ISLAMABAD: President Dr. Arif Alvi has directed an insurance firm to reimburse the widow of a deceased policyholder who was refused payment because her husband did not knowingly reveal his genuine health status to the business when getting the policy.
The President made this decision while accepting a representation filed by Mst Shehnaz Akhtar (the complainant) against the order of the Federal Insurance Ombudsman (FIO) in which the case was closed and disposed of on the grounds that the widow had already been refunded the premiums amounting to PKR 150,000 deducted from her late husband’s account and that, because the matter had been settled on compassionate grounds, the company was not liable to pay the death insurance. Dissatisfied with FIO’s judgment, the complaint filed a representation with the President, which he accepted.
The President noted in his ruling that the company rejected the claim based on the death certificate, claiming that it said that the dead had been suffering from Chronic Liver Disease and Diabetes Mellitus for a year before death, although no such period was listed in the certificate. He further pointed out that the insurance firm was relying on an admission chart given by a hospital in Lahore for the year 2017; although the policy was issued in 2015, therefore it did not apply to the insurance period. He also referred to a 2009 Lahore High Court decision, which stated that the majority of people with ailments such as hypertension, diabetes, and mellitus lived for decades or longer than people without such diseases by being more careful in their lifetime and that concealing such diseases could not be considered fraudulent.
The insurance company is not justified
The President ruled that the insurance company was unjustly rejecting the insurance claim on such thin grounds. He stated that because the insurance company’s maladministration had been revealed, the FIO’s directives were being overturned. The President further instructed the corporation to pay the complainant’s insurance claim within 30 days of receiving the President’s order.
