Mr. ABC went to Singapore and Malaysia for a one week vacation. When he was in Singapore he felt some uneasy feeling and hence he went to a hospital for a Medical check-up but he was identified with a heart problem. Hence he had to undergo a heart surgery. He informed the Insurance Company about his hospitalization. But the insurance Company, repudiated the claim stating that he had the disease earlier and he suppressed the disease while taking the insurance policy. Mr. ABC did not have any knowledge about his disease and his declaration is declaration of his knowledge and not the actual health status. We filed a consumer case and argued that he did not have the knowledge about the disease and the insurance Company could not produce any document to prove the contra and hence Insurance Company must pay the claim. The insurance Company argued that the claimant has to prove that he did not have any knowledge about the decease. But Finally the Consumer Commission held that the onus to prove that the claimant had the knowledge about his disease is on the Insurance Company and since it could not prove that the claimant had the knowledge about the disease, the Insurance Company is liable to pay the claim amount.
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