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Insurer can’t reject claim by citing existing medical condition, says SC

The top court was hearing an appeal filed by Manmohan Nanda against an order of the National Consumer Disputes Redressal Commission (NCDRC), rejecting his plea seeking a claim for medical expenses incurred in the United States

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This picture has been used for representational purpose

This picture has been used for representational purpose

An insurer cannot reject a claim by citing an existing medical condition that was disclosed by the insured in the proposal form, once the policy has been issued, the Supreme Court has said. A bench of justices D Y Chandrachud and B V Nagarathna also said a proposer is under a duty to disclose to the insurer all material facts within his knowledge.

“Once the policy has been issued after assessing the medical condition of the insured, the insurer cannot repudiate the claim by citing an existing medical condition, which was disclosed by the insured in the proposal form and which condition has led to a particular risk in respect of which the claim has been made by the insured,” the bench said in a recent judgment.

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