On August 4, 2023, Sukhdev Singh died of a heart attack while an LIC policy was active. The policy, issued April 28, 2022, had a sum insured of Rs 5 lakh and a monthly premium of Rs 2,290. In January 2024, LIC rejected the claim, citing undisclosed pre‑existing conditions.
LIC's denial hinged on a 2008 ASD/VSD closure and a post‑Fontan procedure, documents it claimed were omitted from the application. The insurer argued that the claim was made before policy maturity and that the deceased had failed to disclose a heart condition during underwriting.
The commission scrutinised two proposal forms. The first was incomplete, lacking signature and date; the second bore a May 22, 2022 date, after the policy had already been issued. LIC failed to produce any medical record from before April 28, 2022 to substantiate the alleged pre‑existing condition.
Commission chairman S. K. Sharma said LIC had misrepresented the disclosure process and the insurer’s evidence was chronically flawed. He noted that the policyholder had paid a cumulative Rs 36,000 in premiums and that the claim denial constituted a deficiency in service.
The commission ordered LIC to pay the nominee Rs 5 lakh plus interest, to be paid by September 30, 2024. The father, who had been seeking a fair settlement, welcomed the decision, while LIC has yet to respond publicly to the ruling.