The National Consumer Disputes Redressal Commission (NCDRC) has directed the lnsurance Regulatory and Development Authority of lndia (IRDAI) to look into the role of insurance agents selling life insurance policies.
The apex consumer commission asked the IRDAI to issue fresh guidelines and modify proposal forms to clearly bring to the notice of customers that non-disclosure of medical conditions would lead to repudiation.
A bench of presiding member Dr S M Kantikar and member Binoy Kumar said this would avoid unnecessary mental agony and expenses of the insured.
The NCDRC was hearing an appeal filed by HDFC Standard Life lnsurance Company Limited challenging an order of the state consumer disputes redressal commission in Jaipur, which ruled in favour of the consumer.
The apex consumer commission said suppression of facts in the proposal form in this case vitiated the case of the complainant.
"The appeal is allowed and the order of the state commission is set aside. We also advise the Insurance Regulatory and Development Authority of lndia (IRDAI) to issue fresh guidelines on the conduct and responsibilities of the insurance agent when dealing with life insurance policy on the need for full disclosure of all diseases suffered by the customer in the proposal form and implications of non-disclosure. The proposal form can also be suitably modified to this effect," the NCDRC said.
The insurance company submitted that the deceased got the life insurance policy by concealing the material information regarding his medical ailments from which he was suffering since 2008.
The counsel of the respondent/complainant argued that the insurance company failed to prove the cited illnesses played a causal role in the death of the insured, and therefore, there was no ground to repudiate the claim.
The complainant has alleged that the agent of the insurance company misled him while filling up the proposal form, and that he signed on the dotted lines in good faith.
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