Archive · 30 Jul 2026
Insurer Ordered to Pay Accident Claim Despite Pre‑Existing Hypertension
A man named Rajinder Saini was in a car crash in Punjab.
His wife was badly hurt and later died.
He had a health insurance plan that should cover accident injuries.
The insurance company said they would not pay because his wife had high blood pressure before the crash.
The court said the high blood pressure had nothing to do with the crash injuries, so the company must pay.
They ordered the company to give him about 8.9 million rupees plus interest and extra money for the trouble.
This shows that insurance companies must prove a direct connection between a pre‑existing illness and the accident before they can refuse payment.
Punjab consumer forum ruled insurer cannot deny accident claim based on unrelated pre‑existing hypertension.
Rajinder Saini’s family floater policy was cancelled after insurer alleged undisclosed hypertension; court found no nexus to accident treatment.
Insurer ordered to reimburse Rs 8.88 lakh plus 6 % interest, and pay Rs 30,000 in compensation and litigation costs.
Policy covered Saini, wife Pinki, and others; accident occurred March 4 2023, wife died May 15 2023.
Decision emphasizes insurers must prove direct link between pre‑existing condition and claim before rejecting accident‑related coverage.
- Who
- Rajinder Saini and Cholamandalam MS General Insurance Company
- What
- Denial of accident claim over alleged undisclosed hypertension
- When
- Accident on March 4, 2023; court decision on July 22, 2023
- Where
- Punjab, India
- Why
- Insurer claimed non‑disclosure of hypertension; court found no link to accident treatment
- Policy type
- Family Floater Arogya Plus
- Sum insured
- Rs 7.5 lakh
- Premium paid
- Rs 21,835
- Accident date
- March 4, 2023
- Claim amount
- Rs 8,88,014
- Interest rate
- 6% per annum
- Compensation awarded
- Rs 30,000
- Court order date
- July 22, 2023