Bajaj Allianz Lic Ltd vs Dalbir Kaur on 11 January, 2019
c) In Branch Manager Bajaj Allianz Life Insurance
Co. v. Dalbir Kaur AIR 2020 SC 5210, a proposal
form was submitted to the appellant therein for a life
insurance policy containing questions pertaining to the
health and medical history of the proposer and required
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a specific disclosure as to whether the proposer had
undergone any treatment. The proposer answered the
queries in the negative. Further a query regarding
specific diseases or disorders suffered was also
responded to in the negative. A policy of insurance was
issued by the insurer on 12th August, 2014, insuring the
life of the proposer for a sum of Rs. 8.50 lakhs payable
on maturity with the death benefit of Rs. 17 lakhs. On
12th September, 2014, the insured, Kulwant Singh, died
giving rise to a claim under the policy. The claim was
subjected to an independent investigation and the
records revealed that the deceased had been suffering
from hepatitis C. The claim was repudiated giving rise to
a consumer complaint which was allowed by the District
Forum. The appeal before the State Forum was also
dismissed, so also by the National Commission, the
revision was dismissed. Being aggrieved the insurance
company had preferred an appeal before this Court. It
was held that the investigation conducted by the insurer
in the said case clearly indicated that the deceased was
suffering from a preexisting medical condition which
was not disclosed to the insurer despite specific queries
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relating to any ailment, hospitalisation or treatment
undergone by the proposer in column 22 of the proposal
form therein. Hence the judgment of the Commission
was set aside but since the claim amount was paid to
the respondent, exercising jurisdiction under Article 142
of the Constitution it was directed that no recoveries be
made by the respondent insurer therein.