Commission orders insurer to pay Rs 30 lakh accidental death claim
The Tamil Nadu State Consumer Disputes Redressal Commission upheld a ruling against an insurer that rejected a claim citing alcohol consumption.
A consumer commission has directed an insurance company to pay a Rs 30 lakh accidental death claim to the family of a pensioner. According to the Times of India, the Tamil Nadu State Consumer Disputes Redressal Commission upheld a previous order from the District Consumer Commission, Vellore, after the insurer appealed.
The pensioner died on April 18, 2022, following a motor accident that caused severe head injuries. His wife and two daughters sought the insurance payout associated with his pension account, but the insurer rejected the request on January 9, 2023, citing a policy exclusion regarding alcohol consumption.
The commission found significant gaps in the evidence provided by the insurer. While the insurer cited a hospital death summary and a plasma alcohol level of 106.1 mg/dL, it failed to provide the original laboratory report or clarify how the intoxication claim was established.
The commission also noted inconsistencies in the documents, including a discrepancy where the insurer's record listed the date of death as April 11, 2022, instead of the actual date of April 18, 2022. The ruling stated that such errors affected the reliability of the insurer's evidence.
In addition to the Rs 30 lakh settlement, the insurer must pay 9 per cent annual interest from September 1, 2023, until the date of the District Commission's order. The family was also awarded Rs 50,000 for mental agony and deficiency in service, plus Rs 25,000 for litigation costs.