2019 ACJ 1866
IN THE SUPREME COURT OF INDIA AT NEW DELHI
(CA No. 3944 of 2019; decided on 15.4.2019)
L.I.C. of India
VERSES
Manish Gupta
📌Insurance-Health-plus/mediclaim policy-Repudiation of claim Suppression of pre-existing disease-Insured is not subject to med. ical examination before issuance of health plus policy and acceptance of proposal is based on solemn declaration made by proposer Non disclosure of any health event is set out as a ground for exclud ing liability of L.I.C.-L.I.C. received hospital claim for insured undergoing mitral valve replacement surgery in which diagnosis has been reflected as rheumatic heart disease since childhood National Commission affirmed the findings of acceptance of consumer com plaint by lower forum on the ground that doctor had not been exam ined to prove his source of information about childhood disease Recording of past history of childhood disease by the hospital was never in dispute Proposal form contained negative response by the insured about his suffering from any cardiovascular disease Whether failure of the insured to disclose past history of cardio vascular disease since childhood was a valid ground for repudiation of claim Held: yes; complaint dismissed.