Failure To Disclose Material Illness Violation Of Utmost Good Faith: NCDRC

The National Consumer Disputes Redressal Commission, chaired by Dr. Sadhna Shekhar, dismissed an appeal against United India Insurance, ruling that the insurer bears no liability if the insured fails to disclose a material fact relevant to risk assessment. The complainant, Chairman of United Shippers Ltd., held an Overseas Medical CFT policy and underwent pacemaker surgery in the USA, seeking coverage thereafter.

The insurer denied the claim, citing non-disclosure of a 2002 angioplasty as a pre-existing condition linked to a prior CABG surgery. The Commission upheld the insurer's decision, noting the complainant's obligation to disclose relevant medical history, including subsequent treatments, affirming the State Commission's dismissal of the complaint.