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Dilip Kumar Singh bought a ₹50 lakh life insurance policy from HDFC Life in June 2015.
Two months later, on August 16, 2015, he was returning from Omkareshwar to Ujjain at night.
His vehicle met with an accident.
He died at the scene. Severe head injury.
His wife, Neeta Singh, filed the death claim.
HDFC Life rejected it.
Their reason: Dilip had not disclosed that he had diabetes, coronary artery disease, triple vessel disease, and had previously undergone angioplasty.
He died in a road accident. His heart had nothing to do with it.
The State Commission dismissed Neeta's claim. She appealed to NCDRC.
In November 2024, NCDRC reversed the decision.
The bench said: "The DLI died from a road accident, which is entirely independent of his undisclosed ailments. The insurance company's repudiation of the claim is untenable."
HDFC Life was ordered to pay ₹50 lakh with 9% interest from the date of complaint.
He had heart disease. He died in a car accident.
HDFC Life used his heart to deny his wife's claim for a death caused by a road.
Save this — if your insured family member dies in an accident, the insurer cannot reject the claim citing unrelated health conditions. The cause of death is what matters. Not the medical history.
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