Giving a big relief to the wife and family of a deceased home loan borrower, the national consumer disputes redressal commission (NCDRC) directed SBI Life Insurance Co Ltd to pay the amount insured for the home loan to State Bank of India (SBI). The lender is directed to accept the payment as final and issue a no dues certificate (NDC) without charging any further payment to the heirs of the deceased life assured (DLA) borrower.
In an
order earlier this month, the NCDRC bench of Binoy Kumar (presiding member) says, "The order of the state commission is partly upheld by directing the insurance company to make payment of the insured amount to the Bank, which had provided the loan to the DLA, and such amount shall be considered as final payment of loan amount and the Bank shall issue the NDC to SBI Life Insurance, thereafter, without charging any further payment from the DLA's family."
Rajinder Kumar, the DLA, obtained a Rs8 lakh home loan from the SBI's Nadaun branch. He also enrolled for insurance coverage under the RiNn Raksha group insurance scheme of SBI Life Insurance on 7 February 2013.
However, on 27 September 2013, Mr Kumar died. The home loan insurance claim filed by his wife, Sumna Devi and her son was rejected by SBI Life Insurance, stating that Mr Kumar did not disclose in the proposal form his coronary artery disease, hypertension and single vessel disease. The SBI home loan outstanding of Mr Kumar was Rs7.87 lakh at that time.
Ms Devi filed a case before the Hamirpur district consumer disputes redressal forum. While allowing her complaint, the district forum directed SBI Life Insurance and SBI to pay Rs8 lakh, the benefits of the insurance policy to Ms Devi along with interest at the rate of 9%pa (per annum) and pay Rs10,000 as compensation and cost of litigation.
SBI Life Insurance's first appeal was also dismissed by the Himachal Pradesh state consumer disputes redressal commission.
Aggrieved by the orders, the insurer then approached NCDRC with its revision petition. SBI Life Insurance reiterated contentions already presented before the district forum and the state commission without introducing any new question of law justifying interference with these orders.
The counsel for Ms Devi argued that the insurance company failed to fulfil its obligation by not conducting a pre-medical examination before issuing the insurance policy, even though the insured was over 45. "Mr Kumar died a natural death on 27 September 2013. The investigator failed to obtain the doctor's statement. The doctor's affidavit was not recorded. The medical report that was gathered by the investigator during the investigation is not to be relied upon as its accuracy is questionable."
After hearing both the parties, NCDRC observed that the district forum and state commission have adjudicated on the merits of the case. The bench says, "They (fora below) have already dealt with the issue of non-disclosure of ailment. They have held that details of the policy have not been disclosed. Except discharge summary, no other corroborative evidence was filed by the insurance company. Though the discharge summary does mention certain ailments, in the peculiarity of this case, such evidence procured by the investigator does not inspire confidence to conclude that the deceased is guilty of non-disclosure."
The bench, while dismissing the petition, directed SBI Life Insurance to pay the full claim for the home loan insurance to SBI as a final payment towards the home loan of Mr Kumar. SBI is directed to issue the NDC to SBI Life Insurance and not to charge any further payment from Ms Devi and her son.
(Revision Petition No548 of 2020 Date: 9 October 2024)
