Insurance firm pulled up for denying accident relief
16 Jun, 2014 12:12 PM
Rapping a private insurance company for not paying insurance amount to a woman whose husband died after an accident, the District Consumer Disputes Redressal Forum, Chennai (North) has directed it to pay 2 lakh as insurance and 22,000 as compensation for negligence and deficiency in service.

In her submissions, R Pushpa of Tirutani said her husband Rajasekaran, a store watchman at Railway Employees Co-operative Credit Society Limited, had subscribed to an accident care insurance scheme from Star Health and Allied Insurance which was valid from April 1, 2010 to March 31, 2011. On May 27, 2010, Rajesekaran slipped while crossing a railway track and sustained grievous head injuries. He was admitted to the railway hospital and died during treatment on June 6, 2010.

However, when Pushpa claimed Rs 3 lakh as the insurance amount, Star Health rejected the claim saying Rajasekaran was under the influence of alcohol at the time of the accident. As such, the claim was invalid, it said. Pushpa then moved the forum seeking a direction for grant of the insurance amount along with compensation for deficiency in services.

She said the postmortem report did not find alcohol in the body and clearly stated Rajasekaran's death was because of injury. Countering her claim, the insurance company denied deficiency in services and said it had examined the medical reports which said Rajasekaran was inebriated at the time of the accident. This was in contravention to the terms and condition of the policy and Pushpa was not entitled for the claim, said Star Health.

The bench of president R Mohandoss and member T Kalaiyarasi said despite its claims, the insurance firm had not produced any document or medical report to prove Rajasekaran had consumed alcohol at the time of the accident. However, negligence and deficiency in services on the pat of the insurance company was established, it said.

It then slapped the branch manager of Star Health and Allied Insurance Co Ltd with the fine for deficiency in services and asked the company to pay the insurance cover with an interest of 9% per annum from April 2011 in six weeks.
Source : The Times Of India

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