The Supreme Court has ruled that insurance companies can reject claims if the insured suppresses the fact of being an alcoholic and succumbs to alcoholism during the validity of the policy.
A bench of Justices Vikram Nath and Sandeep Mehta passed the verdict while allowing an appeal by LIC challenging the findings of the district consumer forum and the State Consumer Commission of Haryana and the National Consumer Disputes Redressal Commission directing the insurer to fulfil the claim of Mahipal, who died of alocoholism.
Mahipal had bought LIC’s Jeevan Arogya policy. After Mahipal’s death in 2014 following a month’s hospitalisation, LIC repudiated his wife’s claim for reimbursement of the medical bills on the ground that he had concealed information about his chronic alcoholism.
“The deceased’s chronic alcoholism and liver disease were material facts that were deliberately suppressed when the policy was obtained. Given the clear exclusion clause, the appellant was justified in repudiating the claim,” the apex court said.