Consumer Forum Orders Insurer to Pay ₹50 Lakh Despite Alcohol Consumption History
What Happened
The Nagpur District Consumer Disputes Redressal Commission directed Edelweiss Tokio Life Insurance to pay over ₹50 lakh to a widow after finding that her husband had disclosed his alcohol consumption habit before buying the policy. The insurer had rejected the claim, alleging concealment of alcoholism, hypertension, and diabetes.
Key Takeaways
The commission ruled that an insurer cannot deny a claim on grounds that were already disclosed during the policy application process. It also noted that hypertension and diabetes are lifestyle diseases and, in this case, there was no evidence that the policyholder had concealed them before policy issuance. The insurer was held guilty of deficiency in service and ordered to pay the claim with interest.