ICICI Lombard General Insurance Company and Dr Reddy’s Laboratories-o...
Aggrieved by the decision of ICICI Lombard, to deny insurance claim, based on the fact that the back seat passenger was drunk, Mr. Gopinath Tripathi, the claimant, filed a complaint with New Delhi Consumer Disputes Redressal Forum. On investigating the case further, the forum stated that the insurer has not applied its mind and illogically denied the claim and ordered the insurer, ICICI Lombard, to pay the insurance claim of Rs. 2.50 lakhs along with Rs. 75,000 as harassment and proceedings charges.
ICICI Lombard GIC Ltd. is a joint venture between ICICI Bank Limited, India's second largest bank with consolidated total assets of over USD 91 billion at March 31, 2012 and Fairfax Financial Holdings Limited, a Canada based USD 30 billion diversified financial services company engaged in general insurance, reinsurance and investment management. It is the largest private sector general insurance company in India with a Gross Written Premium (GWP) of Rs. 5,358 crore for the year ended March 31, 2012. The company issued over 76 lakh policies and settled over 44 lakh claims and has a claim disposal ratio of 99% as on March 31, 2012.
The Consumer Redressal Forum ordered ICICI Lombard General Insurance Company to pay to one of its policy holder Rs. 3,25,000/- (Rs. 2,50,000 towards insurance claims and Rs. 75,000 towards litigation charges) for denying insurance on grounds that the claimant was under the influence of alcohol. The forum also stated that the company has not applied its mind and without rhyme or reason refused the claim.
The policy holder disclosed the fact that he was not driving the car and was on the back seat. Based on the fact and materials gathered the forum observed that the company intentionally did not pay the claim nor produced any proof of the driver who was driving the car and that denied the claim without any merits.
Based on the above findings the forum ordered that Mr. Gopal Tripathi be adequately compensated.