order setting aside the impugned repudiation letter
dated 06.04.2015 of the Opposite Party No. 1 repudiating the
insurance claim of the complainant under the marine ... therefore wrongfully repudiated the
claim. The OP No. 1 has wrongfully observed in the claim
repudiation letter that the consignment was in the hands
documents for processing of her claim. The
complainant was shocked to receive the information that her claim has
been repudiated by the insurance company ... date of the death of the deceased also. The claim
repudiation letter dated 23.10.2015 was received by the complainant
on 12.11.2015. On 04.11.2015, the bank
servicing of claims under health insurance policies by way of
pre-authorization of cashless treatment or settlement of
claims other than cashless claims or both ... reject or repudiate any of the claims directly. In the
present case the claim has been repudiated by opposite party No.2-
TPA, vide letter
servicing of claims under health insurance policies by way of
pre-authorization of cashless treatment or settlement of claims
other than cashless claims or both ... reject or repudiate any of the claims
directly. In the present case the claim has been repudiated and the
cashless service was denied
this case, is
whether the opposite party was justified in repudiating the claim of
the complainant on the ground that he suffered from hypertension
since ... policy is issued. It was held that the Insurance
Company wrongly repudiated the claim of the complainant. If, in
the present case, the complainant
properly appreciated by opposite parties No.1,2&3 while repudiating
the claim. The complainant being widow of the deceased is entitled ... parties are not justified under any circumstances upon
his death to repudiate the claim amount to be paid under the said
policies. On failure
submitted his claim
form, but his claim was repudiated by the O.P. No.1 and O.P. No.2 on the
ground that intimation ... submitted his claim form, but his claim was repudiated by the O.P. No.1
// 8 //
and O.P. No.2 on the ground that
making
payment of the claim amount at the earliest. The claim of the
complainant was repudiated on the ground that in the proposal form
signature ... making payment of the claim amount at the earliest.
The claim of the complainant was repudiated on the ground that in the
proposal form signature
suppressed any
information regarding his health. The OPs by repudiating the claim of
the complainant on wrong ground has committed deficiency in
service ... true and correct health condition.
Therefore, the OPs have rightly repudiated the claim raised by the
complainant on the ground of suppression of material facts
Insurance -
Theft of Vehicle - Delay in Intimation - Claim repudiated - District
Forum dismissed complaint - State Commission dismissed appeal - Hence
revision - Insured (Complainant Society) was duty bound ... Sections 2(1)(g) , 21(b) -
Insurance - Theft - Delay in intimation - Claim repudiated -
Alleged deficiency in service - Report of theft must be lodged
immediately. Intimation
