Husband dies, insurer rejects claim over ‘diabetes’. Woman now wins Rs 58 lakh

Sapna, 34, worked as a chartered accountant. Her husband, Deepesh, ran a mobile shop in Haryana’s Bahadurgarh. They had two daughters, their own flat in the city, and a housing loan they were steadily repaying. Then, in October 2024, Deepesh suffered a cardiac arrest.

Within days, after being taken to three hospitals, he died. Sapna was left with two daughters to support and a housing loan that still had to be paid. “Everything was going fine… then it all fell apart,” she said. The insurance policy she and Deepesh had taken with the loan was supposed to cover the outstanding liability if he died.

Instead, when Sapna filed a death claim, the insurer rejected it. The rejection set off a chain of financial troubles that continued for months. Sapna struggled to keep up with the EMIs while paying for her daughters’ school, rent, food and other household expenses.

She eventually sold the family home and moved with her daughters into a small rented apartment in Bahadurgarh. It was only after that that she decided to challenge the insurer before the consumer commission — and won. On September 9, the South Delhi District Consumer Disputes Redressal Commission ruled in her favour, directing PNB MetLife to pay her over Rs 58 lakh.

Sapna and Deepesh had taken a Rs 52 lakh housing loan from PNB Housing Finance’s Green Park branch in 2023, for a repayment period of 180 months. They mortgaged their home against the loan. As part of the package, they also bought two loan-cover insurance policies, paying a combined premium of Rs 2.6 lakh.

The premium was added to the loan, taking the total amount borrowed to Rs 54.6 lakh. One of the policies was the PNB MetLife Complete Loan Protection Plan, for which they paid a Rs 2 lakh premium. The second was a TATA AIG Group EMI Protect policy, for which they paid Rs 60,000.

When Deepesh died on October 28, 2024, Sapna filed a death claim under the PNB MetLife policy. In March 2025, the firm rejected it. As part of its assessment of the death claim, PNB MetLife relied on an investigator’s report.

Such an investigation can involve gathering information about the policyholder’s medical history and circumstances surrounding the death. In this case, the investigator relied, among other things, on oral accounts from neighbours and a HbA1c test.

The insurer used these to allege that Deepesh had diabetes that had not been disclosed when the policy was taken. “They only told me that the claim was rejected because of diabetes,” Sapna said. After rejecting the claim, the company refunded the Rs 2 lakh premium paid for one policy to Sapna on March 13, 2025.

With the claim denied, things unravelled quickly. “It became so difficult for me… life is tough for a single woman,” she said. “Things had reached a point where the bank was about to take physical possession of our home.

We weren’t able to pay the EMIs for months. We survived on our savings, and even affording basic meals was a struggle.”