Mst. JAMEELA RIAZ vs IGI LIFE INSURANCE through Head of Business and Operation Ss

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Mst. JAMEELA RIAZ VS IGI LIFE INSURANCE through Head of Business and Operation Ss. 122, 75 & 81---Insurance claim---Pre-insurance ailment of insured, concealment of---Utmost good faith---Scope---Plea of the petitioner (mother of deceased son/insured) was that her son got insurance policy, but unfortunately, before the payment of first premium he died---Stance of the respondent/company was that the insured was suffering from jaundice about 07 to 08 years prior to getting the policy, which was concealed by the policy-holder---Validity---Onus was on the petitioner to prove her stance---In her cross-examination she admitted that, at the time of admission of her son in the hospital, in the history of patient/deceased, it was mentioned that he suffered from Hepatitis-C, and at the time of childhood he was suffering from Hepatitis-A---Petitioner further admitted that she stated to the respondent/company that her son had Hepatitis since 06/07 years---Petitioner denied that her son concealed his disease from the respondent/company in his health declaration, however, perusal of the (duly exhibited) policy documents revealed that the deceased did not disclose any disease in the said form, which meant that he concealed his health condition at the time of getting the policy---Under S.75 of the Insurance Ordinance, 2000, the contract of insurance is based on utmost good faith, which requires both the parties to disclose all the relevant facts truly to each other regarding the terms and conditions of the insurance policy---Deceased concealed his disease of Hepatitis-A and C at the time of purchasing the policy, which he was bound to disclose, whereas the insured died the next month after purchasing the policy i.e. just after one month---It was active and glaring concealment of facts, therefore, the claim was rightly rejected by the respondent / company---However, in the given circumstances of the case, total rejection of the claim would be too harsh---Respondent / company received one premium from the deceased---Insurance Tribunal, under S. 81 of the Insurance Ordinance, 2000, directed the Respondent / Company to return the received (one) premium of Rs.50,000/- to the petitioner, and dismissed her prayer for payment of total death claim---Insurance application was partly decreed.

Mst. JAMEELA RIAZ vs IGI LIFE INSURANCE through Head of Business and Operation Ss — 2025 CLD 29 INSURANCE-TRIBUNAL-LAHORE

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