Woman Wins Rs 2L Cover for Hubby’s Accidental Death
CHENNAI: A private insurance company has been directed by a consumer forum in the city to pay accident claim to the wife of a man who died in an accident, declining to accept the argument of the firm that the victim’s drunkenness led to the accident.
The District Consumer Disputes Redressal Forum, Chennai (North), presided over by R Mohandoss, directed the Star Health and Allied Insurance to pay the insurance cover of `2 lakh and a compensation of `22,000 to R Pushpa, a resident of Tirutani.
Pushpa’s husband Rajesekaran slipped and fell on the rail tracks near Taramani in April 2011 and died of head injury later in hospital. He had taken the accidental death cover for himself. However, the insurance company had repudiated the claim on June 29, 2011, as Rajasekaran was in an inebriated state when the accident took place.
Citing a condition in the policy that accidents caused due to drunkenness would not be covered, the company had refused to pay the compensation to Pushpa.
In her petition to the forum, she contended that according to the autopsy report, Rajasekaran died due to head injury and was not connected to drunkenness. She said the medical records did not show the alcohol content in the blood.
The insurance firm had argued that scrutiny of medical records show that Rajasekaran was under the influence of alcohol due to which he fell and sustained the injury. As per the terms and condition of the policy, the claim cannot be made for an accident caused by drunkenness.
The Bench said counsel of the insurance firm failed to submit any document to show that Rajasekaran was fully under the influence of alcohol at the time of accident. The forum maintained that denial of the claim amounts to deficiency in services. So, it ordered the company to the insurance cover and `22,000 as compensation for the delay.