Insurance battle ends: 5 years after husband’s death; Hyderabad woman wins Rs 50 lakh claim

HYDERABAD: What began as a family's financial safeguard turned into a bitter legal battle after an insurer refused to honour a life insurance claim. Now, nearly five years after her husband's death, a Hyderabad woman has won.

The Telangana State Consumer Disputes Redressal Commission has ordered an insurance company to pay her Rs 50 lakh sum assured, plus compensation and interest, for wrongfully denying claim.The story unfolded when a complaint was filed by V Thara, who was left to fend for herself and her three kids following demise of her husband, Vallepu Venugopal, in Aug 2019. Venugopal took an insurance policy in Nov 2018, with a sum assured of Rs 50 lakh.

Thara was named as the nominee.

Following her husband's death due to sudden cardiac arrest, Thara submitted a death claim to insurance company. However, the claim was repudiated on Nov 26, 2019. The insurer argued that Venugopal failed to disclose a pre-existing illness, Chronic Kidney Disease (CKD), and was undergoing dialysis. When the commission began the trial, it found several flaws in the insurer's arguments.

Firstly, there was no evidence to show that Venugopal was diagnosed with or treated for chronic kidney disease before the date of policy issuance. The insurer did not conduct any pre-policy medical examination, which it had right and opportunity to do. Medical records produced during the hearing showed that Venugopal died due to sudden cardiac arrest. There was no documentation showing a diagnosis of CKD or ongoing dialysis treatment at the time policy was taken.The commission stated that the insurance company's refusal to settle the claim lacked merit and amounted to a deficiency in service and unfair trade practice. "The insurer should pay Rs 50 lakh with 9% interest per annum from Nov 26, 2019. Additionally, Rs 2 lakh was awarded as compensation for mental agony, and Rs 25,000 was granted as litigation costs," the court order read.