BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL

COMMISSION, JAIPUR

Complaint No.40/2022

IN THE MATTER OF:

Mamta Sharma ...Complainant

Versus

Exide Life Insurance Company Ltd. & Ors. …Opposite Parties

EVIDENCE ON BEHALF OF THE RESPONDENTS (Exide Life

Insurance Company Ltd. & Ors. )

I, P. Chidanand., Deputy General Manager -Legal, of Exide Life

Insurance Company Ltd., do hereby solemnly affirm and declare that ,
what is stated above are true , correct and as per my knowledge as
ascertained from the records.

1. I state that the Exide Life Insurance Company Ltd. & Ors.
(hereinafter referred to as the “Company” or “answering
Respondents”) having its Registered Office at 3rd Floor JP Techno
Park, No 3/1, Millers Road, Bengaluru, 560001 , is a Company
registered under Companies Act, 1956 and under Section 3 of
the Insurance Act, 1938 .

2. I state that the Late Mahendra Kumar had submitted a proposal

form on 30.09.2020 for issuance of Policy namely “Exide Life
Smart Term Plan – Comprehensive”. The premium opted for the
policy was Rs. 8963/- to be paid annually for a premium paying
term of 20 years.

The details of the Policy issued are mentioned below:

 Policy No. 04295119
Proposal date 30-09-2020
Policy Commencement date 08-10-2020
Risk Commencement Date 08-10-2020
Name of the Policyholder/ Life Mahendra Kumar
Assured Sharma
Plan Exide Life Smart Term
Plan – Comprehensive
Premium/ Frequency Rs.8963/-
Premium payment term 20 years
Policy Term 20 years
Sum Assured on death Rs.50,00,001/-
Complainant/ Nominee Mamta Sharma
Instalments of Premium Paid 1
Status of Policy Repudiated
Copy

Copy of proposal Form along with Policy terms and conditions is

exhibited here with as Exhibit-R1.

1. I state that the Opposite Party Company conducted a medical

examination which was just based on declaration of the Life
Assured. That at the time of medical examination, the Life
Assured had answered negative in all the disease/disorder. It is
submitted that the medical examination was just based on
declaration and scan, any in-depth lab test involving high-cost
equipment’s to detect any risk illness were not conducted by the
Doctor. It is not the complete scan of the body to locate and
identify all types of critical illnesses. During the medical check-
up the Life Assured replied negative in all questions. The Medical
examination declaration dated 05.10.2020 is exhibitedherewith
as Annexure-R2.

2. I state that thereafter, the Answering Opposite Party received

death claim dated 25.06.2021 from the Complainant informed
that the Life Assured died dated 13.05.2021. Copy of Claim
Intimation is exhibitedherewith as Annexure-R3.
3. Since, the death of the Life Assured occurred within 8 months
from the risk commencement date of the subject policy, the
Answering Opposite Party had conducted a statutory
investigation under clause 8 (3) of the Insurance Regulatory and
Development Authority of India (Protection of Policyholder’s
Interest) Regulations, 2002 after receiving the claim from the
Complainant.

 During claim investigation, the Company procured the

below documents which confirmed the pre-existing medical
condition of the Life Assured; document dated 30/12/2017
of Indowestern Brain and Spine Hospital shows ‘Disc
desiccation with diffuse disc bulge, right posterolateral and
sequestered disc at L5-S1 level migrating caudally causing
right lateral recess stenosis and compression of traversing
right S1 nerve root’.
 The document dated 26/06/2018 of Suryam Imaging
Centre, also confirms ‘Loss of Lumbar lordosis’ in the spine
of LA.
 Death summary from Sawai Mansingh Hospital confirms
that the LA was a known case of DM and HTN since 2 years
 Thus, it was revealed during investigation that the Life
Assured suppression his pre-existing illness at the time of
issuance of subject policy. Copy of medical documents is
exhibitedherewith as Annexure-R4 (Colly).

4. I state that the claim under the said Policy was repudiated by
letter dated 12.11.2021 on the grounds of non-disclosure of pre-
existing medical condition and refund the premium amount of
Rs.9022.27/- in the account of the claimant. Copy of repudiation
letter dated 12.11.2021 is exhibitedas Annexure-R5.

5. I state that, thereafter the Complainant sent Legal Notice to the

Answering Opposite Party through her Advocate 17.12.2021 for
 refund of claim amount. That the Answering Opposite Party duly
replied to Legal Notice vide letter dated 24.12.2021 and
informed the Complainant that the claim was repudiated on the
grounds of non-disclosure of pre-existing medical condition.
Copy of Reply to Legal Notice dated 24.12.2021 is
exhibitedherewith as Annexed-R6.

6. I state that in view of the abovementioned facts and

circumstances, it is clear that the present complaint against the
answering Respondents is meritless and legally not tenable. The
present complaint, therefore, is liable to be dismissed with
exemplary cost.

DEPONENT

VERIFICATION

Verified at Bengaluru on this 7 th day of April, 2022, that the

contents of above written version are true to the best of my
knowledge based on the records maintained by the Company in
its due course and legal advice.

DEPONENT