GOKAL CHAND (D) THR. LRS. versus AXIS BANK LTD. & ANR.

GOKAL CHAND (D) THR. LRS. versus AXIS BANK LTD. & ANR.

Given that the loan was sanctioned and the insurer received and retained the premium, the insured underwent a medical test with no adverse findings, and the insurer only took steps to defer and then refund the premium after intimation of death—including issuing an ante-dated postponement letter—there is a clear presumption of acceptance and the insurer’s conduct amounted to mala fide behaviour and deficiency of service. The impugned orders were thus set aside and the insurer was directed to process and pay the claim.

Parties
Appellant: GOKAL CHAND (D) THR. LRS.; Respondent: Axis Bank Ltd.; Respondent: Max Life Insurance Corporation
Jurisdiction
India
Judgment Date
15 December 2022
Procedural Posture
Civil Appeal / Appeal From National Consumer Disputes Redressal Commission Order Dated 12.09.2019
Outcome
Appeal allowed; impugned judgment set aside; complaint allowed
Legal Topics
Deficiency of Service, Life Insurance, Acceptance of Insurance Proposal, Presumption of Acceptance, Medical Examination, Repudiation of Claim, Good Faith
Consumer Protection Insurance Law Deficiency of Service Life Insurance Acceptance of Insurance Proposal Presumption of Acceptance Medical Examination Repudiation of Claim +1 more

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Parties

GOKAL CHAND (D) THR. LRS.

Appellant

Axis Bank Ltd.

Respondent

Max Life Insurance Corporation

Respondent

Procedural Posture

Civil Appeal / Appeal From National Consumer Disputes Redressal Commission Order Dated 12.09.2019

Legal Issues

  1. 1 Whether a concluded life insurance contract existed between the insurer and the insured such that the insurer was liable to pay the claim
  2. 2 Whether the insurer acted mala fide or was deficient in service by ante-dating a postponement letter, refunding the premium and repudiating the claim after intimation of death
  3. 3 Whether retention of premium and surrounding circumstances give rise to a presumption of acceptance of the policy by the insurer

Ratio Decidendi

Given that the loan was sanctioned and the insurer received and retained the premium, the insured underwent a medical test with no adverse findings, and the insurer only took steps to defer and then refund the premium after intimation of death—including issuing an ante-dated postponement letter—there is a clear presumption of acceptance and the insurer’s conduct amounted to mala fide behaviour and deficiency of service. The impugned orders were thus set aside and the insurer was directed to process and pay the claim.

Court Disposition

Appeal allowed; impugned judgment set aside; complaint allowed

Orders

  • Impugned judgment of the National Consumer Disputes Redressal Commission dated 12.09.2019 set aside
  • Respondent No.2 (Max Life Insurance Corporation) directed to process the complainant's insurance claim and remit the payable sum