Insurance Claim Can’t Be Denied On Ground Of Common Lifestyle Diseases
But Insurer Should Not Hide Info, Says NCDRC
The National Consumer Disputes Redressal Commission (NCDRC) had held that insurance claim cannot be denied on the ground of common lifestyle diseases such as diabetes or hypertension but that does not give right to the insured to suppress information in respect of such diseases.
The commission also reiterated that suppression of any information relating to pre-existing disease if it has not resulted in death or has no direct relationship to cause of death, would not completely disentitle the claimant from claiming the insured amount.
NCDRC member Prem Narain said so while deciding the appeal of one Neelam Chopra, a resident of Mohali in Punjab.
Her husband had taken an LIC policy in the year 2003 and after being medically examined by a panel of doctors, he was issued the policy w.e.f. 25.12.2002 to 25.6.2026.
The husband of the complainant died on January 7, 2004 due to cardio-respiratory arrest. Her claim was rejected by LIC on the ground that the insured had suppressed material information regarding his health at the time of effecting the policy as he suffered from diabetes and LL Hansen’s disease.
When Neelam moved the District Forum, LIC was told to pay her the insurance claim amount of Rs 5 lakh along with 12 per cent interest besides Rs 25,000 as compensation for mental agony and Rs 5,000 as cost of litigation. The State Commission of Haryana allowed the appeal moved by LIC. This is when Neelam moved NCDRC. The NCDRC noted, “…the Deceased Life Assured (DLA) died on 07.01.2004 and therefore, the disease on account of which the death occurred was not prevailing on the date of filing of the proposal form as the proposal form was filled on 24.01.2003. It has also been alleged that the DLA was suffering from diabetes as mentioned in the treatment record of PGI Chandigarh. He was suffering for 3-4 years from diabetes. In the certificate of Medical Attendance, it is also mentioned that the DLA was suffering from diabetes, however, diabetes was under control. “So far as the life style diseases like diabetes and high blood pressure are concerned”, the Commission quoted from the Delhi High Court judgment in case titled Hari Om Agarwal Vs. Oriental Insurance Co. Ltd., wherein it was held that, “Insurance- Mediclaim-ReimbursementPresent Petition filed for appropriate directions to respondent to reimburse expenses incurred by him for his medical treatment, in accordance with policy of insurance- Held, there is no dispute that diabetes was a condition at time of submission of proposal, so was hypertension-Petitioner was advised to undergo ECG, which he did- Insurer accepted proposal and issued cover note- It is universally known that hypertension and diabetes can lead to a host of ailments, such as stroke, cardiac disease, renal failure, liver complications depending upon varied factors- That implies that there is probability of such ailments, equally they can arise in non-diabetics or those without hypertension. It would be apparent that giving a textual effect to Clause 4.1 of policy would in most such cases render mediclaim cover meaningless- Policy would be reduced to a contract with no content, in event of happening of contingency”.
The commission, therefore, held that it was clear that “the insurance claim cannot be denied on the ground of these lifestyle diseases that are so common. However, it does not give any right to the person insured to suppress information in respect of such diseases. The person insured may suffer consequences in terms of the reduced claims.” It also relied on Supreme Court’s decision in Sulbha Prakash Motegaonkar and Ors. Vs. Life Insurance Corporation of India to say that, “… suppression of any information relating to pre-existing disease if it has not resulted in death or has no direct relationship to cause of death, would not completely disentitle the claimant for the claim”. The commission, therefore, set aside the order of the state commission and modified the order of the district forum to the extent that LIC was told to pay only the insurance amount of Rs 5 lakh and compensation of Rs 25,000 along with litigation cost of Rs 5,000. Interest at the rate of 8 per cent would be attracted only if the LIC fails to comply with the order within 45 days.
Courtesy: www.livelaw.in
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UK PM Keir Starmer takes ‘China matters’ message on first Beijing visit
London (PTI): “Like it or not, China matters to the UK,” is the message British Prime Minister Keir Starmer is taking on his visit to Beijing on Wednesday, accompanied by a 60-strong business and cultural delegation.
Downing Street said the visit, which will also cover Shanghai, reflects the UK’s “clear-eyed and realistic” approach to China in terms of opportunities and challenges they pose by continuing to pursue cooperation while “maintaining guardrails” when it comes to the country’s national security.
The Labour Party government is keen to highlight its re-engagement with China with this first visit in eight years, coming close on the heels of a ministerial go-ahead for its controversial new “mega embassy” in London.
“For years, our approach to China has been dogged by inconsistency – blowing hot and cold, from Golden Age to Ice Age. But like it or not, China matters for the UK,” Starmer said in a pre-visit statement.
“As one of the world’s biggest economic players, a strategic and consistent relationship with them is firmly in our national interest. That does not mean turning a blind eye to the challenges they pose – but engaging even where we disagree.
“This is what our allies do, and what I will do: delivering for the public, putting more money in their pockets and keeping them safe through pragmatic, consistent cooperation abroad,” he said.
The UK PM is set to meet President Xi Jinping and Premier Li Qiang in Beijing on Thursday for talks on trade, investment and national security, before travelling to Shanghai for a range of engagements with British and Chinese businesses.
Accompanied by a delegation of leading UK-based businesses, including Tata Motors owned Jaguar Land Rover, sporting institutions, museums and theatre groups, Starmer is expected to push for access in areas such as the financial services sector, creative industries and life sciences.
“However, he will be clear that we will not trade economic cooperation for our national security. He will raise the areas where we disagree with China – being clear that we will always defend our national security and where viewpoints differ, frank and open dialogue is of vital importance,” Downing Street said.
Describing China as the world’s second largest economy, a crucial player in global supply chains and a growing military power, the UK said it is important to engage with its third-largest trading partner which supports 3,70,000 British jobs.
“We want to see trade flourish between us. From financial services to advanced manufacturing and the global energy transition, the UK’s strengths increasingly align with the rapidly evolving Chinese economy,” said Peter Kyle, the Business and Trade Secretary travelling with Starmer.
“The first duty of government is security, and we protect ourselves best through active engagement and pragmatic cooperation, not by shutting the door,” he said.
The visit follows the 2025 Economic and Financial Dialogue (EFD) that the UK’s Department for Business and Trade (DBT) claimed secured 600 million pounds in immediate benefits and the first UK-China Joint Economic and Trade Commission (JETCO) since 2018.
“The UK’s world-leading financial services sector is a cornerstone of our economy. With deep and liquid markets, and the FTSE hitting all-time highs, there are real opportunities for mutually beneficial cooperation with China which supports jobs for working people and growth for businesses across Britain,” said Lucy Rigby, Economic Secretary to the Treasury, also part of the ministerial delegation.
The Opposition Conservatives have criticised Starmer’s approach to China, amid human rights concerns and espionage fears. “Starmer has already surrendered to the Chinese Communist Party over their plan for a spy-hub super embassy in the heart of our capital,” said shadow foreign secretary Priti Patel.
“The evidence is overwhelming that China poses a serious threat to our national security and it is clear Starmer is going to China without any leverage. He lacks the backbone to stand up for Britain and is bending over backwards to appease Beijing,” she said.
Following his trip to China, Starmer is set to travel to Tokyo to meet with Japanese Prime Minister Sanae Takaichi to reinforce the UK-Japan partnership, said to be worth over 100 billion pounds and supporting 2,00,000 UK jobs.
