The Supreme Court has pulled up Max Life Insurance Corporation for repudiating the claim of a woman in a “mala fide” manner by rejecting the policy taken by her deceased husband.
The court found that Max Life had issued a letter after the death of the man, pointing to problems in a treadmill test report, although he had cleared medical exams when he took the policy of Rs 6.24 lakh.
“The case at hand shows clear mala fide on the part of respondent No. 2 (Max Life) in the manner they dealt with the insurance policy, after learning of the death of the insured person on intimation from the affected persons. The way the issue was addressed by respondent No. 2 following the information conveyed does fail, in our opinion, the test of reasonable conduct.
“On top of that, to cover up their late reaction, most tellingly, the ante-dated letter under the garb of an unfounded medical reason was dispatched. These in our opinion amount to a clear case of deficiency of service and a non-bona fide conduct by respondent No. 2. The contrary finding in the impugned order do not pass our judicial scrutiny. “We are, therefore, persuaded to conclude that the impugned judgment is unsustainable and the same is set aside. With this order, the appeal and the complaint stand allowed. The respondent No. 2 is accordingly directed to process the complainant’s insurance claim and remit the payable sum,” a bench of Justices K.M. Joseph and Hrishikesh Roy said while hearing the appeal of the deceased Gokal Chand’s wife and other legal heirs challenging the concurrent findings of the District Consumer Forum, Haryana, and the National Consumer Disputes Redressal Commission dismissing the family’s plea.
“On 30.7.2017, the insured was called for medical examination and Gokal Chand’s treadmill test did not flag any health issue. In such backdrop, the communication of the insurance company for postponing the life insurance coverage by six months by adverting to the treadmill test report and that too at a stage after intimation about the death of the insured to the respondents, appears to be a mala fide act,” the court said.
Gokal Chand had obtained a housing loan from Axis Bank for which obtaining a life insurance from Max Insurance was a pre-condition.
On July 25, 2017, Axis Bank had sanctioned a home loan of Rs 7.1 lakh to Gokal Chand.
From the disbursed amount, an insurance premium of Rs 6.24 lakh was paid on behalf of the insured Gokal Chand by the bank to Max.
Gokal Chand underwent a medical test on July 30, 2017, but died of cardiac arrest on August 8, 2017.