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Home Finance

Betrayed by the Promise of Protection: A Supreme Court Case on Insurance Claim Denials

The Supreme Court orders an insurance company to process and pay a denied claim, citing bad faith and a deficiency in service. The case involves a home loan from a bank that required the insured person to obtain a life insurance policy.

India CSR by India CSR
January 1, 2023
in Finance
Reading Time: 4 mins read
Medical Claim Denied Stamp Showing Unsuccessful Medical Reimbursement

Medical Claim Denied Stamp Showing Unsuccessful Medical Reimbursement

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Insurance policies can provide much-needed support in times of crisis, but when a claim is denied or not handled properly, it can feel like a betrayal. This article delves into a recent Supreme Court case involving an insurance company’s handling of a claim and the resulting court findings


I. Introduction

In advertisements, insurance companies often use emotional appeals to gain the trust of potential customers and reassure them that the company will provide support in times of crisis or emergency.

II. Case Overview

The Supreme Court has accepted a legal challenge against an insurance company that denied a claim and issued a backdated letter to defer the claims process. The insured person in this case has died, and the insurance company decided to refund the premium and reject the claim after learning of the death.

The court has ordered Max Life Insurance Corporation to process the insurance claim of the person making the appeal and pay them what is due. The reason for the appeal is related to a home loan from Axis Bank that was granted on the condition of obtaining a life insurance policy in the name of the deceased insured person, Gokal Chand.

The appeal alleges that the bank acted as an agent for the insurance company and paid the insurance premium on behalf of Gokal Chand using funds from the sanctioned loan.

III. Court Findings

The court found it surprising that the insurance company deferred the claims process and refunded the premium after learning of the insured person’s death.
The court criticized the insurance company for exhibiting bad faith in its handling of the situation. The court also found that the insurance company demonstrated a deficiency in service and acted in a non-bona fide (not in good faith) manner.

Also Read

Question: What did insurance companies do in advertisements to gain trust and reassure potential customers?

Answer: Insurance companies often used emotional appeals in advertisements to gain the trust of potential customers and reassure them that the company would provide support in times of crisis or emergency.

Question: What was the legal challenge that the Supreme Court accepted in this case?

Answer: The Supreme Court accepted a legal challenge against an insurance company that denied a claim and issued a backdated letter to defer the claims process.

Question: Why did the insurance company decide to refund the premium and reject the claim in this case?

Answer: The insurance company decided to refund the premium and reject the claim after learning that the insured person had died.

Question: What did the court order Max Life Insurance Corporation to do in this case?

Answer: The court ordered Max Life Insurance Corporation to process the insurance claim of the person making the appeal and pay them what is due.

Question: What was the reason for the appeal in this case?

Answer: The reason for the appeal was related to a home loan from Axis Bank that was granted on the condition of obtaining a life insurance policy in the name of the deceased insured person, Gokal Chand. The appeal alleged that the bank acted as an agent for the insurance company and paid the insurance premium on behalf of Gokal Chand using funds from the sanctioned loan.

Question: What were the court’s findings in this case?

Answer: The court found it surprising that the insurance company deferred the claims process and refunded the premium after learning of the insured person’s death. The court criticized the insurance company for exhibiting bad faith in its handling of the situation. The court also found that the insurance company demonstrated a deficiency in service and acted in a non-bona fide (not in good faith) manner.

Note for Readers: We hope that you enjoyed reading this article and found it useful and thought-provoking. If so, please consider sharing it within your network and on social media.

Declaimer: Reprinting or republishing this article in web media or other formats is not permitted by India CSR.

(CopyRight@India CSR)

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Tags: Insurance Claim DenialsMax Life Insurance CorporationSupreme Court of India

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India CSR is the largest media on CSR and sustainability offering diverse content across multisectoral issues on business responsibility. It covers Sustainable Development, Corporate Social Responsibility (CSR), Sustainability, and related issues in India. Founded in 2009, the organisation aspires to become a globally admired media that offers valuable information to its readers through responsible reporting.

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