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HindustanTimes Wed,22 Oct 2014

Insurance firm to pay Rs. 20,000 for rejecting claim on invalid grounds

Shailee Dogra , Hindustan Times   Chandigarh, October 27, 2013
First Published: 00:54 IST(27/10/2013) | Last Updated: 00:55 IST(27/10/2013)

The district consumer disputes redressal forum, SAS Nagar, has directed an insurance firm to pay a compensation of Rs. 20,000 to the complainant for rejecting an accident claim on invalid grounds.

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Harjinder Kaur of Fatehgarh Sahib had moved the consumer forum, accusing New India Assurance Company Limited insurance company of rejecting a claim, following the death of her husband Gurmit Singh, on flimsy grounds.

According to Kaur, the firm had rejected her claim stating that her husband was not wearing helmet and was under the influence of liquor at the time of the accident.

“However, there was no occasion for Singh to wear helmet as he was a Sikh, and he never consumed alcohol,” she contended.

Kaur submitted that Singh had met with an accident near Todar Majra village in Kharar on November 2, 2011. An injured Singh was rushed to a Kharar hospital from where he was referred to PGIMER, Chandigarh, where he succumbed to his injuries on November 17, 2011.

“Singh was under treatment at PGIMER and during this time no alcohol was found in his blood and urine,” said Kaur, accusing the insurance company of unfair trade practice and deficiency in service.

However, New India Assurance Company Limited, justified repudiation of the claim, stating that as per the surveyor's report, at the time of occurrence of accident, Singh was not wearing a helmet and was under the influence of liquor.

In its order, consumer forum through its president Madhu P Singh said, “Nowhere in the FIR has it been mentioned that the deceased was without helmet or under the influence of alcohol. Therefore, it cannot be inferred that he sustained injuries on account of driving the motorcycle after taking alcohol and without wearing the helmet.”

The forum said, “Without first-hand record of the deceased having driven the motorcycle without helmet and after taking alcohol, the company's claim cannot be treated as valid grounds for repudiation of the genuine and valid claim of the complainant. Thus insurance company is directed to pay Rs. 1 lakh - the insurance amount of the policy with 9% interest from May 2013 - till realisation.”

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