Forum penalises insurance firm

In a rare case, three consumers – a mother and her two sons – combined the power of Right to Information Act and the consumer forum, a judicial platform to redress grievances, to their advantage.

Using the information secured under the RTI Act, they lodged a case with the Dakshina Kannada District Consumer Disputes Redressal Forum and got an order directing an insurance firm to pay Rs. 5 lakh. The forum has also asked it to pay them interest at the rate of 10 per cent per annum for two years on the amount besides litigation cost of Rs. 2,000.

The complaint was filed by K.P. Kamalavathi, her sons K.P. Shivanarayana Bhat and K.P. Mahesh Bhat of Bandaru village in Belthangady taluk against the manager of the Puttur-based United India Insurance Co. Ltd.

Ms. Kamalavathi stated that her husband Laxminarayana Bhat suddenly collapsed and died of head injury in July, 2010. He had taken a home loan of Rs. 5 alkh in 2007 from Canara Bank which was insured by the insurance company. He was also covered under the “Unit Home Care Policy” for fire and personal accident for a sum of Rs. 5 lakh each. But the insurance company kept the fact under the wraps and no copy of the policy was issued to the complainants, who filed an RTI application. When claimed the insured amount, the insurance company contended that the death was not accidental and repudiated it.

The forum held that head injury was due to his sudden fall and that his death was accidental and the company is liable to pay the insured sum to his legal heirs. It said repudiation of the claim was “not justifiable which amounts to deficiency in service”.

The forum relied on an earlier judgment by the National Consumer Commission which declared death due to cold wave is not natural and that it was accidental. It also relied on the definition of an accident: “an unintended and unforeseen injurious occurrence; something that does not occur in the usual course of events or that could not be reasonable anticipated.”

http://www.thehindu.com/news/cities/Mangalore/article3888330.ece