THE DISTRICT Consumer Forum (DCF) has directed the Oriental Insurance Company Limited, Meghdoot building, to pay Rs 5 lakh within a month as accident claim to a complainant. Besides, it also warned that if the said amount was not paid within fixed date, then 10 per cent interest would be imposed on the same the amount from June 11, 2003 till the payment day.
Manjeet Kaur’s husband, resident of the Daheli Sujanpur Colony had taken an insurance policy covering accidental risk on November 11, 1998 valid till November 10, 2006 vide policy number CC 0187548.
Manjeet Kaur alleged that the said policy was illegally cancelled by the company and sent a cheque for Rs 895 dated on February 28, 2002.
However, the policy-holder met with an accident causing facture in his backbone on January 28, 2002. He was hospitalised till February 4, 2002.
At a later stage, injuries were followed with haemorrhage and for treatment of the same he was once again admitted to the same hospital on March 5, 2002 and died during the treatment.
Therefore, as nominee of the policy, wife of the deceased and complainant Manjeet Kaur made a claim for the accidental cover from the company. She stated in the claim that her husband had met with an accident on January 28, 2002 and she was nominee in the policy. Thereafter, she claimed for accidental benefit from the said company.
However, the company got surveyed about the cause of death and in reply to Kaur, company sources turned her claim saying that death of the policy-holder had no relation with the accident he suffered. It further stated that the policy-holder was admitted to the hospital for treatment. After discharging from the hospital, he was not taken for checkup again. However, on the day of his death, he suffered from chest pain and was brought to the hospital in morning and died after about four hours on the same day. Therefore, his death had no connection with his injuries caused by accident.
{{/usCountry}}However, the company got surveyed about the cause of death and in reply to Kaur, company sources turned her claim saying that death of the policy-holder had no relation with the accident he suffered. It further stated that the policy-holder was admitted to the hospital for treatment. After discharging from the hospital, he was not taken for checkup again. However, on the day of his death, he suffered from chest pain and was brought to the hospital in morning and died after about four hours on the same day. Therefore, his death had no connection with his injuries caused by accident.
{{/usCountry}}The other reason stated for denial of claim by the company was that the said policy was cancelled on January 8, 2002 and information for the same was sent by the company to the policy-holder about a week earlier.
Whereas, policy-holder met with an accident later on, on January 28, 2002.
However, the three-member committee of the DCF, including chairman AH Ansari, observed that the company had committed serious negligence in service by cancelling the policy without prior consent of the holder. Besides, it commented that the company’s existence was based on public service norms and not for selfish role.
Therefore, officials of the company had not followed the objectives and passed direction that the company should give fast relief by settling claim in favour of the complainant.