Rejection of ₹50 lakh Term Insurance by Insurance Company

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July 25, 2025

Case Details:

Husband aged 34 and Wife aged 30 with a 2-year-old kid.

They bought a 1 BHK Flat for RS 38 Lakhs in Pune and availed a Loan of ₹30 Lakh for the same.

The bank advised them to take a Term Insurance of ₹50 lakhs before the disbursement of the loan. Eventually, a Term Insurance of ₹50 Lakh was given to the Customer.

Unfortunately, just in the 19th Month of the policy, the Person Suffered a Massive Heart Attack and passed away at the age of 34, leaving behind his wife and 2-year-old child.

Important Background:

In the 13th Month of the policy, the customer was diagnosed with a Heart Problem and was taking treatment from a renowned cardiologist in Pune, BUT unfortunately, he didn’t survive.
Scenario: When the Claim was launched, the Bank did not support anything and diverted the customer to the Insurance Company. Though it was their duty to assist at every step, as they were the agents for this Policy.
The Insurance Company rejected the Claim, stating that the Customer was aware of his Heart Problem before taking the Policy and he had purposely hidden the fact.

Solution:

This case came to us through a reference from a common friend, and we took time in studying all the relevant Documents.
On verifying the documents, we came to know that the Customer was actually not aware of his Heart Condition before taking the policy, and now the Insurance Company had asked the Customer to prove that they were not aware of this fact before taking the Policy.
We took up this case with the Insurance Company and did some mail exchanges with the company, pressing hard that it is the Insurance Company that has to prove that the customer was aware of his health condition before taking the Policy. We also requested them to review again, or else we will approach the Ombudsman or the Consumer Court.
After some 4 Months of rigorous follow-up, finally the Insurance Company accepted the Claim and paid the ₹50 lakh due to the Customer.
Helping the Mother of a 2-year-old Child was the most satisfying experience of our lives.

Conclusion:

Don’t buy any Policy from anyone except an Agent. You should always have an Agent who will always support your family when you will not be there.
SD INSURANCE Does not charge any customer any fees for such help in Claims.

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