NARGIS BANO vs PAK QATAR FAMILY TAKAFUL Ss — 2023 CLD 1319 INSURANCE-TRIBUNAL-LAHORE

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NARGIS BANO VS PAK QATAR FAMILY TAKAFUL Ss. 122, 75, & 118---Qanun-e-Shahadat (10 of 1984), Arts. 78 & 79---Insurance petition---Life insurance policy---Claim, repudiation of---Concealment pertaining to medical condition of the insured---Proof---Liquidated damages, award of---Petitioner was widow/nominee of the insured/policy-holder who passed away just after payment of the first premium---Insurance company paid the petitioner the cash value of the policy (Rs. 64,624/-) only and repudiated the death claim on the ground that deceased was suffering from pre-insurance ailments (heart, diabetes etc.) which were not declared by him at the time of his health declaration while purchasing the policy---Validity---Insurance company produced its Regional Sales Manager as a witness who admitted that neither he investigated the claim nor he conducted any inquiry of the death claim---No medical record was produced by the respondent/ company, instead the petitioner produced the record-keeper of the respondent/company who produced the same (medical record) showing that the deceased remained under treatment before his death---Respondent/company had neither produced any medical record of the insured prior to the insurance policy nor any doctor to prove its contention in accordance with Arts. 78 & 79 of the Qanun-e-Shahadat, 1984---Respondent/company though produced its investigation report but neither produced the Claim Examiner who prepared the said report nor produced any neighbor on whose statement the report was prepared---Respondent/company failed to discharge the onus of the pre-insurance ailment of the deceased---Both the parties were bound to make correct declarations, however the respondent/company failed to prove that the deceased made material concealment pertaining to his medical condition---Payment of cash value to the petitioner amounted to the admission of the claim by the respondent/company as, If the claim was liable to be rejected by the respondent/company on ground of pre-insurance ailment, the petitioner was not entitled even to cash value of the policy---It appeared that the respondent/company tried to pacify the petitioner by paying meager amount of cash value of the policy---Regarding liquidated damages, the petitioner could not be held responsible for a long delay in recovery of her claim, instead it was respondent/company who occasioned delay by rejecting her claim, so she was entitled to recover the liquidated damages from the respondent/company as provided under S. 118 of the Insurance Ordinance, 2000, from 90 days after filing the claim---Petitioner had successfully proved her claim against the respondent/company---Insurance Tribunal decreed the claim as prayed for with costs along with liquidated damages.

NARGIS BANO vs PAK QATAR FAMILY TAKAFUL Ss — 2023 CLD 1319 INSURANCE-TRIBUNAL-LAHORE

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