In a significant ruling, the Kerala High Court has sided with the Life Insurance Corporation of India (LIC), setting aside an earlier judgment that had directed the insurer to pay cancer insurance benefits to a policyholder. The division bench, comprising Justice Anil K. Narendran and Justice Muralee Krishna S., held that the diagnosis of cancer occurred within the mandatory 180-day waiting period stipulated in the policy, thereby making the claim ineligible.
Background
The case traces back to Haripreetha T, a 44-year-old resident of Alappuzha, who had purchased LIC’s Cancer Cover Policy worth ₹10 lakh on March 16, 2021. She fell ill in late August that year and was hospitalised at Life Line Hospital, Adoor, where tests pointed towards endometrial malignancy. Later, on September 9, 2021, she underwent surgery at Lake Shore Hospital in Ernakulam, with a biopsy confirming Carcinoma Endometriosis Grade II on September 28, 2021.
Believing that she was entitled to the insurance benefit, Haripreetha submitted her claim. LIC, however, rejected it on the ground that the disease was first diagnosed on August 25, 2021-just 162 days after the policy’s commencement-thus falling within the 180-day waiting period mentioned in Clause 8(G) of the policy.
Feeling wronged, Haripreetha approached the LIC's Grievance Redressal Office, and subsequently the Insurance Ombudsman, both of whom upheld LIC’s stand. She then filed a writ petition before the Kerala High Court, which a single judge allowed in August 2024, directing LIC to release the insurance amount. LIC appealed.
Court's Observations
During the hearing of the appeal (W.A. No. 1670 of 2024), the division bench closely examined medical records and the timeline of the diagnosis. Justice Muralee Krishna S., who authored the judgment, noted that the ultrasound scan dated August 25, 2021, and subsequent pathology and MRI reports pointed towards a malignancy even before the biopsy confirmation on September 28.
"The final opinion of the pathology report dated 28.09.2021 is merely a confirmation of the diagnosis already made in earlier medical reports," the bench observed. "Hence, the diagnosis of cancer must be treated as made within the waiting period of 180 days."
LIC’s counsel argued that the policy clearly excluded claims arising within the waiting period, regardless of later confirmations. The insurer also contended that the insured had failed to disclose that her mother had a history of breast cancer, which amounted to suppression of material facts.
However, the court rejected this latter contention, agreeing with the single judge's observation that there was no clear evidence about the mother’s age or the time of diagnosis.
"In the absence of concrete proof, it cannot be said that the policyholder suppressed material information," the court clarified.
Still, the bench found merit in LIC’s core argument regarding the waiting period, remarking that
"the learned Single Judge failed to appreciate the material evidence on record in its correct perspective."
Decision
Concluding that the diagnosis fell squarely within the 180-day exclusion clause, the court ruled that Haripreetha was not entitled to the insurance benefits.
The division bench allowed the writ appeal filed by LIC, setting aside the single judge's ruling and dismissing the original writ petition.
With this, the High Court reaffirmed the insurer’s right to enforce the waiting period strictly, underlining that even a medically confirmed suspicion before the 180-day limit can disqualify a claim.
As the courtroom settled into a brief silence after the pronouncement, the message was unmistakable - in matters of insurance, the fine print often decides the fate of the claim.
Case Title: Life Insurance Corporation of India v. Haripreetha T & The Ombudsman
Case Number: Writ Appeal No. 1670 of 2024
Judgment Date: October 6, 2025