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  • Disease - Illness That Is Commonplace and Curable Need Not Be Disclosed - Handle Your Own Case

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    Alok kumar Tripathi
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    1) The document discusses a case where an insurance claim was denied due to the non-disclosure of a prior eye infection. 2) The court ruled that the eye infection was a common and curable viral infection, and there was no connection between it and the insured's actual cause of death, which was a heart attack. 3) The court determined that it is unreasonable to expect insureds to disclose every minor viral infection on their forms, and therefore the non-disclosure in this case did not amount to suppressing a material fact.

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    Disease_illness That is Commonplace and Curable Need Not Be Disclosed _ Handle Your Own Case

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    1) The document discusses a case where an insurance claim was denied due to the non-disclosure of a prior eye infection. 2) The court ruled that the eye infection was a common and curable viral infection, and there was no connection between it and the insured's actual cause of death, which was a heart attack. 3) The court determined that it is unreasonable to expect insureds to disclose every minor viral infection on their forms, and therefore the non-disclosure in this case did not amount to suppressing a material fact.

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    3 views3 pages

    Disease - Illness That Is Commonplace and Curable Need Not Be Disclosed - Handle Your Own Case

    Uploaded by

    Alok kumar Tripathi
    1) The document discusses a case where an insurance claim was denied due to the non-disclosure of a prior eye infection. 2) The court ruled that the eye infection was a common and curable viral infection, and there was no connection between it and the insured's actual cause of death, which was a heart attack. 3) The court determined that it is unreasonable to expect insureds to disclose every minor viral infection on their forms, and therefore the non-disclosure in this case did not amount to suppressing a material fact.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
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    12/4/2018 Disease/illness that is commonplace and curable need not be disclosed | handle your own case

    handle your own case

    Get armed with your appropriate citation.

    Disease/illness that is commonplace and curable


    need not be disclosed

    December 30, 2015December 30, 2015 cdisputes  cases favouring consumers, cause of
    death, connection, curable diseases, curable illness, life insurance, nexus, Nexus between the suppressed
    fact and the cause of death, relationship, Suppression of illness, Suppression of material facts, trivial
    illness, Uncategorized Uncategorized
    Crux: 1) Non-disclosure of trivial illness not concerning the cause of death is not a material
    suppression.

    2) In this case, nexus between the eye ailment (viral infection) and the cause of death (heart
    a ack) not established.

    3) While filling up an insurance proposal form, it is not expected that the insured has to also
    state all incidents of viral infections from which he may have suffered which are frequent, common
    place and curable.

    NCDRC – RP No.2837/2007, decided on 03.11.2011

    Parties: LIC of India Vs Surekha Rameshrao Mankar

    Genre: Life Insurance

    Case of the Complainant: The claim was repudiated on the ground that the insured had suppressed
    material fact i.e., he had suffered from a disease known as “Herpes Zoster” relating to the eye. The
    complainant contended that this was a curable viral infection of the eye and was thus not suppression of
    a material fact and therefore, the claim was wrongly repudiated.

    Case of the Insurer: It is on record that in the Insurance Proposal Form relating to his health status, the
    insured had suppressed the fact regarding his having suffered from Herpes Zoster and had stated that
    his health was good. Since an insurance policy is a contract between two parties entered into in “utmost
    good faith”, the suppression of a material fact justified the repudiation of the insurance claim.

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    12/4/2018 Disease/illness that is commonplace and curable need not be disclosed | handle your own case

    Held: “The facts pertaining to the insurance policy, the death of the insuree due to a heart a ack and the
    fact that he underwent treatment for Herpes Zoster of the eye are not in dispute. The point at issue,
    therefore, is whether by concealing the fact that he had suffered from Herpes Zoster of the eye amounted
    to suppression of a material fact. As per medical literature on the subject, Herpes Zoster is a viral
    infection commonly known as ‘shingles’ which can affect various parts of the body. 10% to 25% of all
    Herpes Zoster cases reportedly affect the eye and is called Herpes Zoster OPTHAMICUS (Source: C
    Stefan Foster, MD, Eye Research and Surgery Institute, Harvard Medical School). This is a viral infection
    and is a curable disease like most viral infections. In fact, the Herpes Zoster virus can also cause chicken
    pox which is a common disease. No doubt the insuree suffered from this viral infection and was cured as
    per the documents on record. This disease was in no way related to the heart a ack. Normally while
    filling up an insurance proposal form, it is not expected that the insuree has to also state all incidents of
    viral infections from which he may have suffered since these are frequent, common place and curable. In
    the instance case, this infection apart from having been cured was in no way related to the heart a ack
    from which the insuree died. We are therefore of the view that not revealing information about this
    curable viral infection did not amount to suppression of any material fact”.

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