case The State Commission noted that the Insurance Company
An appeal filed by Reliance Nippon Life Insurance Company, was unable to demonstrate that the Complainant's spouse
which alleged that the policy holder had misrepresented had committed fraud and misrepresented himself because
their age when obtaining the policy, was dismissed by the the Insurance Company's own Life Advisor completed the
State Consumer Disputes Redressal Commission, Bihar proposal form in his presence after confirming his age. The
bench, which is made up of Mr. Justice Sanjay Kumar State Commission added that an individual's age may be
(President), Mr. Ram Prawesh Das (Member), and Mr. determined just by observing their face and physical
Shamim Akhtar (Member). The State Commission characteristics, and that they are unable to hide their age.
determined that the Insurance Company had not met its
burden of proof because the advisor for the company Supreme Court Vacates SAT Stay On
completed the proposal form after confirming the
policyholder's age. IRDAI Order To Transfer Policies From
Sahara Life Insurance to SBI Life
Reliance Nippon Life Insurance Company Limited ("Insurance
Company") sold an insurance policy to Gharohari Devi's Insurance.

50 May 2024 The Insurance Times