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Home India

Can Insurer Use Exclusion Clause To Scrap Claim? Supreme Court To Examine

October 24, 2021
in India
Reading Time: 1 min read
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No presumption of innocence once a person is convicted by trial court: Supreme Court
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New Delhi: The Supreme Court has agreed to examine an appeal filed by an insurance firm challenging an order of the National Consumer Disputes Redressal Commission (NCDRC) that directed it to pay ₹ 13.48 lakh to a woman whose husband died by suicide.

Reliance Life Insurance Company Limited had refused the claim, relying on the exclusion clause of the policy.

Staying the NCDRC order, a bench of Justices D Y Chandrachud and B V Nagarathna issued a notice to the woman on the appeal filed by a branch manager of the insurance firm.

“Issue notice, returnable in eight weeks. Pending further orders, there shall be a stay of the operation of the impugned judgment and order of the National Consumer Disputes Redressal Commission,” the bench said in its October 20 order.

The counsel for the insurance company submitted before the bench that in view of the specific exclusion in Clause 9 and Clause 12 — general conditions — of the insurance policy, suicide by an insured having taken place within 12 months from the date of the reinstatement of the policy has no amount as payable.

He said the policy was issued on September 28, 2012, and lapsed on 28 September 2013, due to the failure to pay the renewal premium.

The insurance policy was reinstated on February 25, 2014, and the death due to suicide took place on June 30, 2014, that is within 12 months of reinstatement of the policy, the lawyer said.

The woman’s husband was the holder of the insurance policy and had paid a premium of ₹ 1 lakh, which was issued to him on September 28, 2012, according to the case.

In June 2014, the man jumped into the Indravati River in Chitrakoot and died. When the insurance company refused to pay the insurance amount, she approached the district forum, which directed the company to pay ₹ 13.48 lakh to her.

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