From Financialexpress · FE News Desk · · 1m 20s
Kolkata Consumer Panel Awards Rs 99.41 Lakh in Insurance Claim
Kolkata consumer panel orders insurer to pay Rs 99.41 lakh after rejecting mother's Rs 1 crore life insurance claim.
In brief
Kolkata consumer panel orders insurer to pay Rs 99.41 lakh after rejecting mother's Rs 1 crore life insurance claim. Kolkata District Consumer Commission ordered insurance company to pay Rs 99.41 lakh for wrongly rejecting a Rs 1 crore death claim after mother's death. Originally reported by Financialexpress.
Claim Rejected
Kolkata District Consumer Commission ordered insurance company to pay rs 99 point four one lakh after wrongly rejecting mother's rs one crore term insurance death claim.
“the commission also ordered the insurer to pay rs 50,000 as compensation and rs 10,000 towards litigation costs”
Initial Rejection
Insurer first rejected claim over allegedly forged income and occupation documents, later citing non-disclosure of pre-existing diseases in death certificate.
“the insurer first alleged forged documents and later shifted to an unproven "pre-existing disease" defence”
Pre-existing Disease Defense
Commission rejected insurer's pre-existing disease defense as it appeared only after legal notice, not in initial repudiation letter.
“the plea of pre-existing disease fares no better. it is significant that this plea was not taken in the repudiation letter at all, and surfaced for the first time only in reply to the legal notice”
No Evidence of Non-disclosure
Insurer provided no evidence that pre-existing diseases predated policy or that deceased suppressed material facts.
“there is no material, and no evidence, to show either that the terminal ailments predated the proposal or that the deceased deliberately suppressed any material fact with knowledge and intent”
Insurer Absent
Insurance company did not appear before commission and filed no written evidence, leading to adverse inference.
“the commission held that, on the material before it, the policy was subsisting and in force on the date of death”
Payment Order
Insurer must pay rs 99 point four one lakh for death claim, rs 50,000 compensation, and rs 10,000 litigation costs.
“the commission directed the insurer to pay rs 99 point four one lakh towards the death claim, rs 50,000 as compensation for harassment and mental agony, and rs 10,000 towards litigation costs”
Jurisdiction Clarified
Kolkata district handles cases where deceased was resident and repudiation letter received there.
“the complaint was maintainable in kolkata because the cause of action arose within its territorial limits: the deceased was a resident of the district and the repudiation letter was received there”
Consumer Helpline
West Bengal consumer helpline: 033-2252-0448; national helpline: 1915 for similar claim rejections.
“for consumers facing similar claim rejections, help is available through state consumer helplines in west bengal: 033-2252-0448 or national consumer helpline at 1915”
The big picture
Kolkata District Consumer Commission ordered insurance company to pay Rs 99.41 lakh for wrongly rejecting a Rs 1 crore death claim after mother's death.
