Complainant Jassa Singh lodged the claim with the Max Life Insurance Company Limited on account of death of insured Sarabjit Kaur, but the said company repudiated his claim vide letter dated 28.2.2013 on the ground that the medical disclosure, as required in the proposal form, was not made by late Sarabjit Kaur.
On this Jassa Singh filed a complaint before the District Consumer Forum, Ferozepur on July 16, 2013. Max Life Insurance Company Limited appeared and filed written reply to the complaint pleading therein that the deceased life assured (Sarabjit Kaur) was suffering from Pulmonary Tuberculosis and HIV+ much before the proposal form filled in by her and she had suppressed the fact about her illness. Both the parties led their evidence in support of their respective versions.
After hearing the learned counsel for the parties as well as after going through the pleadings and evidence led by the parties, the District Consumer Forum, Ferozepur held that the proposal form was filled in by the agent of the opposite parties and the deceased Sarabjit Kaur had only put her signatures on the said proposal form in Punjabi script; report of Integrated Counselling & Testing Centre Laboratory, District Ferozepur dated 26.12.2010, produced by the Max Life Insurance Company Limited to prove that Sarabjit Kaur was detected as HIV positive case, was having cutting/overwriting in its PID number besides some other cuttings and the alleged Pulmonary Tuberculoses and HIV+ was not the cause of death of deceased life assured Sarabjit Kaur, rather, her death was occurred due to falling from the roof.
Ultimately the consumer forum concluded that the repudiation of the claim of the complainant by the Max Life Insurance Company Limited was not justified. The full bench of the consumer forum then while accepting the complaint of the complainant, directed the Max Life Insurance Company Limited to pay the sum assured of Rs.6,00,000/- on account of death of deceased life assured Sarabjit Kaur along with interest at the rate of 9% per annum from the date of repudiation of the claim i.e. 28.2.2013 till realisation to complainant Jassa Singh.
Besides the forum also directed the Max Life to make a payment of Rs.5000/- as compensation for harassment and Rs.3000/- as litigation expenses, within a period of thirty days from the date of receipt of a copy of the order.
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