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Honest, full disclosures key to hassle-free health insurance claims

Customers must disclose habits like smoking and alcohol consumption honestly, regardless of frequency

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Proposal forms are designed to extract detailed information about each member. Each member must be treated as a separate entity during disclosure.

Himali Patel

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In a recent ruling, the Supreme Court overturned the National Consumer Disputes Resolution Commission’s order and upheld Life Insurance Corpo­ration (LIC) of India’s decision to deny a claim due to non-disclosure of alcohol consumption. The insured had purchased Jeevan Arogya, a hospitalisation cash benefit policy. The court held that long-term alcohol use was a material fact, and failure to disclose it justified claim rejection after the policyholder’s death. 
Insurance, say experts, is based on the principle of utmost good faith. “This verdict reinforces the importance of transparency and full disclosure in the proposal form to ensure successful claim settlement,” says