NCDRC asks LIC to pay Rs 7 lakh to woman who lost ailing son

The apex consumer commission has asked the Life Insurance Corporation (LIC) of India to pay Rs 7 lakh to the kin of a youth whose medical claim was rejected on the ground of non-disclosure of material facts.
The National Consumer Disputes Redressal Commission (NCDRC) upheld the district forum's order directing the LIC to pay Rs 7 lakh under the policy, Rs 2,000 towards deficiency in service and Rs 1,500 as litigation cost to Gujarat-resident Jamnaben Shambhubhai Mange, who lost her ailing son.
"The allegation of suppression of material information against the insured is not established. It is also stated that the insured was subjected to examination by the panel of doctor of insurance company and nothing adverse was noticed against him," the NCDRC bench headed by presiding member B C Gupta said.

According to the complaint filed by Mange, her son Hitesh, who had an insurance cover of Rs 7 lakh, was admitted with fever to a private hospital on August 29, 2006.
He was diagonised with kidney-related ailments and was subjected to dialysis and also given vaccine for jaundice, it said, adding that he died on October 8, 2006.
The LIC claimed that Hitesh had earlier undergone treatment for pain in abdomen and renal disease, but those facts were not disclosed at the time of availing the insurance cover.

The NCDRC, however, observed that even if Hitesh was suffering from stomach pain or headache, there was no need or occasion to mention the same in the proposal form, unless some specific disease is indicated and treatment for it was taken.

"At the time of filling up the proposal form in March 2006, the youth was not suffering from the disease of chronic renal failure (CRF) and hence, he cannot be charged with the allegation of non-disclosure of material information," it said.
The NCDRC was hearing Mange's appeal against the state commission's order which had denied the relief to her, saying true facts about the health condition of the youth were not stated in the proposal form.