Mumbai: Consumer panel directs insurance company to pay rejected claim money worth ₹1 lakh with 9% interest per annum

Mumbai: A district consumer commission, in an order, has directed an insurance firm to pay claim money to a family saying it did not follow procedure while rejecting the claim under the Farmers Personal Accident Insurance policy.

The order comes after the case was referred back to it by the state commission. The predecessors of the commission had rejected the claim when filed originally with it. The state commission while referring the case back stated that it insisted upon the production of relevant and necessary documents from the parties before it and then decide the complaint on merits. The commission directs the firm to pay Rs 1 lakh claim money with 9% interest per annum and Rs 15,000 towards mental agony and litigation cost.

The order was passed on a complaint by Ganpat Yenpe against Future General India Insurance Co Ltd, Cabal Insurance Co Ltd and Government of Maharashtra.

Details about the case

Yenpe's mother, Bhagirathi Yenpe, had died in an accident in May 2012. She had insurance cover till August 2012. To help farmer families and avoid crises when the elder or earning member of a family dies, the Maharashtra government brought in a Farmers Personal Accident Insurance policy. The Maharashtra government had paid a premium on behalf of farmers to Future.

After the matter was referred by state to district commission, Future, before the district commission stated that the postmortem (PM) report was not submitted and that the claim was not payable as per the Tripartite Agreement and GR.

During the hearing, the commission stated that it was the duty of the insurance firm to ask for documents instead of rejecting the claim. Calling it deficiency in service, it directed the order to be complied within 45 days.