Supreme Court clears insurance air on stated existing illness

A bench of Justices D.Y. Chandrachud and B.V. Nagarathna also said a proposer was duty-bound to disclose to the insurer all material facts within his knowledge

Supreme Court.: File photo

PTI   |   TT  |  New Delhi   |  29.12.21  :   An insurer cannot repudiate a claim by citing an existing medical condition, which had been disclosed by the insured in the proposal form, once the policy has been issued, the Supreme Court has said.

A bench of Justices D.Y. Chandrachud and B.V. Nagarathna also said a proposer was duty-bound to disclose to the insurer all material facts within his knowledge. The proposer is presumed to know all the facts and circumstances concerning the proposed insurance, it added.

“Once the policy has been issued after assessing the medical condition of the insured, the insurer cannot repudiate the claim by citing an existing medical condition, which was disclosed by the insured in the proposal form and which condition has led to a particular risk in respect of which the claim has been made by the insured,” the bench said in a recent judgment.

The top court declared illegal United India Insurance’s denial of the claim of Manmohan Nanda, who had undergone angioplasty in the US after suffering a heart attack there.

The company had said Nanda had not disclosed that he had had a history of hyperlipidaemia — abnormally elevated levels of any or all lipids such as fats, cholesterol and triglycerides — and diabetes.