2/3/2019 Gujarat court junks insurance company's claim that depression caused heart attack - Times of India

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Gujarat court junks insurance company's claim that

depression caused heart attack
TNN | Feb 3, 2019, 07.14 AM IST

AHMEDABAD: Can severe depression lead to heart attack? Can an

insurance company deny claim after an insured person's death due to
heart attack merely because he was suffering from depression?

The Gujarat State Consumer Dispute Redressal Commission has turned

down arguments by the Life Insurance corporation of India (LIC) wherein it
rejected insurance claim saying that the insured person, who died due to
heart attack, was suffering from severe depression. The consumer court
on Thursday ordered LIC to pay Rs 47.90 lakh towards insurance claim in
two different policies.

The court said that there is no co-relation between depression and the
cause of death and hence LIC could not have repudiated claims made by kin of the deceased on the ground that he was
severely depressed.

The case involved a family of one Hetalkumar Patel from Nadiad. He died of heart attack in 2012. Two years before his death,
he had bought nine different policies from LIC.

‘Claim made by LIC not justified’

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2/3/2019 Gujarat court junks insurance company's claim that depression caused heart attack - Times of India

Hetalkumar Patel’s family members claimed insurance money and the LIC repudiated the claims saying that Patel was being
treated for depression and he had not declared his ailment while opting for insurance.

For seven claims, the family members successfully approached the district consumer dispute redressal forum in Nadiad. But for
two policies, which involved amount higher than Rs 20 lakh each, Patel's widow Dr Nilam Patel, two children and his parents
knocked at the commission. LIC also challenged the lower court’s orders.

LIC placed medical literature showing how damaging major depressive disorder could prove. Patel’s advocate argued that
there is no connection between depression and heart attack. He cited various orders passed by the Supreme Court and the
National Consumer Dispute Redressal Commission (NCDRC) to show that insurance companies were directed to pay claims in
case of deaths in which cause of death and the pre-existing ailments had no nexus. The court said, “It is very clear that the
husband of the original complainant was suffering from major depression and he died due to heart attack. Thus, it cannot be
said that there is any nexus between the ailment and the cause of death.”

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