Kathmandu. Insurance is not only about paying premiums and taking claims, but it is also a contract of good faith. There is a growing trend of insurers hiding their health condition and companies getting into legal trouble during the subsequent claim.
The recent verdict of Nepal Insurance Authority in a case of Himalayan Life Insurance has proved this again.
This was the event
Sita Bhattarai, who had a life insurance of Rs 500,000 on March 28, 2019 at Himalayan Life Office, died on March 1, 2022. Maniram Bhattarai, the heir of the deceased, filed an application for payment of the death claim. However, when the company investigated, it was found that the deceased had concealed a serious illness before getting insurance.
Hospital Medical Records Reveal
During the investigation conducted by the Insurance Authority, a frightening fact was found in the records of Lumbini Provincial Hospital. According to the OPD and emergency tickets of the hospital, the insured had been suffering from stroke for the last 7 years. He also had chronic diabetes and thyroid problems. While filling up the insurance proposal form, she claimed that she was completely healthy without being informed about any of these serious diseases.
Based on this fact, consultant doctor of Himalayan Life Dr. Saroj Gaudel said that the disease was concealed before the insurance was issued.
What is a stroke?
A stroke is a sudden blockage of blood flow to the brain, or a rupture of blood inside the brain. This makes the brain cells inadequate with oxygen and nutrition. This can cause cell damage in a short time.
Judgment of the Authority
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The Insurance Authority has endorsed the decision of the insurer by giving its final verdict in this case on October 7, 2081. It has been observed that the insured has been trying to take advantage of the insurance against the universally accepted principle of good faith by making false declaration in the insurance proposal form by concealing the disease he has suffered prior to the issuance of the policy. With this, the authority has dismissed the claim of the insured and ordered the company not to bear the liability.
