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Insurance Company penalized by consumer forum for wrongful rejection of claim

Consumer’s dispute redressal forum of Panchkula district passed against the New India Insurance Company Limited directing insurance company to pay the claim of

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2 mins 44 secs
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Last Updated - May 16, 2023
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Consumer’s dispute redressal forum of Panchkula district passed against the New India Insurance Company Limited directing insurance company to pay the claim of Rs. 500,000 along with an interest of 9% and slapped Axis bank with a fine of Rs. 10,000 to the beneficiary of the deceased.

The fact of the claim is that Mr. Manoj Kumar Dhiman, a native of Abdullapur in Pinjore, had opened a bank account with Axis bank on October 7, 2011. Along with the opening of the bank account, he took a personal accident cover of Rs. 5 lakh., which was valid till April 2011. 42 days later, he met with a road accident and died on the spot. 

When his wife and father lodged a claim with the Axis bank, they were asked to open a separate bank account so that claim money could be deposited in that bank account. However bank later refused to acknowledge the claim citing reason that the deceased had not used the debit card within 90 days as one of the condition and secondly he did not maintain the average quarterly balance of Rs. 15,000. 

Aggrieved by the decision of the Axis bank, they approached the consumer forum. On hearing both the parties, the forum concluded that since the deceased Mr. Manoj died within 42 days, both of the above conditions will not be valid to repudiate the claim. The forum passed an order in favour of the legal heirs of the deceased.

However, insurance company rejected the claim stating that the claim has been lodge very late after the incident. On this the parents of Mr. Manoj said that they had already informed the bank about the incident as on 16th December 2011.
On this the consumer’s forum said that there was no proof that the reason of delay has been specifically ascertained or recorded by the company and hence the bank as well as the insurance company is liable for deficient in services.

The forum passed an order that the claimants been paid the insured amount of Rs. 5 lakhs along with an interest of 9% and a penalty of Rs. 10,000.

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