NCDRC Rules in Favor of Policyholder: LIC Ordered to Pay Despite Alleged Depression Non-Disclosure



In a landmark ruling, the National Consumer Dispute Redressal Commission (NCDRC) has directed the Life Insurance Corporation (LIC) to honor nine insurance policies of a Nadiad resident, despite LIC’s claims of non-disclosure of depression-leading to a heart attack.

The decision sets a precedent, emphasizing that the lack of a clear link between depression and the cause of death should not be used as grounds for denying insurance claims.

Anil Patel from Nadiad had purchased nine LIC policies and tragically passed away due to a heart attack two years later. The family faced a denial of insurance claims, as LIC alleged that Patel concealed his struggle with depression when acquiring the policies. Undeterred, the grieving family contested the denial and took the matter to the Kheda district consumer forum, which ruled in their favor.

LIC, adhering to Insurance Regulatory and Development Authority guidelines, argued that the rejection of claims was justified due to Patel’s alleged non-disclosure of his depression.

The insurer emphasized the necessity for policyholders to declare their medical history and treatment during the policy acquisition. The case escalated to the National Consumer Commission after the Gujarat State Dispute Redressal Commission upheld the district forum’s decision in 2019.

Patel’s family countered LIC’s claims, asserting that impaneled doctors had conducted medical tests on Patel, for which he paid an extra premium due to his excess weight. The family argued that this negated any suggestion of information suppression.

They also maintained that depression had no bearing on the heart attack that led to Patel’s demise, a stance supported by both the state commission and the district forum.

NCDRC Ruling And LIC Insurance Amounts

The NCDRC, after careful consideration, stated that the medical literature provided by LIC did not establish depression as a serious ailment. Additionally, the commission observed that there was no documented evidence to indicate a link between depression and heart failure.

In a decisive statement, the NCDRC asserted, “There is no nexus between the ailment and the cause of death, i.e., heart failure,” directing LIC to fulfill the insurance amounts.

This ruling has far-reaching implications for the insurance sector, emphasizing the need for a concrete link between non-disclosed ailments and the cause of death. It establishes a precedent that depression, in itself, cannot be used as a blanket reason to deny insurance claims related to heart attacks.

The decision underscores the importance of thorough examination of medical evidence and challenges the practice of outright claim denials based on alleged non-disclosure.

The NCDRC’s ruling in favor of the policyholder against LIC signifies a victory for consumer rights and brings clarity to the interplay between mental health disclosures and insurance claims.

As families grapple with the loss of loved ones, this decision sets a standard that ensures insurance companies thoroughly evaluate medical evidence before denying claims.

It prompts a reevaluation of the criteria used by insurers to assess the relationship between pre-existing conditions and the cause of death, paving the way for fairer and more just insurance practices.


— About the Author —

Leave a Reply

Your email address will not be published. Required fields are marked *

Up Next

Controversy Surrounds Proposed “Betting on Our Future Act” Targeting Mobile Sports Betting Ads

Congressman Paul D. Tonko (D-NY) has ignited debate with the introduction of the “Betting on Our Future Act,” a bill aimed at banning online and electronic advertising of sports gambling in the United States. Tonko’s proposed legislation unveiled just before the Super Bowl, is motivated by concerns for the younger demographic.

In his statement introducing the bill, Tonko emphasized the potential risks posed by such advertisements, particularly to adolescents and young adults who may be unaware of the dangers associated with gambling.

Drawing parallels to the Public Health Cigarette Smoking Act of 1969, which prohibited tobacco advertising, Tonko underscores the need to regulate the promotion

Up Next

Survey On Mental Health Struggles Reveals That Students Opt-Out of College Due To Anxiety And Depression

As high school juniors and seniors contemplate their futures, the decision to pursue higher education weighs heavily on many. However, for a significant portion of students, concerns about mental well-being are influencing their choices, leading them to either delay college enrollment or forego it altogether.

A recent study conducted by EAB, formerly known as the Education Advisory Board, has brought to light a concerning statistic: nearly one-third of the nearly 6,500 students surveyed cited mental health concerns as the primary reason for opting out of college.

This trend is particularly pronounced among underrepresented groups, with mental well-being issues disproportionately affecting stu

Up Next

Funding Shortage Threatens Vital Mental Wellness Program for Farmers

In a bid to support the mental health of Utah’s agricultural community, the Ag Stress Assistance Program (ASAP) was launched in March 2023.

Spearheaded by the Utah Department of Agriculture and Food (UDAF) and Utah State University (USU) Extension Ag Wellness, the program provided behavioral healthcare vouchers to farmers and ranchers, offering crucial support during challenging times.

However, recent funding shortages have cast a shadow over the mental wellness program for farmers, raising concerns about the well-being of those it serves.

Up Next

New York City Sues Social Media Giants for Allegedly Exacerbating Youth Mental Health Crisis

In a bold move, New York City has launched a lawsuit against several major social media companies, including Meta, Google, Snap, and TikTok, accusing them of exacerbating a nationwide youth mental health crisis.

The lawsuit, filed after designating social media as a “public health hazard” in late January, targets TikTok, Instagram, Facebook, Snapchat, and YouTube, alleging that they are “fueling” the crisis by endangering children’s mental health, promoting addiction, and encouraging unsafe behavior.

The Mayor Eric Adams administration has leveled three counts against these companies in the lawsuit: public nu

Up Next

Understanding “Popcorn Brain”: How Social Media Impacts Attention Span and Mental Health

In an age dominated by digital media, the term “popcorn brain” is gaining traction to describe the phenomenon of rapidly shifting attention spans. Coined by University of Washington researcher David Levy in 2011, this concept refers to the tendency of individuals to quickly jump from one task or thought to another, akin to popping corn kernels.

According to clinical psychologist Dr. Daniel Glazer, “popcorn brain” stems from the constant bombardment of digital stimuli, particularly through social media platforms.

As people scroll through endless feeds of new posts, alerts, engagements, and advertisements, they experience a small dopamine release that reinforces this behavior, leading to a cyc

Up Next

Anti-Psychotic Drug Clozapine Under Scrutiny: Medicines Watchdog Initiates Review

In a recent development, the use of the anti-psychotic drug clozapine is under scrutiny after reports of its association with hundreds of deaths annually. The Times investigation has shed light on lapses in monitoring its usage, prompting the medicines watchdog to initiate a review.

The Royal College of Psychiatrists has echoed concerns, calling for a reassessment of clozapine’s prescription practices, asserting that it may have contributed to preventable deaths.

Often considered a last resort in treating conditions like paranoid schizophrenia and psychosis in Parkinson’s disease, clozapine is prescribed to approximately 37,000 individuals in the UK.

Up Next

Rising Job Anxiety Grips Big Tech Industry Amid Changing Workplace Dynamics

In recent years, the once-cushy atmosphere of the Big Tech industry has undergone a significant transformation, with job anxiety becoming increasingly prevalent among workers. What was once characterized by free lunches, moonshot projects, and job security now faces a new reality marked by layoffs, increased competition, and a focus on efficiency.

Dubbed the “Zero Interest Rate Phenomenon” (ZIRP), this shift reflects a changed workplace landscape where companies prioritize reducing layers and streamlining operations. Job cuts once considered temporary measures, have now become a permanent fixture, leading to a sense of uncertainty and diminished job satisfaction among employees.

Despite these challenges, Big Tech companies continue to thrive financially, with giants like Mic