Thane Consumer Forum pulls up Insurance Company for rejecting claim on technical grounds
The Thane District Consumer Redressal Forum has pulled up the New India Assurance Company for refusing to accept an insurance claim of a businessman on the grounds that rainwater and not flood water had destroyed his goods.
Citing that the insurance company’s defense to refuse claim on such technical grounds as unjust, the forum has directed the company to pay a compensation of Rs 20,000 and insurance of Rs 8.46 lakh at six per cent interest to Ajay Shivnani of M/s Satyam Distributors. His goods were destroyed in heavy rains in 2009. In his complaint, Shivnani told the forum that he took an insurance of Rs 15 lakh for goods stored in a warehouse between May 26, 2009 and May 25, 2010. Shivnani said despite his attempts to shift the goods to dry area, heavy rains on October 4 and 5, 2009 destroyed a huge chunk of goods estimated to be worth Rs 11.74 lakh.
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National Commission orders National Insurance to pay Rs 2.35 lakh for vehicle (matador) damage
DNA: In an eight-year-old case, the National Comsumer Forum, while allowing additional payment as per surveyor report, said, the complainant did not claim total loss and hence the insurer cannot be forced to pay full compensation
The National Consumer Disputes Redressal Commission (NCDRC) has asked National Insurance Co Ltd to pay Rs1.85 lakh with an additional amount of Rs50,000 to a vehicle owner whose vehicle was damaged in a accident about nine years ago.
The brief facts of the case are that complainant/ petitioner, owner of matador MH 19S 1758 was insured by opposite party/respondent for a period of one year from 28.01.2005 to 27.01.2006. On 26.06.2005, matador met with an accident and turned down besides roads and smashed. Report was lodged with the police and intimation was given to the opposite party. Opposite party appointed surveyor, who inspected vehicle at the spot and assessed loss. Complainant submitted estimate given by Ujjwal Auto Pvt. Ltd. for Rs. 5,61,098/- and submitted claim to the opposite party. The opposite party did not settle claim. Alleging deficiency on the part of the opposite party, complainant filed complaint before the District Forum. The opposite party resisted complaint and submitted that complainant did not submit necessary documents for assessing loss, so claim was not settled and prayed for dismissal of complaint as premature.
The District Forum, after hearing both the parties, allowed the complaint and directed the opposite party to pay Rs. 4,50,000/- with interest and further allowed Rs. 2,000/- for mental agony. The opposite party filed appeal and the State Commission, vide impugned order, allowed appeal partly and reduced compensation from Rs. 4,50,000/- to Rs. 1,84,575/-, against which this revision petition has been filed.
Order: It would be appropriate to allow Rs. 50,000/- in addition to amount awarded by the State Commission, which will meet expenses to be incurred on repairs and replacement of parts, which have not been dismantled and surveyor have kept them open for assessment. In the light of above discussions, revision petition is partly allowed and order dated 27.09.2011, passed by the State Commission in appeal no. 2599/2006, National Insurance Company Limited vs. Ismail Khan Amir Khan is partly modified and respondent is directed to pay Rs. 50,000/- in addition to amount of Rs. 1,84,575/-, awarded by the State Commission, as per surveyor report, with no order as to costs.
Complete Judgment can be downloaded here
ICICI Lombard asked by a Mumbai South Forum to pay Rs 3 Lakh for repudiation of claim on wrong grounds of a Globetrotter Overseas Individual Student Travel Insurance Policy
The facts of this case as stated by the Complainants are that the Complainant, Mr Mayank A. Tody, was having insurance policy known as Globetrotter Overseas Individual Student Travel Insurance Policy obtained from the Opposite Party, which covered various risks at abroad while the Complainant travelled abroad for pursuing his studies. While in the college abroad, the Complainant (who was a student), suddenly took ill and had to be admitted in North West London Hospitals, where he was treated as impatient from 27/01/05 to 03/02/05. After discharge, post hospitalization treatment was continued. After discharge, he was medically advised not to go to college but to return to India for recuperation.
ICICI Lombard, the opposite party admitted the policy and information as to hospitalization of the Complainant and also father’s visit from Hong Kong to London and return to India. However, the Opposite Party has stated that it rejected the claims as the Complainant violated the terms and conditions of the policy. The Opposite Party has specifically stated that the Complainant was liable to get the claim had he been hospitalized for a period of more than two months consecutively.
Order: In the present case it is not stated by the Opposite Party as to when the treatment of the insured was completed. The clause does not stipulate the one month period after discharge from the hospital but completion of the treatment. It is on record that the insured was suffering from fatigue ad general unwellness. Therefore, after repatriation to home country (India) he must be under treatment after recovery from serious illness like typhoid and diarrhoea and blood clotting. The Opposite Party has failed to state the duration of Complainant’s treatment post hospitalization. Therefore, as it has not mentioned this ground in its repudiation letter and it does not know exact date when insured completed his treatment, the Opposite Party does not expect the sick person to submit the claim immediately or within one month of his hospitalization. Therefore, the objection raised by the Opposite Party in the written statement does not hold wafer.
Therefore, in view of the above observation/the Opposite Party has rejected the claim of the Complainant No.2 under benefit 8, on wrong ground ad there is a deficiency on its (Opposite Party’s) part. The Complainant No.2 is entitled for the compensation under benefit 8 of the policy i.e. studies interruption, the amount being GBP3500@ Rs.82 per GBP. This amount comes to Rs.2,87,000/-. The Complainant No.2 is also entitled for interest @ 9% on this amount since 14/12/05 i.e. the date of repudiating the claim of Complainant No.2. The Complainant is also entitled for the compensation of Rs.10,000/- for mental agony, harassment ad inconvenience caused to him because of the deficiency in service on the part of Opposite Party as it rejected the claim of the Complainant No.2 under benefit 8 of the policy obtained from the Opposite Party. The Complainant is also entitled for Rs.5,000/- as a cost of this complaint. Hence, we pass the following order –
O R D E R
1. Complaint No.259/2008 is partly allowed.
2. The Opposite Party is directed to pay Rs.2,87,000/- (Rs. Two Lacs Eighty Seven Thousand Only) to the Complainant No.2 for interruption in studies alongwith interest @ 9% p.a. from 14/12/2005 till its payment.
3. The Opposite Party is also directed to pay Rs.10,000/- (Rs. Ten Thousand Only) to the Complainant No.2 as compensation for mental agony, harassment and
inconvenience caused to the Complainant due to the deficiency in service on the part of Opposite Party.
4. The Opposite Party is also directed to pay to the Complainant No.2 Rs.5,000/-(Rs. Five Thousand Only) towards the cost of this complaint.
5. Opposite Party is directed to comply with the above said order within 30 days of the receipt of this order.
6. Certified copies of this order be furnished to the parties.
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Insurance firm to pay a Zirakpur Resident Rs. 1 lakh for failing to cancel the Policy
Disposing of the complaint filed by ML Sharma, a resident of Dhakauli, Zirakpur, the consumer forum, on April 9, also directed Sriram Life Insurance Company Limited, to refund 4 lakh with 9 % interest from the date of deposit till realisation along with a direction to cancel the disputed insurance policies.
Sharma had purchased two policies from Sriram Life Insurance Company Limited in the name of his grandson in September 2012 after paying
2 lakh. He was assured that a representative would visit his grandson to get his signatures on the form. Sharma alleged that the cheques were enchased by the insurance company but no one turned up to get the signatures, after which he decided to cancel the policies.
However, Sharma was told that he could only cancel the policies within free look period of 15 days from the date of receipt of policy documents, which were already delivered to him.
As none appeared on behalf of Sriram Life Insurance Company Limited, they were proceeded exparte. “The insurance company is liable for deficiency in service as the insurance policies were never delivered to the complainant. The insurance company has also not cancelled the policies despite request and refund of the money,” held the consumer forum presided over by Madhu P Singh.
more @ http://www.hindustantimes.com/punjab/chandigarh/insurance-firm-to-pay-rs-1-lakh-for-not-providing-services/article1-1208645.aspx
Insurance firm pays for violating policy terms
Several consumers have voiced grievances about LIC not paying benefits in accordance with the terms of its Bal Vidya policy. Here is a case of a consumer who fought for his rights.
Background: A child’s education is a responsibility and a duty for every conscientious parent. The cost of education is high, and parents have to budget for this expense. The Life Insurance Corporation (LIC) has a Bal Vidya policy whose objective is to help parents meet the increasing costs of education.
Case Study @ http://timesofindia.indiatimes.com/city/mumbai/Insurance-firm-pays-for-violating-policy-terms/articleshow/34022175.cms
Aviva Life Insurance Company to pay Rs 2 lakh for issuing wrong policy, Mumbai district forum
A consumer forum recently held an insurance firm guilty of deficiency of service for issuing the wrong life insurance policy, and not cancelling it upon the policy holder’s request. The district forum directed Aviva Life Insurance Company (I) to refund Rs 1.50 lakh and Rs 45,000 in compensation to a Bhandup resident, Cini Panicker.
Panicker said that in 2012 the insurance firm’s sales manager showed her a policy insisting it carried a one-time premium payment. Panicker wrote a cheque of Rs 1.50 lakh for it. She alleged the email copy of the policy received on March 1, 2012 showed multiple premiums.
The manager told her to wait for the hard copy which Panicker got on March 20, 2012. But it showed the same details. Panicker alleged that the manager did not forward this to the firm, who rejected her refund request on grounds that her 15-day free-look period had lapsed. Panicker then filed a complaint with the Additional Mumbai Suburban District Consumer Disputes Redressal Forum on March 4 last year.
The forum said the manager had deliberately delayed returning the policy to the firm. “Due to delay on part of the opponent (the insurance company), the complainant was not allowed to send her documents for cancellation within the stipulated period,” the forum said.
more @ http://timesofindia.indiatimes.com/city/mumbai/Pay-Rs-2-lakh-for-issuing-wrong-policy-district-forum-tells-insurance-company/articleshow/33712750.cms