Archive · 8 Oct 2026
Widow Wins Rs 50 Lakh Insurance Claim After Six-Year Dispute
Raj Kumar bought a life insurance policy in 2019.
He died in 2020, and his family asked the insurer to pay the policy benefit.
The insurer refused, saying Raj Kumar had not disclosed earlier health problems.
A consumer commission reviewed the evidence.
It said old medical records and a later liver finding did not prove that Raj Kumar knew about an illness when he applied.
The commission ordered SBI Life to pay Rs 50 lakh to four complainants, after adjusting a premium refund.
It also ordered the insurer to pay Rs 75,000 for distress, harassment and legal costs.
The payments have deadlines and may carry additional interest if they are late.
Chandigarh’s State Consumer Commission ordered SBI Life Insurance to pay a Rs 50 lakh claim to four complainants.
The insurer had rejected the claim, alleging Raj Kumar failed to disclose earlier illness and chronic liver disease.
The commission found the insurer had not shown that Raj Kumar knew of a material condition when he bought the policy or deliberately concealed it.
It said the 2014 hospital records and a later cirrhosis finding did not establish continuous illness or prove the alleged concealment.
The award includes 9% annual interest on the sum assured from October 24, 2020, plus Rs 75,000 compensation and expenses.
- Who
- Raj Kumar’s widow Anita Yadav, his minor daughter, his son and another complainant; SBI Life Insurance.
- What
- The Chandigarh State Consumer Commission allowed the family’s appeal and ordered payment of the Rs 50 lakh insurance benefit and Rs 75,000 in compensation and expenses.
- When
- The commission issued its order on October 5; Raj Kumar died on October 24, 2020.
- Where
- Chandigarh, India.
- Why
- The commission found the insurer had not established that Raj Kumar knew of a material illness when buying the policy and deliberately failed to disclose it.
Insurer’s position
Commission’s findings
Alleged non-disclosure
Insurer’s position
SBI Life argued Raj Kumar had a history of chronic alcoholism and liver disease and had failed to disclose these conditions when applying for the policy.
Commission’s findings
The commission said the insurer had not shown that Raj Kumar knew of a material condition at the time of application and deliberately withheld it.
Medical records and cause of death
Insurer’s position
The insurer relied on a 2014 hospitalisation and December 2019 records noting a cirrhotic liver.
Commission’s findings
The commission found the records did not establish continuous illness, knowledge at the time of purchase, or a proven link to the cause of death. It noted that the medical record cited by the complainants attributed death to complications of atherosclerosis of the left coronary artery.
- Policy
- SBI Life Smart Savadhan Plus
- Policy purchased
- March 2019
- Sum assured
- Rs 50 lakh
- Claim repudiated
- March 2, 2021
- Compensation and expenses
- Rs 75,000, to be shared equally by the complainants
- Payment deadline
- Within 30 days of SBI Life receiving the certified order
- Interest terms
- The Rs 50 lakh carries 9% annual interest from October 24, 2020; if unpaid after the deadline, it carries 12% annual interest from default. The Rs 75,000 carries 9% simple annual interest if unpaid within 30 days.