ISLAMABAD: President Dr Arif Alvi termed the non-payment of a life insurance claim worth Rs 1.7 million by the State Life Insurance Corporation of Pakistan (SLICP) to the claimant on the frivolous ground as maladministration, arbitrary and oppressive.
The president, while rejecting representation against the decision of the Wafaqi Mohtasib, directed SLICP to settle the matter and provide relief to the complainant in accordance with its policy, procedure, rules and regulations within 30 days of the orders.
He observed that point of view of SLICP that the policyholder did not declare that the policyholder was a patient of hypertension before availing the policy as untenable because the patient did not die because of hypertension but from cardiopulmonary arrest.
Moreover, hypertension was a common disease and its patient have the probability to live for decades or longer than people not having such diseases, therefore, concealment of such diseases could not be termed as done fraudulently, the president observed.
While endorsing the point of view of the claimant, the president observed that according to the Death Certificate of Dow Medical College & Civil Hospital Karachi, the deceased had died of cardiopulmonary arrest and not of hypertension at the age of 63.
He further observed that SLICP had all the means available to it to discover the alleged pre-insurance ailment of the deceased through its Authorized Medical Officer but it failed to undertake this simple exercise which is contrary to the relevant provision of the Contract Act. The Act says that a contract is not voidable if the party whose consent was so caused had the means of discovering the truth with ordinary diligence.
As per details, the deceased Oscar Malik obtained a life insurance policy from SLICP on 23.01.2020 for the sum assured of Rs. 1,700,000. He died on 30.04.2020 and his complainant brother Terrence Malik applied for the death insurance claim. The SLICP refused to pay claim on the ground that the deceased policyholder had a pre-insurance ailment and was a patient of Hypertension as per the medical record of the deceased’s employer.
Feeling aggrieved, the complainant approached Wafaqi Mohtasib who passed the order in favour of the complainant. SLICP, then, filed a representation with the president, which was rejected.
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