Gujarat court junks insurance company's claim that depression caused heart attack
Saeed Khan | TNN | Feb 3, 2019, 07:14 IST
Representative imageAHMEDABAD: Can severe depression lead to heart attack? Can an insurance company deny claim after an insured person's death due to heart attack merely because he was suffering from depression?
The Gujarat State Consumer Dispute Redressal Commission has turned down arguments by the Life Insurance corporation of India (LIC) wherein it rejected insurance claim saying that the insured person, who died due to heart attack, was suffering from severe depression. The consumer court on Thursday ordered LIC to pay Rs 47.90 lakh towards insurance claim in two different policies.
The court said that there is no co-relation between depression and the cause of death and hence LIC could not have repudiated claims made by kin of the deceased on the ground that he was severely depressed.
The case involved a family of one Hetalkumar Patel from Nadiad. He died of heart attack in 2012. Two years before his death, he had bought nine different policies from LIC.
‘Claim made by LIC not justified’
Hetalkumar Patel’s family members claimed insurance money and the LIC repudiated the claims saying that Patel was being treated for depression and he had not declared his ailment while opting for insurance.
For seven claims, the family members successfully approached the district consumer dispute redressal forum in Nadiad. But for two policies, which involved amount higher than Rs 20 lakh each, Patel's widow Dr Nilam Patel, two children and his parents knocked at the commission. LIC also challenged the lower court’s orders.
LIC placed medical literature showing how damaging major depressive disorder could prove. Patel’s advocate argued that there is no connection between depression and heart attack. He cited various orders passed by the Supreme Court and the National Consumer Dispute Redressal Commission (NCDRC) to show that insurance companies were directed to pay claims in case of deaths in which cause of death and the pre-existing ailments had no nexus. The court said, “It is very clear that the husband of the original complainant was suffering from major depression and he died due to heart attack. Thus, it cannot be said that there is any nexus between the ailment and the cause of death.”
The Gujarat State Consumer Dispute Redressal Commission has turned down arguments by the Life Insurance corporation of India (LIC) wherein it rejected insurance claim saying that the insured person, who died due to heart attack, was suffering from severe depression. The consumer court on Thursday ordered LIC to pay Rs 47.90 lakh towards insurance claim in two different policies.
The court said that there is no co-relation between depression and the cause of death and hence LIC could not have repudiated claims made by kin of the deceased on the ground that he was severely depressed.
The case involved a family of one Hetalkumar Patel from Nadiad. He died of heart attack in 2012. Two years before his death, he had bought nine different policies from LIC.
‘Claim made by LIC not justified’
Hetalkumar Patel’s family members claimed insurance money and the LIC repudiated the claims saying that Patel was being treated for depression and he had not declared his ailment while opting for insurance.
For seven claims, the family members successfully approached the district consumer dispute redressal forum in Nadiad. But for two policies, which involved amount higher than Rs 20 lakh each, Patel's widow Dr Nilam Patel, two children and his parents knocked at the commission. LIC also challenged the lower court’s orders.
LIC placed medical literature showing how damaging major depressive disorder could prove. Patel’s advocate argued that there is no connection between depression and heart attack. He cited various orders passed by the Supreme Court and the National Consumer Dispute Redressal Commission (NCDRC) to show that insurance companies were directed to pay claims in case of deaths in which cause of death and the pre-existing ailments had no nexus. The court said, “It is very clear that the husband of the original complainant was suffering from major depression and he died due to heart attack. Thus, it cannot be said that there is any nexus between the ailment and the cause of death.”
All Comments ()+^ Back to Top
Refrain from posting comments that are obscene, defamatory or inflammatory, and do not indulge in personal attacks, name calling or inciting hatred against any community. Help us delete comments that do not follow these guidelines by marking them offensive. Let's work together to keep the conversation civil.
HIDE