Mr. Pawan, aged 40 Years purchased an Insurance Policy for the Sum Assured of ₹1 Crore from XYZ Company Limited. The proposal date was 22.02.2024 and has paid one year premium of ₹30,733/-. In the proposal form, he nomin
CS Professional · Insurance - Law & Practice · PYQS · June 2025
Mr. Pawan, aged 40 Years purchased an Insurance Policy for the Sum Assured of ₹1 Crore from XYZ Company Limited. The proposal date was 22.02.2024 and has paid one year premium of ₹30,733/-. In the proposal form, he nominated his second wife Ms. Aparna and minor son Mr. Abhiroop who was born to his first wife as beneficiaries of 50% share of each for policy benefits. As his son is minor, his second wife Ms. Aparna is considered as legal trustee/guardian for the minor son. His first wife Ms. Karuna passed away on 1-2-2021 with post-partum problems leaving behind a son. Since his first wife passed away in 2021, he has been using anti-depressant medicines to come out from his bereavement and also married Ms. Aparna on 20-12-2023 to take care of his two-year-old son Mr. Abhiroop. The usage of depressant medicines is not mentioned in the proposal form as he thought that was not a material fact. His business also got affected with his mental depression and to raise money for his business continuation he assigned this ₹1 Crore insurance policy to his creditor on 25.06.2024 against the loan of ₹30 lakhs. Within 7 months of the proposal date, he died on 28.08.2024. The cause of death was reported in the discharge form of deceased life assured as sudden cardiac arrest in the sleep due to atherosclerosis (hardening of the arteries). As Ms. Aparna is not biological mother to Abhiroop and father passed away, parents of Ms. Karuna the biological mother of Mr. Abhiroop approached the insurance company for the policy benefits in the name of minor son Mr. Abhiroop under the trustee of biological grandparents. As it is an early claim, the investigation on death of the insured is initiated and the insurance company could not prove that it is a suicide though they come acrossed the rumors of suicide from neighborhood due to his depressive mentality. But on investigation, it is identified that life assured had suppressed or concealed the material fact of using anti-depressant medicines. Research showing that antidepressants might contribute to atherosclerosis by affecting factors like blood pressure, platelet aggregation, inflammation and endothelial function within the blood vessels which may lead to heart failure. Insurer put on hold the claim based on the following issues: Suppression of material facts or breach of the condition of 'utmost good faith' from the life assured. Early claim with a suspicion of suicide. Litigation on Trustee/Guardian for the minor son. Part of Insurance policy benefits is assigned to creditor. As per this case, life assured has assigned his insurance policy to his creditor. What is an Assignment? What are the provisions as per the Insurance Laws (Amendment) Act, 2015 regarding assignment of insurance policies? Can the creditor in this case is eligible for entire death benefit of Mr. Pawan? Explain your answer with the support of Laws of Insurance.
Answer & Explanation:
An assignment is a legal transfer of rights or benefits under an insurance policy from the policyholder to another party, known as the assignee. The provisions regarding assignment are covered under Section 38 of the Insurance Act, 1938 , which states that a policyholder can assign their insurance policy to another party, provided that the assignment is duly registered with the insurer. The provisions regarding assignment of insurance policies are: Notice of assignment to insurer and registration of assignment mandatory. Conditional assignment is recognized i.e., assigned policy can be retransferred to the original policy holder once the conditions are fulfilled. In this case, repayment of loan. KYC of Assignee is mandatory. Partial assignments of insurance policies recognized. In this case, it is assigned the ₹1 Crore policy for ₹30 lakhs only. If Mr. Pawan assigned his life insurance policy to his creditor in accordance with the provisions of Section 38 of the Insurance Act, 1938 , and the assignment was properly documented and registered, then the creditor is eligible to claim the entire death benefit upon Mr. Pawan's death, up to the amount of the debt owed. However, if there were any nominations made or restrictions on the policy, those would need to be taken into account to determine the final distribution of the benefits.
Topics: Life Insurance
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