Old medical history vs current claims: What do Irdai rules say?

My insurer has rejected my claim for acute motor axonal polyneuropathy, citing nondisclosure of resolved 2008 ankylosing spondylitis diagnosis. As it was fully cleared, I didn’t consider it relevant when buying the policy. Can insurers deny the claim on this basis, and what do Irdai rules say?

- Shilpa Arora

A health claim cannot be rejected just because the policyholder had an illness years ago, especially if it was treated, and certified as resolved by the doctor, and no medical connection with present ailments. Irdai rules require insurers to rely on clear linkage and evidence, not assumptions. In your case, ankylosing spondylitis was diagnosed in 2008, treated, and your doctor certified complete recovery. When buying the policy, you did not consider it relevant as it was no longer an issue. Duty of disclosure applies to material facts that are ongoing, or likely to risk at the time of proposal. A remote, resolved condition does not qualify as “material,” especially when supported by a medical certificate.