President directs insurance companies to pay Rs 3.46 million to heirs of insurance policyholders

Islamabad,  : President Dr Arif Alvi has directed two private insurance companies to pay the death insurance claims of Rs 3 million and Rs 460,000 to the legal heirs of the deceased policyholders.

The President gave these directions while deciding upon two separate representations filed by Adamjee Life Assurance Company Ltd and EFU Life Assurance Ltd against the decisions of Wafaqi Mohtasib directing them to pay the death insurance claims to the respective claimants.

As per details, Ms Zahid Nasreen’s deceased sister had obtained an insurance policy from Adamjee Life Assurance Company for the sum assured of Rs. 3 million against an annual premium of Rs. 300,000 in 2021. After her sister died in 2022, the company refused to pay the death insurance claim on the pretext that the deceased had hidden her pre-insurance ailment of acute kidney injury and chronic liver disease at the time of obtaining the insurance policy. Similarly, Memoona Naeem’s husband obtained an insurance policy from EFU Life Assurance Ltd for the sum assured of Rs 460,000 against an annual premium of Rs 23,000 in 2015. Her husband died the same year and when she filed the death insurance claim, it was repudiated on the ground that the deceased had not disclosed his pre-insurance ailment of Hypertension at the time of obtaining the policy. Feeling aggrieved, the complainants’ separately filed complaints with the Wafaqi Mohtasib to seek relief. Wafaqi Mohtasib passed the orders in the complainants’ favour and directed the respective insurance companies to honour their claims. Later, the companies filed separate representations with the President against the decisions of the Mohtasib.

The President after perusing the material facts of the case and hearing the parties rejected both the representations. He held that the companies had failed to produce any evidence establishing the pre-insurance ailments. He said that the onus to prove the pre-insurance ailments rested upon the companies and the repudiation of death insurance claims required unimpeachable evidence to prove the ailments and their knowledge on the part of the policyholders. He also referred to Lahore High Court’s decision wherein it had been held that concealment of ailments, such as diabetes and hypertension, could not be termed as done fraudulently as most people having such ailments, by remaining more careful in their lifetime, lived either for decades or longer than people not having such diseases.

Keeping in view the facts, the President upheld the orders of the Mohtasib directing both the companies to pay the death insurance to the heirs of the deceased policyholders.